1-1 By: Cuellar (Senate Sponsor - Zaffirini) H.B. No. 2088
1-2 (In the Senate - Received from the House May 8, 1997;
1-3 May 9, 1997, read first time and referred to Committee on Health
1-4 and Human Services; May 17, 1997, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 9, Nays
1-6 0; May 17, 1997, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 2088 By: Zaffirini
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of certain midwives; providing
1-11 administrative penalties.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Sections 1(c)(1), (2), (11), (12), and (13),
1-14 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes),
1-15 are amended to read as follows:
1-16 (1) "Midwife" means a person who practices midwifery
1-17 and has met the requirements for documentation as established by
1-18 this Act and the rules of the [standards of the] midwifery board.
1-19 (2) "Midwifery" means the practice by a midwife of:
1-20 (A) providing [giving] the necessary
1-21 supervision, care, and advice to a woman during normal pregnancy,
1-22 labor, and the postpartum period;
1-23 (B) conducting a normal delivery of a child; and
1-24 (C) providing normal newborn care.
1-25 (11) "Normal [childbirth]" means, as applied in this
1-26 Act to pregnancy, [means the] labor, [and] delivery, the postpartum
1-27 period, and the newborn period, the determination by a midwife that
1-28 a client during those periods is at a low risk of developing [at or
1-29 close to term, of a pregnant woman whose assessment reveals no
1-30 abnormality or signs or symptoms of] complications, as defined in
1-31 rules adopted by the midwifery board.
1-32 (12) "Newborn [care]" means an infant from birth
1-33 through [the care of a child for] the first six weeks of [the
1-34 child's] life.
1-35 (13) "Postpartum period [care]" means [the care of a
1-36 woman for] the first six weeks after a [the] woman has given birth.
1-37 SECTION 2. Section 3D(c), Texas Midwifery Act (Article
1-38 4512i, Vernon's Texas Civil Statutes), is amended to read as
1-39 follows:
1-40 (c) If the program coordinator has knowledge that a
1-41 potential ground for removal exists, the program coordinator shall
1-42 notify the chairman of the midwifery board of the ground. The
1-43 program coordinator and chairman of the midwifery board [of health]
1-44 shall then notify the board [governor] that a potential ground for
1-45 removal exists.
1-46 SECTION 3. Section 8, Texas Midwifery Act (Article 4512i,
1-47 Vernon's Texas Civil Statutes), is amended to read as follows:
1-48 Sec. 8. DUTIES AND POWERS OF THE MIDWIFERY BOARD. Subject
1-49 to the approval of the Texas Board of Health, the midwifery board
1-50 shall:
1-51 (1) establish requirements for basic [approved]
1-52 midwifery education and midwifery continuing education [courses];
1-53 (2) [establish qualifications for the instructors of
1-54 those courses;]
1-55 [(3)] issue midwifery basic information manuals;
1-56 (3) [(4)] establish eligibility requirements for
1-57 taking a comprehensive midwifery [the final] examination before
1-58 initial documentation [of a basic midwifery education course]; and
1-59 (4) approve a comprehensive midwifery examination that
1-60 must be passed before initial documentation
1-61 [(5) issue final examinations for basic midwifery
1-62 education courses].
