By Cuellar H.B. No. 2088
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of certain midwives; providing
1-3 administrative penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Sections 1(c)(1), (2), (11), (12), and (13),
1-6 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes),
1-7 are amended to read as follows:
1-8 (1) "Midwife" means a person who practices midwifery
1-9 and has met the requirements for documentation as established by
1-10 this Act and the rules of the [standards of the] midwifery board.
1-11 (2) "Midwifery" means the practice by a midwife of:
1-12 (A) providing [giving] the necessary
1-13 supervision, care, and advice to a woman during normal pregnancy,
1-14 labor, and the postpartum period;
1-15 (B) conducting a normal delivery of a child; and
1-16 (C) providing normal newborn care.
1-17 (11) "Normal [childbirth]" means, as applied in this
1-18 Act to pregnancy, [means the] labor, [and] delivery, the postpartum
1-19 period, and the newborn period, the determination by a midwife that
1-20 a client during those periods is at a low risk of developing [at or
1-21 close to term, of a pregnant woman whose assessment reveals no
1-22 abnormality or signs or symptoms of] complications, as defined in
1-23 rules adopted by the midwifery board.
1-24 (12) "Newborn [care]" means an infant from birth
2-1 through [the care of a child for] the first six weeks of [the
2-2 child's] life.
2-3 (13) "Postpartum period [care]" means [the care of a
2-4 woman for] the first six weeks after a [the] woman has given birth.
2-5 SECTION 2. Section 3D(c), Texas Midwifery Act (Article
2-6 4512i, Vernon's Texas Civil Statutes), is amended to read as
2-7 follows:
2-8 (c) If the program coordinator has knowledge that a
2-9 potential ground for removal exists, the program coordinator shall
2-10 notify the chairman of the midwifery board of the ground. The
2-11 program coordinator and chairman of the midwifery board [of health]
2-12 shall then notify the board [governor] that a potential ground for
2-13 removal exists.
2-14 SECTION 3. Section 8, Texas Midwifery Act (Article 4512i,
2-15 Vernon's Texas Civil Statutes), is amended to read as follows:
2-16 Sec. 8. DUTIES AND POWERS OF THE MIDWIFERY BOARD. Subject
2-17 to the approval of the Texas Board of Health, the midwifery board
2-18 shall:
2-19 (1) establish requirements for basic [approved]
2-20 midwifery education and midwifery continuing education [courses];
2-21 (2) [establish qualifications for the instructors of
2-22 those courses;]
2-23 [(3)] issue midwifery basic information manuals;
2-24 (3) [(4)] establish eligibility requirements for
2-25 taking a comprehensive midwifery [the final] examination before
2-26 initial documentation [of a basic midwifery education course]; and
2-27 (4) approve a comprehensive midwifery examination that
3-1 must be passed before initial documentation
3-2 [(5) issue final examinations for basic midwifery
3-3 education courses].
3-4 SECTION 4. Section 8A, Texas Midwifery Act (Article 4512i,
3-5 Vernon's Texas Civil Statutes), is amended by amending Subsections
3-6 (b) and (c) and by adding Subsection (e) to read as follows:
3-7 (b) Subject to the approval of the Texas Board of Health,
3-8 the midwifery board shall:
3-9 (1) adopt substantive and procedural rules as
3-10 necessary for the documentation [identification] of midwives;
3-11 (2) adopt rules prescribing minimum standards for the
3-12 approval and revocation of approval of basic midwifery education
3-13 courses and midwifery continuing education courses;
3-14 (3) adopt rules prescribing the standards for the
3-15 practice of midwifery in this state, including standards required
3-16 for the delineation of findings that preclude a woman or newborn
3-17 from being classified as having a normal pregnancy, labor,
3-18 delivery, postpartum period, or newborn period;
3-19 (4) adopt rules prescribing minimum standards for the
3-20 approval and revocation of approval of instructors or facilities
3-21 used in basic midwifery education courses and midwifery continuing
3-22 education courses;
3-23 (5) [(4)] adopt rules prescribing the type of courses
3-24 and number of hours required to meet the mandatory basic midwifery
3-25 education course and midwifery continuing education course
3-26 requirements;
3-27 (6) [(5)] adopt rules prescribing a procedure for
4-1 reporting and processing complaints relating to the practice of
4-2 midwifery in this state;
4-3 (7) adopt and implement substantive and procedural
4-4 rules as necessary to discipline midwives determined to be in
4-5 violation of this Act or otherwise a threat to the public health
4-6 and safety;
4-7 (8) adopt rules as necessary to establish eligibility
4-8 for reciprocity for initial documentation under this Act;
4-9 (9) [(6)] prepare and publish reports on the practice
4-10 of midwifery in this state including statistical reporting of
4-11 infant fetal morbidity and mortality; and
4-12 (10) [(7)] adopt any additional rules necessary to
4-13 implement any duty imposed on the board or the department under
4-14 this Act.
