BILL ANALYSIS


                                                    C.S.S.B. 1229
                                                    By: Zaffirini
                                        Health and Human Services
                                                           4-5-95
                                   Committee Report (Substituted)
BACKGROUND

Federal law grants the Texas Department of Health, as the agency
administering the federal Title V (Maternal and Child Health block
grant), broader authority and responsibility than does state law. 
Under Title V, the department is responsible for needs assessment,
fund distribution, quality assurance, coordination of services,
infrastructure development, and other activities as they relate to
preventive and primary care services for pregnant women, infants,
children, and adolescents.

PURPOSE

As proposed, C.S.S.B. 1229 authorizes the Texas Board of Health to
implement voluntary perinatal health care systems within the state.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the Texas Board of Health under SECTION 7 (Sections 32.042 and
32.045, Health and Safety Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Sections 32.001-32.021, Health and Safety Code,
by designating them as Subchapter A, as follows:

          SUBCHAPTER A.  PROGRAM FOR WOMEN AND CHILDREN

SECTION 2. Amends Section 32.002(a), Health and Safety Code, to
redefine "facility," "infant care," "maternal and infant health
improvement services," "medical assistance program," and "perinatal
care."  Defines "postpartum care" and "preconceptional care."

SECTION 3. Amends Section 32.003(f), Health and Safety Code, to
make a nonsubstantive change.

SECTION 4. Amends Section 32.011, Health and Safety Code, to make
conforming and nonsubstantive changes.

SECTION 5. Amends Section 32.012(c), Health and Safety Code, to
require an individual requesting or receiving services, when a
determination of eligibility to receive maternal and infant health
improvement services is made or the services are received, to
inform the Texas Department of Health (department) of certain
benefits.

SECTION 6. Amends Section 32.015(c), Health and Safety Code, to
delete the provision exempting the department from the requirement
to provide maternal and infant health improvement services unless
funds are appropriated to the Texas Department of Human Services to
administer this chapter.

SECTION 7. Amends Chapter 32, Health and Safety Code, by adding
Subchapter B, as follows:

           SUBCHAPTER B.  PERINATAL HEALTH CARE SYSTEM

     Sec. 32.041.  LEGISLATIVE FINDINGS.  Sets forth the findings
     of the legislature concerning perinatal health care.
     
     Sec. 32.042.  DUTIES OF BOARD; RULES.  (a) Requires the Texas
     Board of Health (board), by rule, to adopt standards and
     objectives to implement voluntary perinatal health care
     systems, and policies for health promotion and education, risk
     assessment, access to care, and perinatal system structure.
     
     (b) Requires the rules to reflect all geographic areas of
       the state, provide specific requirements for appropriate
       care of perinatal patients, and to facilitate coordination
       among all perinatal service providers and health care
       facilities in the delivery area.
       
       (c) Requires the rules to include certain items.
       
       Sec. 32.043.  DUTIES OF DEPARTMENT.  Requires the department
     to develop and monitor a statewide network of voluntary
     perinatal health care systems, develop and maintain a
     perinatal reporting and analysis system to monitor and
     evaluate perinatal patient care in the state's perinatal
     health care systems, and provide for coordination and
     cooperation in this state and in conjunction with adjoining
     states.
     
     Sec. 32.044.  SYSTEM REQUIREMENTS.  (a) Requires each
     voluntary perinatal health care system to have certain
     information.
     
     (b) Provides that this subchapter does not prohibit a health
       care facility from providing services as authorized by the
       department.
       
       Sec. 32.045.  GRANT PROGRAM.  (a) Authorizes the department to
     establish a program to award grants to initiate, expand,
     maintain, and improve voluntary perinatal health care systems.
     
     (b) Requires the board, by rule, to establish eligibility
       criteria for awarding the grants.  Require the rules to make
       certain considerations.
       
       (c) Authorizes the department to approve grants according to
       the rules adopted by the board.  Provides that a grant
       awarded under this section is governed by Chapter 783,
       Government Code, and rules adopted under that chapter.
       
       SECTION 8.   Repealer: Sections 32.004, 32.007-010, 32.019, 32.020,
Health and Safety Code (Program Services - Provision of Program
Services by Department - Service Providers - Individual Referral
and Application for Services - Eligibility for Services -
Memorandum of Understanding - Maternal and Child Health Advisory
Committee).

SECTION 9. Effective date: September 1, 1995.

SECTION 10.    Emergency clause.