1-63 SECTION 4. Section 8A, Texas Midwifery Act (Article 4512i,
1-64 Vernon's Texas Civil Statutes), is amended by amending Subsections
2-1 (b) and (c) and by adding Subsection (e) to read as follows:
2-2 (b) Subject to the approval of the Texas Board of Health,
2-3 the midwifery board shall:
2-4 (1) adopt substantive and procedural rules as
2-5 necessary for the documentation [identification] of midwives;
2-6 (2) adopt rules prescribing minimum standards for the
2-7 approval and revocation of approval of basic midwifery education
2-8 courses and midwifery continuing education courses;
2-9 (3) adopt rules prescribing the standards for the
2-10 practice of midwifery in this state, including standards required
2-11 for the delineation of findings that preclude a woman or newborn
2-12 from being classified as having a normal pregnancy, labor,
2-13 delivery, postpartum period, or newborn period, and standards for
2-14 administration of oxygen to a mother or newborn by a midwife;
2-15 (4) adopt rules prescribing minimum standards for the
2-16 approval and revocation of approval of instructors or facilities
2-17 used in basic midwifery education courses and midwifery continuing
2-18 education courses;
2-19 (5) [(4)] adopt rules prescribing the type of courses
2-20 and number of hours required to meet the mandatory basic midwifery
2-21 education course and midwifery continuing education course
2-22 requirements;
2-23 (6) [(5)] adopt rules prescribing a procedure for
2-24 reporting and processing complaints relating to the practice of
2-25 midwifery in this state;
2-26 (7) adopt and implement substantive and procedural
2-27 rules as necessary to discipline midwives determined to be in
2-28 violation of this Act or otherwise a threat to the public health
2-29 and safety;
2-30 (8) adopt rules as necessary to establish eligibility
2-31 for reciprocity for initial documentation under this Act;
2-32 (9) [(6)] prepare and publish reports on the practice
2-33 of midwifery in this state including statistical reporting of
2-34 infant fetal morbidity and mortality; and
2-35 (10) [(7)] adopt any additional rules necessary to
2-36 implement any duty imposed on the board or the department under
2-37 this Act.
2-38 (c) The department, with the recommendation [advice] of the
2-39 midwifery board, shall:
2-40 (1) implement the rules governing basic midwifery
2-41 education courses and midwifery continuing education courses;
2-42 (2) implement the rules governing the approval of
2-43 instructors or facilities used for offering basic midwifery
2-44 education courses and midwifery continuing education courses;
2-45 (3) prepare and distribute basic midwifery information
2-46 and instructor manuals; and
2-47 (4) enter into contracts and agreements necessary to
2-48 carry out this Act.
2-49 (e) The rules adopted under Subsection (b)(7) of this
2-50 section must include rules relating to:
2-51 (1) warnings provided to midwives for violations of
2-52 this Act or rules adopted under this Act;
2-53 (2) agreed orders for additional education by
2-54 midwives;
2-55 (3) recommendations or requirements for medical or
2-56 psychological treatment, including treatment related to substance
2-57 abuse by midwives; and
2-58 (4) restrictions on the practice of a midwife,
2-59 including practice limitation and the suspension, revocation, and
2-60 placement on probation of documentation.
2-61 SECTION 5. Section 9(a), Texas Midwifery Act (Article 4512i,
2-62 Vernon's Texas Civil Statutes), is amended to read as follows:
2-63 (a) The midwifery board shall approve basic information
2-64 manuals and instructor manuals for the practice of midwifery, which
2-65 may be used in basic midwifery education courses. The department
2-66 shall provide the manuals to each documented midwife and to any
2-67 other person on request. An approved basic information manual must
2-68 include information about:
2-69 (1) the knowledge necessary to practice as a midwife;
3-1 (2) the basic education and continuing education
3-2 requirements for a midwife;
3-3 (3) the legal requirements and procedures pertaining
3-4 to midwifery;
3-5 (4) the standards of practice for a midwife; and
3-6 (5) other information or procedures required by the
3-7 midwifery board or the board.
3-8 SECTION 6. Section 10(b), Texas Midwifery Act (Article
3-9 4512i, Vernon's Texas Civil Statutes), is amended to read as
3-10 follows:
3-11 (b) At the time of initial documentation, the person shall
3-12 provide the program coordinator with documentary evidence that the
3-13 person has met all of the requirements for [the] mandatory basic
3-14 midwifery education [course] as prescribed by rules approved by the
3-15 board and has passed the comprehensive midwifery examination
3-16 approved by the midwifery board. [The person may also provide the
3-17 program coordinator with a letter of documentation issued under
3-18 Section 12 of this Act as evidence that the midwife has passed the
3-19 voluntary examination of the course.]
3-20 SECTION 7. Section 11, Texas Midwifery Act (Article 4512i,
3-21 Vernon's Texas Civil Statutes), is amended to read as follows:
3-22 Sec. 11. EXAMINATION. (a) The midwifery board, with the
3-23 approval of the board, shall adopt a comprehensive midwifery
3-24 examination for persons regulated under this Act.
3-25 (b) [(e)] The midwifery board shall have the written portion
3-26 of the examination, if any, validated by an independent testing
3-27 professional.