4-15 (c) The department, with the recommendation [advice] of the
4-16 midwifery board, shall:
4-17 (1) implement the rules governing basic midwifery
4-18 education courses and midwifery continuing education courses;
4-19 (2) implement the rules governing the approval of
4-20 instructors or facilities used for offering basic midwifery
4-21 education courses and midwifery continuing education courses;
4-22 (3) prepare and distribute basic midwifery information
4-23 and instructor manuals; and
4-24 (4) enter into contracts and agreements necessary to
4-25 carry out this Act.
4-26 (e) The rules adopted under Subsection (b)(7) of this
4-27 section must include rules relating to:
5-1 (1) warnings provided to midwives for violations of
5-2 this Act or rules adopted under this Act;
5-3 (2) agreed orders for additional education by
5-4 midwives;
5-5 (3) recommendations or requirements for medical or
5-6 psychological treatment, including treatment related to substance
5-7 abuse by midwives; and
5-8 (4) restrictions on the practice of a midwife,
5-9 including practice limitation and the suspension, revocation, and
5-10 placement on probation of documentation.
5-11 SECTION 5. Section 9(a), Texas Midwifery Act (Article 4512i,
5-12 Vernon's Texas Civil Statutes), is amended to read as follows:
5-13 (a) The midwifery board shall approve basic information
5-14 manuals and instructor manuals for the practice of midwifery, which
5-15 may be used in basic midwifery education courses. The department
5-16 shall provide the manuals to each documented midwife and to any
5-17 other person on request. An approved basic information manual must
5-18 include information about:
5-19 (1) the knowledge necessary to practice as a midwife;
5-20 (2) the basic education and continuing education
5-21 requirements for a midwife;
5-22 (3) the legal requirements and procedures pertaining
5-23 to midwifery;
5-24 (4) the standards of practice for a midwife; and
5-25 (5) other information or procedures required by the
5-26 midwifery board or the board.
5-27 SECTION 6. Section 10(b), Texas Midwifery Act (Article
6-1 4512i, Vernon's Texas Civil Statutes), is amended to read as
6-2 follows:
6-3 (b) At the time of initial documentation, the person shall
6-4 provide the program coordinator with documentary evidence that the
6-5 person has met all of the requirements for [the] mandatory basic
6-6 midwifery education [course] as prescribed by rules approved by the
6-7 board and has passed the comprehensive midwifery examination
6-8 approved by the midwifery board. [The person may also provide the
6-9 program coordinator with a letter of documentation issued under
6-10 Section 12 of this Act as evidence that the midwife has passed the
6-11 voluntary examination of the course.]
6-12 SECTION 7. Section 11, Texas Midwifery Act (Article 4512i,
6-13 Vernon's Texas Civil Statutes), is amended to read as follows:
6-14 Sec. 11. EXAMINATION. (a) The midwifery board, with the
6-15 approval of the board, shall adopt a comprehensive midwifery
6-16 examination for persons regulated under this Act.
6-17 (b) [(e)] The midwifery board shall have the written portion
6-18 of the examination, if any, validated by an independent testing
6-19 professional.
6-20 SECTION 8. Section 12, Texas Midwifery Act (Article 4512i,
6-21 Vernon's Texas Civil Statutes), is amended to read as follows:
6-22 Sec. 12. DOCUMENTATION LETTER. The department shall provide
6-23 a letter of documentation to a person who fulfills the
6-24 [educational] requirements for documentation.
