80R2749 DLF-F
 
  By: Veasey H.B. No. 420
 
 
 
   
 
 
A BILL TO BE ENTITLED
AN ACT
relating to fetal and infant mortality review and health warnings
related to fetal and infant mortality; imposing a penalty.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Subtitle A, Title 8, Health and Safety Code, is
amended by adding Chapter 674 to read as follows:
CHAPTER 674.  FETAL AND INFANT MORTALITY REVIEW
       Sec. 674.001.  DEFINITIONS.  In this chapter:
             (1)  "Decedent" means:
                   (A)  a person for whom a fetal death certificate
must be filed; or
                   (B)  a deceased infant.
             (2)  "Fetal death certificate" means a death
certificate filed for any fetus weighing 350 grams or more or, if
the weight is unknown, a fetus age 20 weeks or more as calculated
from the start date of the last normal menstrual period to the date
of delivery.
             (3)  "Health care provider" means any health care
practitioner or facility that provides medical evaluation or
treatment, including mental health evaluation or treatment.
             (4)  "Infant" means a child younger than one year of
age.
             (5)  "Local health authority" means:
                   (A)  a municipal or county health authority;
                   (B)  a director of a local health department or
public health district; or
                   (C)  a regional director of a public health
region.
             (6)  "Review" means a reexamination of information
regarding a decedent from relevant agencies, professionals, health
care providers, and the family of the decedent.
             (7)  "Review team" means the fetal and infant mortality
review team.
       Sec. 674.002.  REVIEW TEAM.  (a)  A fetal and infant
mortality review team may be established only:
             (1)  by a local health authority or other local health
official or by the Department of State Health Services; or
             (2)  under a contract or in accordance with a
memorandum of agreement with a local health authority or other
local health official or the Department of State Health Services.
       (b)  Local health authorities or other local health
officials for two or more adjacent counties or municipalities may
join to establish a joint review team.
       (c)  A review team must be composed of culturally diverse
members representing multiple disciplines, including professionals
and representatives of agencies that provide services or community
resources for families in the community and community
representatives.  The review team may include:
             (1)  a physician, including a pediatrician, an
obstetrician, or a physician practicing in another relevant
specialty;
             (2)  a registered nurse;
             (3)  a certified nurse-midwife or licensed midwife;
             (4)  a county attorney or a designee of a county
attorney;
             (5)  a representative of a school district;
             (6)  a representative of the local health department;
             (7)  a forensic pathologist;
             (8)  a mental health professional;
             (9)  a representative from a local hospital;
             (10)  a local registrar of births and deaths;
             (11)  a person working in a supervisory position in
local administration of the state Medicaid program;
             (12)  a person working with local implementation of the
Special Supplemental Nutrition Program for Women, Infants, and
Children;
             (13)  an educator;
             (14)  a pastoral counselor;
             (15)  a member of the health committee of a chamber of
commerce; and
             (16)  other community representatives.
       (d)  Members of a review team may select additional members
according to the resources of the review team and its needs.
       (e)  The review team shall select a presiding officer from
its members.
       (f)  A local health authority or other local health official
or the Department of State Health Services is not required to
establish a review team for a particular municipality or county.
       Sec. 674.003.  PURPOSE AND POWERS AND DUTIES OF REVIEW TEAM.  
(a)  The purpose of a review team is to:
             (1)  improve the health and well-being of women,
infants, and families;
             (2)  reduce racial disparities in the rates of and the
overall rates of fetal and infant mortality;
             (3)  facilitate the operations of the review team and
train review team members on the review team process; and
             (4)  develop and deliver reports of findings to the
community.
       (b)  For a death or fetal death subject to review, the review
team shall collect information relating to the death of the
decedent, including medical, dental, and mental health care records
or information, autopsy reports, social services records, and other
pertinent records related to the decedent and the family of the
decedent.
       (c)  Before review at a meeting of the review team, the names
and addresses of the decedent and the decedent's family and the name
and address of each health care provider that provided services to
the decedent or decedent's family shall be removed from information
collected under Subsection (b).  A summary of the information, with
the identifying information described by this subsection removed,
shall be prepared for consideration of the review team.
       (d)  The review team shall:
             (1)  compile statistics of fetal and infant mortality;
             (2)  analyze the causes of fetal and infant mortality;
and
             (3)  recommend measures to decrease fetal and infant
mortality to a community action team formed for this purpose or to
state or local governmental officials or other appropriate members
of the community.
       Sec. 674.004.  GOVERNMENTAL UNIT.  A review team is a
governmental unit for purposes of Chapter 101, Civil Practice and
Remedies Code.  A review team is a unit of local government under
that chapter.
       Sec. 674.005.  MEETINGS.  (a)  Meetings of a review team are
closed to the public and are not subject to Chapter 551, Government
Code.
       (b)  A member of a review team participating in the review of
a death or fetal death, and any person employed by or acting in an
advisory capacity to the review team and who provides counsel or
services to the review team, are immune from civil or criminal
liability arising from information presented in a review team
meeting or recommendations resulting from the meeting.
       Sec. 674.006.  DISCLOSURE OF INFORMATION TO REVIEW TEAM.  