3-28 SECTION 8. Section 12, Texas Midwifery Act (Article 4512i,
3-29 Vernon's Texas Civil Statutes), is amended to read as follows:
3-30 Sec. 12. DOCUMENTATION LETTER. The department shall provide
3-31 a letter of documentation to a person who fulfills the
3-32 [educational] requirements for documentation.
3-33 SECTION 9. Section 15, Texas Midwifery Act (Article 4512i,
3-34 Vernon's Texas Civil Statutes), is amended to read as follows:
3-35 Sec. 15. ROSTER. (a) The department shall maintain a
3-36 roster of all persons documented as midwives in this state
3-37 [identified to practice midwifery].
3-38 (b) The roster shall contain for each person the information
3-39 required on the documentation [identification] form of this Act and
3-40 other information that the department determines necessary to
3-41 identify with accuracy each midwife who is documented [identified]
3-42 under this Act. This information shall be [a] public information
3-43 [record] as defined in Chapter 552, Government Code [424, Acts of
3-44 the 63rd Legislature, Regular Session, 1973 (Article 6252-17a,
3-45 Vernon's Texas Civil Statutes)].
3-46 SECTION 10. Section 16(f), Texas Midwifery Act (Article
3-47 4512i, Vernon's Texas Civil Statutes), is amended to read as
3-48 follows:
3-49 (f) A midwife shall encourage a client to seek medical care
3-50 through consultation or referral, as specified by rules adopted by
3-51 the midwifery board, if the midwife determines that the pregnancy,
3-52 labor, delivery, postpartum period, or newborn period of a woman or
3-53 newborn may not be classified as "normal" for purposes of this Act
3-54 [recognizes a sign or symptom of a complication to the client's
3-55 childbirth].
3-56 SECTION 11. The Texas Midwifery Act (Article 4512i, Vernon's
3-57 Texas Civil Statutes) is amended by adding Section 16A to read as
3-58 follows:
3-59 Sec. 16A. PREVENTION OF OPHTHALMIA NEONATORUM. Unless the
3-60 newborn is immediately transferred to a hospital because of an
3-61 emergency, a midwife who attends the birth of a child shall
3-62 administer to that child prophylaxis approved by the board for the
3-63 prevention of ophthalmia neonatorum as required under Section
3-64 81.091, Health and Safety Code.
3-65 SECTION 12. Section 17, Texas Midwifery Act (Article 4512i,
3-66 Vernon's Texas Civil Statutes), is amended to read as follows:
3-67 Sec. 17. PROHIBITED ACTS. (a) A midwife may not:
3-68 (1) provide midwifery care in violation of rules
3-69 adopted by the midwifery board, except in an emergency situation
4-1 that poses an immediate threat to the life of a woman or newborn;
4-2 (2) except for prophylaxis approved by the board to
4-3 prevent ophthalmia neonatorum or the administration of oxygen in
4-4 accordance with rules of the midwifery board, administer a
4-5 prescription drug to a client except under the supervision of a
4-6 licensed physician in accordance with the laws of this state;
4-7 (3) [(2)] use forceps or surgical instruments for any
4-8 procedure other than cutting the umbilical cord or providing
4-9 emergency first aid during delivery;
4-10 (4) [(3)] remove placenta by invasive techniques;
4-11 (5) [(4)] advance or retard labor or delivery by using
4-12 medicines or mechanical devices;
4-13 (6) except as provided by Subsection (b) of this
4-14 section, [(5)] use in connection with the midwife's name a title,
4-15 abbreviation or any designation tending to imply that the midwife
4-16 is a "registered" or "certified" midwife as opposed to one who is
4-17 identified in compliance with this Act;
4-18 [(6) assist at childbirth other than a normal
4-19 childbirth except in an emergency situation that poses an immediate
4-20 threat to the life of the mother or newborn;]
4-21 (7) advertise or otherwise represent that the midwife
4-22 is a physician or a graduate of a medical school unless the midwife
4-23 is licensed to practice medicine by the Texas State Board of
4-24 Medical Examiners;
4-25 (8) use any advertising or identification statement
4-26 that is false, misleading, or deceptive;
4-27 (9) [(8)] except as authorized by rules adopted by the
4-28 Board of Nurse Examiners and the Board of Vocational Nurse
4-29 Examiners, use in combination with the term "midwife," the term
4-30 "nurse" or other title, initials, or other designation that implies
4-31 that the midwife is licensed as a registered nurse or licensed
4-32 vocational nurse; or
4-33 (10) [(9)] make a false statement or false record on a
4-34 birth certificate pursuant to Section 195.003, Health and Safety
4-35 Code.