6-25 SECTION 9. Section 15, Texas Midwifery Act (Article 4512i,
6-26 Vernon's Texas Civil Statutes), is amended to read as follows:
6-27 Sec. 15. ROSTER. (a) The department shall maintain a
7-1 roster of all persons documented as midwives in this state
7-2 [identified to practice midwifery].
7-3 (b) The roster shall contain for each person the information
7-4 required on the documentation [identification] form of this Act and
7-5 other information that the department determines necessary to
7-6 identify with accuracy each midwife who is documented [identified]
7-7 under this Act. This information shall be [a] public information
7-8 [record] as defined in Chapter 552, Government Code [424, Acts of
7-9 the 63rd Legislature, Regular Session, 1973 (Article 6252-17a,
7-10 Vernon's Texas Civil Statutes)].
7-11 SECTION 10. Section 16(f), Texas Midwifery Act (Article
7-12 4512i, Vernon's Texas Civil Statutes), is amended to read as
7-13 follows:
7-14 (f) A midwife shall encourage a client to seek medical care
7-15 through consultation or referral, as specified by rules adopted by
7-16 the midwifery board, if the midwife determines that the pregnancy,
7-17 labor, delivery, postpartum period, or newborn period of a woman or
7-18 newborn may not be classified as "normal" for purposes of this Act
7-19 [recognizes a sign or symptom of a complication to the client's
7-20 childbirth].
7-21 SECTION 11. The Texas Midwifery Act (Article 4512i, Vernon's
7-22 Texas Civil Statutes) is amended by adding Section 16A to read as
7-23 follows:
7-24 Sec. 16A. PREVENTION OF OPHTHALMIA NEONATORUM. Unless the
7-25 newborn is immediately transferred to a hospital because of an
7-26 emergency, a midwife who attends the birth of a child shall
7-27 administer to that child prophylaxis approved by the board for the
8-1 prevention of ophthalmia neonatorum as required under Section
8-2 81.091, Health and Safety Code.
8-3 SECTION 12. Section 17, Texas Midwifery Act (Article 4512i,
8-4 Vernon's Texas Civil Statutes), is amended to read as follows:
8-5 Sec. 17. PROHIBITED ACTS. A midwife may not:
8-6 (1) provide midwifery care in violation of rules
8-7 adopted by the midwifery board, except in an emergency situation
8-8 that poses an immediate threat to the life of a woman or newborn;
8-9 (2) except for prophylaxis approved by the board to
8-10 prevent ophthalmia neonatorum, administer a prescription drug to a
8-11 client except under the supervision of a licensed physician in
8-12 accordance with the laws of this state;
8-13 (3) [(2)] use forceps or surgical instruments for any
8-14 procedure other than cutting the umbilical cord or providing
8-15 emergency first aid during delivery;
8-16 (4) [(3)] remove placenta by invasive techniques;
8-17 (5) [(4)] advance or retard labor or delivery by using
8-18 medicines or mechanical devices;
8-19 (6) [(5) use in connection with the midwife's name a
8-20 title, abbreviation or any designation tending to imply that the
8-21 midwife is a "registered" or "certified" midwife as opposed to one
8-22 who is identified in compliance with this Act;]
8-23 [(6) assist at childbirth other than a normal
8-24 childbirth except in an emergency situation that poses an immediate
8-25 threat to the life of the mother or newborn;]
8-26 [(7)] advertise or otherwise represent that the
8-27 midwife is a physician or a graduate of a medical school unless the
9-1 midwife is licensed to practice medicine by the Texas State Board
9-2 of Medical Examiners;
9-3 (7) use any advertising or identification statement
9-4 that is false, misleading, or deceptive, including holding the
9-5 midwife out to be a registered nurse, certified nurse midwife, or
9-6 licensed vocational nurse, unless the midwife is licensed
9-7 [(8) except as authorized by rules adopted] by the Board of Nurse
9-8 Examiners or [and] the Board of Vocational Nurse Examiners, as
9-9 appropriate [use in combination with the term "midwife," the term
9-10 "nurse" or other title, initials, or other designation that implies
9-11 that the midwife is licensed as a registered nurse or licensed
9-12 vocational nurse]; or
9-13 (8) [(9)] make a false statement or false record on a
9-14 birth certificate pursuant to Section 195.003, Health and Safety
9-15 Code.