(a)  A review team may request information regarding a decedent or
the decedent's family as necessary to carry out the review team's
purpose and duties, including any information described by Section
674.003(b).
       (b)  On the request of the review team, a health care
provider or other custodian of the requested information shall
provide the information to the review team.  The information shall
be provided without the authorization of the decedent's parent,
guardian, or other representative.
       (c)  A health care provider or other person who provides
information to a review team is not subject to a civil action for
damages or other relief as a result of having provided the
information.  This subsection does not apply if the information
provided was false and the health care provider or other person knew
or had reason to know that the information was false.
       Sec. 674.007.  CONFIDENTIALITY OF RECORDS; PRIVILEGE.  (a)  
Information is confidential for purposes of this chapter if the
disclosure of the information would compromise the privacy of the
decedent or the decedent's family.  Confidential information
includes any information pertaining to the decedent's death.
       (b)  Confidential information that is acquired by the review
team and that permits the identification of an individual or health
care provider is privileged and may not be disclosed to any person
except to the extent necessary to carry out the purposes of the
review team.  Information that may not be disclosed under this
subsection includes:
             (1)  names and addresses of the decedent or the
decedent's family;
             (2)  services received by the decedent or the
decedent's family;
             (3)  the social and economic condition of the decedent
or the decedent's family;
             (4)  medical, dental, and mental health care
information related to the decedent or the decedent's family,
including diagnoses, conditions, diseases, or disability; and
             (5)  the identity of health care providers that
provided services to the decedent or the decedent's family.
       (c)  Review team work product and information obtained by a
review team, including files, records, reports, records of
proceedings, recommendations, meeting notes, records of
interviews, statements, and memoranda, are confidential and are not
subject to disclosure under Chapter 552, Government Code.  This
subsection does not prevent a review team from releasing
information described by Subsection (d) or (e).
       (d)  Information is not confidential under this section if
the information is general information that cannot be connected
with any specific individual, case, or health care provider, such
as:
             (1)  total expenditures made for specified purposes;
             (2)  the number of families served by particular health
care providers or agencies;
             (3)  aggregated data on social and economic conditions;
             (4)  medical data and information related to health
care services that do not include any identifying information
relating to a decedent or the decedent's family; and
             (5)  other statistical information.
       (e)  A review team may publish statistical studies and
research reports based on information that is confidential under
this section, provided that the information published may not
identify a decedent or the decedent's family and may not include any
information that could be used to identify a decedent or the
decedent's family.
       (f)  A review team shall adopt and follow practices and
procedures to ensure that information that is confidential under
this section is not disclosed in violation of this section.
       Sec. 674.008.  IMMUNITY FROM SUBPOENA AND DISCOVERY.  
(a)  Review team work product and information obtained by a review
team, including files, records, reports, records of proceedings,
recommendations, meeting notes, records of interviews, statements,
and memoranda, are privileged, are not subject to subpoena or
discovery, and may not be introduced into evidence in any civil or
criminal proceeding against a member of the family of a decedent or
a health care provider.
       (b)  A document or other information that is otherwise
available from another source is not protected from subpoena,
discovery, or introduction into evidence under Subsection (a)
solely because the document or other information was presented
during a meeting of a review team or because a record of the
document or other information is maintained by the review team.
       Sec. 674.009.  UNAUTHORIZED DISCLOSURE BY REVIEW TEAM
MEMBER; OFFENSE.  (a)  A person commits an offense if the person is a
member of a review team and the person knowingly:
             (1)  discloses confidential information in violation
of Section 674.007; or
             (2)  inspects confidential information without
authority granted in accordance with procedures established by the
review team.
       (b)  An offense under Subsection (a) is a Class A
misdemeanor.
       Sec. 674.010.  IMMUNITY.  A member of a review team is not
liable for damages to a person for an action taken or a
recommendation made within the scope of the functions of the review
team if the member acts without malice and in the reasonable belief
that the action or recommendation is warranted by the facts known to
the review team member.
       Sec. 674.011
.  INAPPLICABILITY OF CHAPTER.  This chapter
does not apply to disclosure of records pertaining to voluntary or
therapeutic termination of pregnancy, and those records may not be
disclosed under this chapter.
       SECTION 2.  Section 161.084(b), Health and Safety Code, is
amended to read as follows:
       (b)  The sign must include the statement:
       PURCHASING OR ATTEMPTING TO PURCHASE TOBACCO PRODUCTS BY A
MINOR UNDER 18 YEARS OF AGE IS PROHIBITED BY LAW. SALE OR PROVISION
OF TOBACCO PRODUCTS TO A MINOR UNDER 18 YEARS OF AGE IS PROHIBITED
BY LAW. UPON CONVICTION, A CLASS C MISDEMEANOR, INCLUDING A FINE OF
UP TO $500, MAY BE IMPOSED. VIOLATIONS MAY BE REPORTED TO THE TEXAS
COMPTROLLER'S OFFICE BY CALLING (insert toll-free telephone
number). PREGNANT WOMEN SHOULD NOT SMOKE. SMOKERS ARE MORE LIKELY
TO HAVE BABIES WHO ARE BORN WITH LOW BIRTH WEIGHT, ARE BORN
PREMATURE, ARE STILLBORN, OR DIE BECAUSE OF SUDDEN INFANT DEATH
SYNDROME (SIDS).
       SECTION 3.  The comptroller shall adopt rules as necessary
to implement Section 161.084, Health and Safety Code, as amended by
this Act, not later than the 90th day after the effective date of
this Act.
       SECTION 4.  This Act takes effect September 1, 2007.