4-36 (b) Notwithstanding Subsection (a)(6) of this section, a
4-37 midwife certified by the North American Registry of Midwives that,
4-38 in an identification statement or advertisement, uses "certified"
4-39 as part of the midwife's title must include in the statement or
4-40 advertisement that the midwife is certified by the North American
4-41 Registry of Midwives and is not certified by the State of Texas.
4-42 SECTION 13. The Texas Midwifery Act (Article 4512i, Vernon's
4-43 Texas Civil Statutes) is amended by adding Section 17A to read as
4-44 follows:
4-45 Sec. 17A. GROUNDS FOR DISCIPLINARY ACTION; REFUSAL TO ISSUE
4-46 LETTER OF DOCUMENTATION. The midwifery board may discipline a
4-47 documented midwife and may refuse to issue a letter of
4-48 documentation to an individual for:
4-49 (1) noncompliance with this Act or rules adopted under
4-50 this Act;
4-51 (2) submission of false or misleading information to
4-52 the midwifery board, the board, or the department;
4-53 (3) conviction of a felony or of a misdemeanor
4-54 involving moral turpitude;
4-55 (4) intemperate use of alcohol or drugs;
4-56 (5) unprofessional or dishonorable conduct that may
4-57 reasonably be determined to deceive or defraud the public;
4-58 (6) inability to practice midwifery with reasonable
4-59 skill and safety because of illness, disability, or psychological
4-60 impairment;
4-61 (7) judgment by a court of competent jurisdiction that
4-62 the individual is mentally impaired;
4-63 (8) a suspension, a revocation, or another
4-64 disciplinary action taken by another jurisdiction affecting the
4-65 individual's authority to practice midwifery;
4-66 (9) submission of a birth or death certificate known
4-67 by the individual to be false or fraudulent or other noncompliance
4-68 with Title 3, Health and Safety Code, and rules adopted under that
4-69 title;
5-1 (10) noncompliance with Chapter 244, Health and Safety
5-2 Code, or rules adopted under that chapter; or
5-3 (11) failure to practice midwifery in a manner
5-4 consistent with the public health and safety.
5-5 SECTION 14. Section 18(a), Texas Midwifery Act (Article
5-6 4512i, Vernon's Texas Civil Statutes), is amended to read as
5-7 follows:
5-8 (a) A person required to be documented under this Act
5-9 [midwife] commits an offense if the person [midwife] knowingly or
5-10 intentionally[:]
5-11 [(1)] practices midwifery without proper documentation
5-12 issued under this Act[;]
5-13 [(2) fails to comply with the requirements of this Act
5-14 relating to the collection of blood specimens for the screening of
5-15 newborns;]
5-16 [(3) commits an act prohibited by Section 17 of this
5-17 Act; or]
5-18 [(4) fails to comply with the disclosure requirements
5-19 of this Act].
5-20 SECTION 15. Section 18B(a), Texas Midwifery Act (Article
5-21 4512i, Vernon's Texas Civil Statutes), is amended to read as
5-22 follows:
5-23 (a) At the request of the midwifery board or commissioner,
5-24 the attorney general or a district, county, or city attorney may
5-25 institute a civil action in district court to collect a civil
5-26 penalty from a person who is required to be documented under this
5-27 Act and who knowingly or intentionally has practiced midwifery:
5-28 (1) without proper documentation issued under
5-29 [violated] this Act; or
5-30 (2) in violation of an order of the midwifery board or
5-31 while the person's documentation was suspended or revoked.