9-16 SECTION 13. The Texas Midwifery Act (Article 4512i, Vernon's
9-17 Texas Civil Statutes) is amended by adding Section 17A to read as
9-18 follows:
9-19 Sec. 17A. GROUNDS FOR DISCIPLINARY ACTION; REFUSAL TO ISSUE
9-20 LETTER OF DOCUMENTATION. (a) The board, with the recommendation
9-21 of the midwifery board, may discipline a documented midwife and may
9-22 refuse to issue a letter of documentation to an individual for:
9-23 (1) noncompliance with this Act or rules adopted under
9-24 this Act;
9-25 (2) submission of false or misleading information to
9-26 the midwifery board, the board, or the department;
9-27 (3) conviction of a felony or of a misdemeanor
10-1 involving moral turpitude;
10-2 (4) intemperate use of alcohol or drugs;
10-3 (5) unprofessional or dishonorable conduct that may
10-4 reasonably be determined to deceive or defraud the public;
10-5 (6) inability to practice midwifery with reasonable
10-6 skill and safety because of illness, disability, or psychological
10-7 impairment;
10-8 (7) judgment by a court of competent jurisdiction that
10-9 the individual is mentally impaired;
10-10 (8) a suspension, a revocation, or another
10-11 disciplinary action taken by another jurisdiction affecting the
10-12 individual's authority to practice midwifery;
10-13 (9) submission of a birth or death certificate known
10-14 by the individual to be false or fraudulent or other noncompliance
10-15 with Title 3, Health and Safety Code, and rules adopted under that
10-16 title;
10-17 (10) noncompliance with Chapter 244, Health and Safety
10-18 Code, or rules adopted under that chapter; or
10-19 (11) failure to practice midwifery in a manner
10-20 consistent with the public health and safety.
10-21 (b) The board shall inform the midwifery board of, and
10-22 provide the midwifery board an opportunity for input in, each stage
10-23 of a disciplinary proceeding initiated by the board under this Act,
10-24 including the imposition of an administrative penalty under Section
10-25 18E of this Act.
10-26 SECTION 14. Section 18(a), Texas Midwifery Act (Article
10-27 4512i, Vernon's Texas Civil Statutes), is amended to read as
11-1 follows:
11-2 (a) A person required to be documented under this Act
11-3 [midwife] commits an offense if the person [midwife] knowingly or
11-4 intentionally[:]
11-5 [(1)] practices midwifery without proper documentation
11-6 issued under this Act[;]
11-7 [(2) fails to comply with the requirements of this Act
11-8 relating to the collection of blood specimens for the screening of
11-9 newborns;]
11-10 [(3) commits an act prohibited by Section 17 of this
11-11 Act; or]
11-12 [(4) fails to comply with the disclosure requirements
11-13 of this Act].
11-14 SECTION 15. Section 18B(a), Texas Midwifery Act (Article
11-15 4512i, Vernon's Texas Civil Statutes), is amended to read as
11-16 follows:
11-17 (a) On the recommendation of the midwifery board and at [At]
11-18 the request of the commissioner, the attorney general or a
11-19 district, county, or city attorney may institute a civil action in
11-20 district court to collect a civil penalty from a person who is
11-21 required to be documented under this Act and who knowingly or
11-22 intentionally has practiced midwifery:
11-23 (1) without proper documentation issued under
11-24 [violated] this Act; or
11-25 (2) in violation of an order of the midwifery board or
11-26 while the person's documentation was suspended or revoked.
11-27 SECTION 16. Section 18D, Texas Midwifery Act (Article 4512i,
12-1 Vernon's Texas Civil Statutes), is amended to read as follows:
12-2 Sec. 18D. COMPLAINT INVESTIGATION AND DISPOSITION. The
12-3 midwifery board shall adopt rules concerning the investigation of a
12-4 complaint filed with the midwifery board. The rules adopted under
12-5 this subsection shall:
12-6 (1) distinguish between categories of complaints;
12-7 [and]
12-8 (2) ensure that the person who filed the complaint has
12-9 an opportunity to explain the allegations made in the complaint;
12-10 and
12-11 (3) provide for the release of any relevant midwifery
12-12 or medical record to the midwifery board, without the necessity of
12-13 consent by the midwife's client, as necessary to conduct an
12-14 investigation of a complaint.
12-15 SECTION 17. The Texas Midwifery Act (Article 4512i, Vernon's
12-16 Texas Civil Statutes) is amended by adding Section 18E to read as
12-17 follows:
12-18 Sec. 18E. ADMINISTRATIVE PENALTY. (a) The department may
12-19 assess an administrative penalty against a person who violates this
12-20 Act or a rule adopted under this Act.
12-21 (b) The penalty may not exceed $1,000 for each violation.
12-22 Each day of a continuing violation constitutes a separate
12-23 violation.
12-24 (c) In determining the amount of an administrative penalty
12-25 assessed under this section, the department shall consider:
12-26 (1) the seriousness of the violation;
12-27 (2) the history of previous violations;
13-1 (3) the amount necessary to deter future violations;
13-2 (4) efforts made to correct the violation; and
13-3 (5) any other matters that justice may require.
13-4 (d) All proceedings for the assessment of an administrative
13-5 penalty under this Act are subject to Chapter 2001, Government
13-6 Code.
13-7 (e) If, after investigation of a possible violation and the
13-8 facts surrounding that possible violation, the department
13-9 determines that a violation has occurred, the department shall give
13-10 written notice of the violation to the person alleged to have
13-11 committed the violation. The notice must include:
13-12 (1) a brief summary of the alleged violation;
13-13 (2) a statement of the amount of the proposed penalty
13-14 based on the factors set forth in Subsection (c) of this section;
13-15 and
13-16 (3) a statement of the person's right to a hearing on
13-17 the occurrence of the violation, the amount of the penalty, or both
13-18 the occurrence of the violation and the amount of the penalty.
13-19 (f) Not later than the 20th day after the date on which the
13-20 notice is received, the person notified may accept the
13-21 determination of the department made under this section, including
13-22 the proposed penalty, or make a written request for a hearing on
13-23 that determination.
13-24 (g) If the person notified of the violation accepts the
13-25 determination of the department, the commissioner of health or that
13-26 commissioner's designee shall issue an order approving the
13-27 determination and ordering that the person pay the proposed
14-1 penalty.
14-2 (h) If the person notified under Subsection (e) of this
14-3 section timely requests a hearing, the department shall:
14-4 (1) set a hearing;
14-5 (2) give written notice of the hearing to the person;
14-6 and
14-7 (3) designate a hearings examiner to conduct the
14-8 hearing.
14-9 (i) The hearings examiner shall make findings of fact and
14-10 conclusions of law and shall promptly issue to the commissioner of
14-11 health or that commissioner's designee a proposal for decision as
14-12 to the occurrence of the violation and a recommendation as to the
14-13 amount of the proposed penalty if a penalty is determined to be
14-14 warranted.
14-15 (j) Based on the findings of fact and conclusions of law and
14-16 the recommendations of the hearings examiner, the commissioner of
14-17 health or that commissioner's designee by order may find that a
14-18 violation has occurred and may assess a penalty or may find that no
14-19 violation has occurred.
14-20 (k) The department shall give notice of the order under
14-21 Subsection (j) of this section to the person notified. The notice
14-22 must include:
14-23 (1) separate statements of the findings of fact and
14-24 conclusions of law;
14-25 (2) the amount of any penalty assessed; and
14-26 (3) a statement of the right of the person to judicial
14-27 review of the order.