5-32 SECTION 16. Section 18D, Texas Midwifery Act (Article 4512i,
5-33 Vernon's Texas Civil Statutes), is amended to read as follows:
5-34 Sec. 18D. COMPLAINT INVESTIGATION AND DISPOSITION. The
5-35 midwifery board shall adopt rules concerning the investigation of a
5-36 complaint filed with the midwifery board. The rules adopted under
5-37 this subsection shall:
5-38 (1) distinguish between categories of complaints;
5-39 [and]
5-40 (2) ensure that the person who filed the complaint has
5-41 an opportunity to explain the allegations made in the complaint;
5-42 and
5-43 (3) provide for the release of any relevant midwifery
5-44 or medical record to the midwifery board, without the necessity of
5-45 consent by the midwife's client, as necessary to conduct an
5-46 investigation of a complaint.
5-47 SECTION 17. The Texas Midwifery Act (Article 4512i, Vernon's
5-48 Texas Civil Statutes) is amended by adding Section 18E to read as
5-49 follows:
5-50 Sec. 18E. ADMINISTRATIVE PENALTY. (a) The midwifery board
5-51 may assess an administrative penalty against a person who violates
5-52 this Act or a rule adopted under this Act.
5-53 (b) The penalty may not exceed $1,000 for each violation.
5-54 Each day of a continuing violation constitutes a separate
5-55 violation.
5-56 (c) In determining the amount of an administrative penalty
5-57 assessed under this section, the midwifery board shall consider:
5-58 (1) the seriousness of the violation;
5-59 (2) the history of previous violations;
5-60 (3) the amount necessary to deter future violations;
5-61 (4) efforts made to correct the violation; and
5-62 (5) any other matters that justice may require.
5-63 (d) All proceedings for the assessment of an administrative
5-64 penalty under this Act are subject to Chapter 2001, Government
5-65 Code.
5-66 (e) If, after investigation of a possible violation and the
5-67 facts surrounding that possible violation, the midwifery board or
5-68 its designee determines that a violation has occurred, the
5-69 midwifery board or its designee shall give written notice of the
6-1 violation to the person alleged to have committed the violation.
6-2 The notice must include:
6-3 (1) a brief summary of the alleged violation;
6-4 (2) a statement of the amount of the proposed penalty
6-5 based on the factors set forth in Subsection (c) of this section;
6-6 and
6-7 (3) a statement of the person's right to a hearing on
6-8 the occurrence of the violation, the amount of the penalty, or both
6-9 the occurrence of the violation and the amount of the penalty.
6-10 (f) Not later than the 20th day after the date on which the
6-11 notice is received, the person notified may accept the
6-12 determination of the midwifery board or its designee made under
6-13 this section, including the proposed penalty, or make a written
6-14 request for a hearing on that determination.
6-15 (g) If the person notified of the violation accepts the
6-16 determination of the midwifery board or its designee, the midwifery
6-17 board shall issue an order approving the determination and ordering
6-18 that the person pay the proposed penalty.
6-19 (h) If the person notified under Subsection (e) of this
6-20 section timely requests a hearing, the midwifery board or its
6-21 designee shall:
6-22 (1) set a hearing;
6-23 (2) give written notice of the hearing to the person;
6-24 and
6-25 (3) designate a hearings examiner to conduct the
6-26 hearing.
6-27 (i) The hearings examiner shall make findings of fact and
6-28 conclusions of law and shall promptly issue to the midwifery board
6-29 a proposal for decision as to the occurrence of the violation and a
6-30 recommendation as to the amount of the proposed penalty if a
6-31 penalty is determined to be warranted.
6-32 (j) Based on the findings of fact and conclusions of law and
6-33 the recommendations of the hearings examiner, the midwifery board
6-34 by order may find that a violation has occurred and may assess a
6-35 penalty or may find that no violation has occurred.
6-36 (k) The midwifery board shall give notice of the order under
6-37 Subsection (j) of this section to the person notified. The notice
6-38 must include:
6-39 (1) separate statements of the findings of fact and
6-40 conclusions of law;
6-41 (2) the amount of any penalty assessed; and
6-42 (3) a statement of the right of the person to judicial
6-43 review of the order.