15-1 (l) Not later than the 30th day after the date on which the
15-2 decision is final as provided by Chapter 2001, Government Code, the
15-3 person shall:
15-4 (1) pay the penalty;
15-5 (2) pay the penalty and file a petition for judicial
15-6 review contesting the occurrence of the violation, the amount of
15-7 the penalty, or both the occurrence of the violation and the
15-8 amount of the penalty; or
15-9 (3) without paying the penalty, file a petition for
15-10 judicial review contesting the occurrence of the violation, the
15-11 amount of the penalty, or both the occurrence of the violation and
15-12 the amount of the penalty.
15-13 (m) Within the 30-day period, a person who acts under
15-14 Subsection (l)(3) of this section may:
15-15 (1) stay enforcement of the penalty by:
15-16 (A) paying the penalty to the court for
15-17 placement in an escrow account; or
15-18 (B) giving to the court a supersedeas bond that
15-19 is approved by the court for the amount of the penalty and that is
15-20 effective until all judicial review of the order is final; or
15-21 (2) request the court to stay enforcement of the
15-22 penalty by:
15-23 (A) filing with the court a sworn affidavit of
15-24 the person stating that the person is financially unable to pay the
15-25 amount of the penalty and is financially unable to give the
15-26 supersedeas bond; and
15-27 (B) giving a copy of the affidavit to the
16-1 department by certified mail.
16-2 (n) If the department receives a copy of an affidavit under
16-3 Subsection (m)(2) of this section, the department may file with the
16-4 court, within five days after the date the copy is received, a
16-5 contest to the affidavit. The court shall hold a hearing on the
16-6 facts alleged in the affidavit as soon as practicable and shall
16-7 stay the enforcement of the penalty on finding that the alleged
16-8 facts are true. The person who files an affidavit has the burden
16-9 of proving that the person is financially unable to pay the penalty
16-10 and to give a supersedeas bond.
16-11 (o) If the person does not pay the penalty and the
16-12 enforcement of the penalty is not stayed, the department may refer
16-13 the matter to the attorney general for collection of the penalty.
16-14 (p) Judicial review of the order:
16-15 (1) is instituted by filing a petition as provided by
16-16 Subchapter G, Chapter 2001, Government Code; and
16-17 (2) is under the substantial evidence rule.
16-18 (q) If the court sustains the occurrence of the violation,
16-19 the court may uphold or reduce the amount of the penalty and order
16-20 the person to pay the full or reduced amount of the penalty. If
16-21 the court does not sustain the occurrence of the violation, the
16-22 court shall order that no penalty is owed.
16-23 (r) When the judgment of the court becomes final, the court
16-24 shall proceed under this subsection. If the person paid the amount
16-25 of the penalty under Subsection (l)(2) of this section and if that
16-26 amount is reduced or is not upheld by the court, the court shall
16-27 order that the department pay the appropriate amount plus accrued
17-1 interest to the person. The rate of the interest is the rate
17-2 charged on loans to depository institutions by the New York Federal
17-3 Reserve Bank, and the interest shall be paid for the period
17-4 beginning on the date the penalty was paid and ending on the date
17-5 the penalty is remitted. If the person paid the penalty under
17-6 Subsection (m)(1)(A) of this section or gave a supersedeas bond and
17-7 if the amount of the penalty is not upheld by the court, the court
17-8 shall order the release of the escrow account or bond. If the
17-9 person paid the penalty under Subsection (m)(1)(A) and the amount
17-10 of the penalty is reduced, the court shall order that the amount of
17-11 the penalty be paid to the department from the escrow account and
17-12 that the remainder of the account be released. If the person gave
17-13 a supersedeas bond and if the amount of the penalty is reduced, the
17-14 court shall order the release of the bond after the person pays the
17-15 amount.
17-16 (s) An administrative penalty collected under this section
17-17 shall be deposited in the state treasury to the credit of the
17-18 general revenue fund.
17-19 (t) The department may assess reasonable expenses and costs
17-20 against a person in an administrative hearing if, as a result of
17-21 the hearing, an administrative penalty is assessed against the
17-22 person. The person shall pay expenses and costs assessed under
17-23 this subsection not later than the 30th day after the date of the
17-24 order of the commissioner of health or that commissioner's designee
17-25 requiring the payment of expenses and costs is final. The
17-26 department may refer the matter to the attorney general for
17-27 collection of the expenses and costs.