6-44 (l) Not later than the 30th day after the date on which the
6-45 decision is final as provided by Chapter 2001, Government Code, the
6-46 person shall:
6-47 (1) pay the penalty;
6-48 (2) pay the penalty and file a petition for judicial
6-49 review contesting the occurrence of the violation, the amount of
6-50 the penalty, or both the occurrence of the violation and the
6-51 amount of the penalty; or
6-52 (3) without paying the penalty, file a petition for
6-53 judicial review contesting the occurrence of the violation, the
6-54 amount of the penalty, or both the occurrence of the violation and
6-55 the amount of the penalty.
6-56 (m) Within the 30-day period, a person who acts under
6-57 Subsection (l)(3) of this section may:
6-58 (1) stay enforcement of the penalty by:
6-59 (A) paying the penalty to the court for
6-60 placement in an escrow account; or
6-61 (B) giving to the court a supersedeas bond that
6-62 is approved by the court for the amount of the penalty and that is
6-63 effective until all judicial review of the order is final; or
6-64 (2) request the court to stay enforcement of the
6-65 penalty by:
6-66 (A) filing with the court a sworn affidavit of
6-67 the person stating that the person is financially unable to pay the
6-68 amount of the penalty and is financially unable to give the
6-69 supersedeas bond; and
7-1 (B) giving a copy of the affidavit to the
7-2 midwifery board by certified mail.
7-3 (n) If the midwifery board receives a copy of an affidavit
7-4 under Subsection (m)(2) of this section, the midwifery board may
7-5 file with the court, within five days after the date the copy is
7-6 received, a contest to the affidavit. The court shall hold a
7-7 hearing on the facts alleged in the affidavit as soon as
7-8 practicable and shall stay the enforcement of the penalty on
7-9 finding that the alleged facts are true. The person who files an
7-10 affidavit has the burden of proving that the person is financially
7-11 unable to pay the penalty and to give a supersedeas bond.
7-12 (o) If the person does not pay the penalty and the
7-13 enforcement of the penalty is not stayed, the midwifery board may
7-14 refer the matter to the attorney general for collection of the
7-15 penalty.
7-16 (p) Judicial review of the order:
7-17 (1) is instituted by filing a petition as provided by
7-18 Subchapter G, Chapter 2001, Government Code; and
7-19 (2) is under the substantial evidence rule.
7-20 (q) If the court sustains the occurrence of the violation,
7-21 the court may uphold or reduce the amount of the penalty and order
7-22 the person to pay the full or reduced amount of the penalty. If
7-23 the court does not sustain the occurrence of the violation, the
7-24 court shall order that no penalty is owed.
7-25 (r) When the judgment of the court becomes final, the court
7-26 shall proceed under this subsection. If the person paid the amount
7-27 of the penalty under Subsection (l)(2) of this section and if that
7-28 amount is reduced or is not upheld by the court, the court shall
7-29 order that the midwifery board pay the appropriate amount plus
7-30 accrued interest to the person. The rate of the interest is the
7-31 rate charged on loans to depository institutions by the New York
7-32 Federal Reserve Bank, and the interest shall be paid for the period
7-33 beginning on the date the penalty was paid and ending on the date
7-34 the penalty is remitted. If the person paid the penalty under
7-35 Subsection (m)(1)(A) of this section or gave a supersedeas bond and
7-36 if the amount of the penalty is not upheld by the court, the court
7-37 shall order the release of the escrow account or bond. If the
7-38 person paid the penalty under Subsection (m)(1)(A) and the amount
7-39 of the penalty is reduced, the court shall order that the amount of
7-40 the penalty be paid to the midwifery board from the escrow account
7-41 and that the remainder of the account be released. If the person
7-42 gave a supersedeas bond and if the amount of the penalty is
7-43 reduced, the court shall order the release of the bond after the
7-44 person pays the amount.
7-45 (s) An administrative penalty collected under this section
7-46 shall be deposited in the state treasury to the credit of the
7-47 general revenue fund.
7-48 (t) The midwifery board may assess reasonable expenses and
7-49 costs against a person in an administrative hearing if, as a result
7-50 of the hearing, an administrative penalty is assessed against the
7-51 person. The person shall pay expenses and costs assessed under
7-52 this subsection not later than the 30th day after the date of the
7-53 order of the midwifery board requiring the payment of expenses and
7-54 costs is final. The midwifery board may refer the matter to the
7-55 attorney general for collection of the expenses and costs.
7-56 (u) If the attorney general brings an action against a
7-57 person to enforce an administrative penalty assessed under this Act
7-58 and the person is found liable for an administrative penalty, the
7-59 attorney general may recover, on behalf of the attorney general,
7-60 midwifery board, and the department, reasonable expenses and
7-61 costs.
7-62 (v) For purposes of this section, "reasonable expenses and
7-63 costs" includes expenses incurred by the department, midwifery
7-64 board, and the attorney general in the investigation, initiation,
7-65 or prosecution of an action, including reasonable investigative
7-66 costs, court costs, attorney's fees, witness fees, and deposition
7-67 expenses.
7-68 (w) Costs and expenses collected under this section shall be
7-69 deposited in the state treasury to the credit of a special account
8-1 that may be appropriated only to the department. Section 403.095,
8-2 Government Code, does not apply to the account.
8-3 SECTION 18. Section 483.001(13), Health and Safety Code, is
8-4 amended to read as follows:
8-5 (13) "Prescription" means an order from a
8-6 practitioner, or an agent of the practitioner designated in writing
8-7 as authorized to communicate prescriptions, or an order made in
8-8 accordance with Section 3.06(d)(5) or (6), Medical Practice Act
8-9 (Article 4495b, Vernon's Texas Civil Statutes), or Section 16A,
8-10 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes),
8-11 to a pharmacist for a dangerous drug to be dispensed that states:
8-12 (A) the date of the order's issue;
8-13 (B) the name and address of the patient;
8-14 (C) if the drug is prescribed for an animal, the
8-15 species of the animal;
8-16 (D) the name and quantity of the drug
8-17 prescribed;
8-18 (E) the directions for the use of the drug;
8-19 (F) the intended use of the drug unless the
8-20 practitioner determines the furnishing of this information is not
8-21 in the best interest of the patient;
8-22 (G) the name, address, and telephone number of
8-23 the practitioner at the practitioner's usual place of business,
8-24 legibly printed or stamped; and
8-25 (H) the name, address, and telephone number of
8-26 the documented midwife, registered nurse, or physician assistant,
8-27 legibly printed or stamped, if signed by a documented midwife,
8-28 registered nurse, or physician assistant.
8-29 SECTION 19. Section 483.041(c), Health and Safety Code, is
8-30 amended to read as follows:
8-31 (c) Subsection (a) does not apply to the possession of a
8-32 dangerous drug in the usual course of business or practice or in
8-33 the performance of official duties by the following persons or an
8-34 agent or employee of the person:
8-35 (1) a pharmacy licensed by the board;
8-36 (2) a practitioner;
8-37 (3) a person who obtains a dangerous drug for lawful
8-38 research, teaching, or testing, but not for resale;
8-39 (4) a hospital that obtains a dangerous drug for
8-40 lawful administration by a practitioner;
8-41 (5) an officer or employee of the federal, state, or
8-42 local government;
8-43 (6) a manufacturer or wholesaler licensed by the
8-44 commissioner of health under Chapter 431 (Texas Food, Drug, and
8-45 Cosmetic Act);
8-46 (7) a carrier or warehouseman; [or]
8-47 (8) a home and community support services agency
8-48 licensed under Chapter 142, which may possess sterile water for
8-49 injection and irrigation and sterile saline for injection and
8-50 irrigation as authorized by Section 142.0061; or
8-51 (9) a documented midwife who obtains oxygen for
8-52 administration to a mother or newborn or who obtains a dangerous
8-53 drug for the administration of prophylaxis to a newborn for the
8-54 prevention of ophthalmia neonatorum in accordance with Section 16A,
8-55 Texas Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes).
8-56 SECTION 20. Sections 10(e)-(i), Texas Midwifery Act (Article
8-57 4512i, Vernon's Texas Civil Statutes), are repealed.
8-58 SECTION 21. This Act takes effect September 1, 1997.
8-59 SECTION 22. The importance of this legislation and the
8-60 crowded condition of the calendars in both houses create an
8-61 emergency and an imperative public necessity that the
8-62 constitutional rule requiring bills to be read on three several
8-63 days in each house be suspended, and this rule is hereby suspended.
8-64 * * * * *