18-1 (u) If the attorney general brings an action against a
18-2 person to enforce an administrative penalty assessed under this Act
18-3 and the person is found liable for an administrative penalty, the
18-4 attorney general may recover, on behalf of the attorney general and
18-5 the department, reasonable expenses and costs.
18-6 (v) For purposes of this section, "reasonable expenses and
18-7 costs" includes expenses incurred by the department and the
18-8 attorney general in the investigation, initiation, or prosecution
18-9 of an action, including reasonable investigative costs, court
18-10 costs, attorney's fees, witness fees, and deposition expenses.
18-11 (w) Costs and expenses collected under this section shall be
18-12 deposited in the state treasury to the credit of a special account
18-13 that may be appropriated only to the department. Section 403.095,
18-14 Government Code, does not apply to the account.
18-15 SECTION 18. Section 483.001(13), Health and Safety Code, is
18-16 amended to read as follows:
18-17 (13) "Prescription" means an order from a
18-18 practitioner, or an agent of the practitioner designated in writing
18-19 as authorized to communicate prescriptions, or an order made in
18-20 accordance with Section 3.06(d)(5) or (6), Medical Practice Act
18-21 (Article 4495b, Vernon's Texas Civil Statutes), or Section 16A,
18-22 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes),
18-23 to a pharmacist for a dangerous drug to be dispensed that states:
18-24 (A) the date of the order's issue;
18-25 (B) the name and address of the patient;
18-26 (C) if the drug is prescribed for an animal, the
18-27 species of the animal;
19-1 (D) the name and quantity of the drug
19-2 prescribed;
19-3 (E) the directions for the use of the drug;
19-4 (F) the intended use of the drug unless the
19-5 practitioner determines the furnishing of this information is not
19-6 in the best interest of the patient;
19-7 (G) the name, address, and telephone number of
19-8 the practitioner at the practitioner's usual place of business,
19-9 legibly printed or stamped; and
19-10 (H) the name, address, and telephone number of
19-11 the documented midwife, registered nurse, or physician assistant,
19-12 legibly printed or stamped, if signed by a documented midwife,
19-13 registered nurse, or physician assistant.
19-14 SECTION 19. Section 483.041(c), Health and Safety Code, is
19-15 amended to read as follows:
19-16 (c) Subsection (a) does not apply to the possession of a
19-17 dangerous drug in the usual course of business or practice or in
19-18 the performance of official duties by the following persons or an
19-19 agent or employee of the person:
19-20 (1) a pharmacy licensed by the board;
19-21 (2) a practitioner;
19-22 (3) a person who obtains a dangerous drug for lawful
19-23 research, teaching, or testing, but not for resale;
19-24 (4) a hospital that obtains a dangerous drug for
19-25 lawful administration by a practitioner;
19-26 (5) an officer or employee of the federal, state, or
19-27 local government;
20-1 (6) a manufacturer or wholesaler licensed by the
20-2 commissioner of health under Chapter 431 (Texas Food, Drug, and
20-3 Cosmetic Act);
20-4 (7) a carrier or warehouseman; [or]
20-5 (8) a home and community support services agency
20-6 licensed under Chapter 142, which may possess sterile water for
20-7 injection and irrigation and sterile saline for injection and
20-8 irrigation as authorized by Section 142.0061; or
20-9 (9) a documented midwife who obtains oxygen for
20-10 administration to a mother or newborn or who obtains a dangerous
20-11 drug for the administration of prophylaxis to a newborn for the
20-12 prevention of ophthalmia neonatorum in accordance with Section 16A,
20-13 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes).
20-14 SECTION 20. Sections 10(e)-(i), Texas Midwifery Act (Article
20-15 4512i, Vernon's Texas Civil Statutes), are repealed.
20-16 SECTION 21. This Act takes effect September 1, 1997.
20-17 SECTION 22. The importance of this legislation and the
20-18 crowded condition of the calendars in both houses create an
20-19 emergency and an imperative public necessity that the
20-20 constitutional rule requiring bills to be read on three several
20-21 days in each house be suspended, and this rule is hereby suspended.