| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the use of certain controlled substances by women who |
|
|
are pregnant or may become pregnant and the designation of neonatal |
|
|
abstinence syndrome from substance use as a reportable condition. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Chapter 32, Health and Safety Code, is amended by |
|
|
adding Subchapter E to read as follows: |
|
|
SUBCHAPTER E. SUBSTANCE USE SCREENING DURING PREGNANCY |
|
|
Sec. 32.081. INITIAL SUBSTANCE USE SCREENING OF PREGNANT |
|
|
WOMAN. (a) At the first health care visit with a pregnant woman, a |
|
|
physician or other person authorized by law to attend a pregnant |
|
|
woman during gestation shall screen the pregnant woman for |
|
|
substance use. The physician or other person shall conduct the |
|
|
screening verbally using a validated screening tool in accordance |
|
|
with the screening recommendations provided by the American College |
|
|
of Obstetricians and Gynecologists. |
|
|
(b) The commission shall make available to physicians and |
|
|
other persons required to conduct a substance use screening under |
|
|
this section information that includes: |
|
|
(1) guidance regarding the process for verbally |
|
|
screening a pregnant woman for substance use using a validated |
|
|
screening tool; and |
|
|
(2) a list of substance abuse treatment resources in |
|
|
each geographic region of this state. |
|
|
SECTION 2. Section 81.041, Health and Safety Code, is |
|
|
amended by adding Subsection (e-1) to read as follows: |
|
|
(e-1) Neonatal abstinence syndrome is a reportable health |
|
|
condition under this chapter for which the executive commissioner |
|
|
shall require reports for public health surveillance purposes. A |
|
|
person required to report a reportable disease under Section 81.042 |
|
|
shall report a case of neonatal abstinence syndrome to the |
|
|
department. |
|
|
SECTION 3. Section 81.044, Health and Safety Code, is |
|
|
amended by adding Subsection (e) to read as follows: |
|
|
(e) For a case of neonatal abstinence syndrome, the |
|
|
executive commissioner shall require the reports to omit personally |
|
|
identifying information about the mother or newborn and to contain: |
|
|
(1) the newborn's ethnicity, national origin, and |
|
|
municipality and county of residence; |
|
|
(2) the name of the newborn's attending physician; |
|
|
(3) the maternal history of substance use; |
|
|
(4) the drug or other substance that likely caused the |
|
|
syndrome; and |
|
|
(5) other information the executive commissioner |
|
|
determines necessary. |
|
|
SECTION 4. Chapter 161, Health and Safety Code, is amended |
|
|
by adding Subchapter S-1 to read as follows: |
|
|
SUBCHAPTER S-1. OPIOID DRUG USE AMONG PREGNANT WOMEN |
|
|
Sec. 161.481. REVIEW OF PRESCRIPTION HISTORY. (a) A |
|
|
physician or other person authorized to attend a pregnant woman |
|
|
during gestation and authorized to access prescription information |
|
|
under Section 481.076(a)(5) shall, during a pregnant patient's |
|
|
first visit with the physician or person: |
|
|
(1) review the patient's prescription history by |
|
|
accessing the prescription information submitted to the Texas State |
|
|
Board of Pharmacy as authorized by Section 481.076(a)(5) to assess: |
|
|
(A) the pregnant patient's exposure to |
|
|
prescription opioid drugs; and |
|
|
(B) the possibility of the patient delivering a |
|
|
newborn with neonatal abstinence syndrome; and |
|
|
(2) place a record of the assessment in the patient's |
|
|
medical record. |
|
|
(b) A physician or other person described by Subsection (a) |
|
|
is not required to review a pregnant patient's prescription history |
|
|
if the physician or other person verifies the patient's medical |
|
|
record contains a record of the assessment described by Subsection |
|
|
(a). |
|
|
SECTION 5. Subtitle A, Title 3, Occupations Code, is |
|
|
amended by adding Chapter 107A to read as follows: |
|
|
CHAPTER 107A. PRESCRIBING OPIOID DRUGS TO CERTAIN PATIENTS |
|
|
Sec. 107A.001. DEFINITIONS. In this chapter: |
|
|
(1) "Department" means the Department of State Health |
|
|
Services. |
|
|
(2) "Executive commissioner" means the executive |
|
|
commissioner of the Health and Human Services Commission. |
|
|
Sec. 107A.002. APPLICABILITY. This chapter applies to a |
|
|
health care provider authorized by law to prescribe an opioid drug |
|
|
in the course of professional practice in this state. |
|
|
Sec. 107A.003. REQUIREMENTS FOR PRESCRIBING OPIOID DRUG TO |
|
|
FEMALE PATIENT OF CHILDBEARING AGE. (a) Before a health care |
|
|
provider may issue an opioid drug prescription to a female patient |
|
|
of childbearing age, the provider shall, in accordance with rules |
|
|
adopted by the executive commissioner, counsel the patient on and |
|
|
provide the patient with the educational materials described by |
|
|
Section 107A.004 regarding the consequences of opioid drug use |
|
|
during pregnancy. |
|
|
(b) If the female patient is a minor, the health care |
|
|
provider shall also counsel and provide the educational materials |
|
|
under Subsection (a) to the patient's parent, conservator, or |
|
|
guardian, or other person authorized to consent to the minor's |
|
|
medical treatment. |
|
|
(c) The health care provider shall document in the female |
|
|
patient's medical record that the provider complied with Subsection |
|
|
(a) and, if applicable, Subsection (b). |
|
|
Sec. 107A.004. EDUCATIONAL MATERIALS. (a) The department |
|
|
shall develop educational materials on the consequences of opioid |
|
|
drug use during pregnancy. |
|
|
(b) The department shall make the educational materials |
|
|
available on the department's Internet website. |
|
|
Sec. 107A.005. RULES. The executive commissioner shall |
|
|
adopt rules necessary to implement this chapter. |
|
|
SECTION 6. As soon as practicable after the effective date |
|
|
of this Act, the executive commissioner of the Health and Human |
|
|
Services Commission shall adopt rules necessary to implement the |
|
|
changes in law made by this Act. |
|
|
SECTION 7. (a) Not later than March 1, 2018, the Health and |
|
|
Human Services Commission shall make the information regarding |
|
|
verbally screening a pregnant woman for substance use and regarding |
|
|
substance abuse treatment resources available to physicians and |
|
|
other persons authorized by law to attend a pregnant woman, as |
|
|
required by Section 32.081(b), Health and Safety Code, as added by |
|
|
this Act. A physician or other person authorized by law to attend a |
|
|
pregnant woman during gestation is not required to conduct the |
|
|
verbal substance use screening required by Section 32.081(a), |
|
|
Health and Safety Code, as added by this Act, before September 1, |
|
|
2018. |
|
|
(b) Sections 81.041(e-1) and 81.044(e), Health and Safety |
|
|
Code, as added by this Act, apply only to a case of neonatal |
|
|
abstinence syndrome diagnosed in a child born on or after September |
|
|
1, 2018. |
|
|
(c) Notwithstanding Subchapter S-1, Chapter 161, Health and |
|
|
Safety Code, as added by this Act, a person is not required to |
|
|
comply with the requirements of Section 161.481, Health and Safety |
|
|
Code, as added by this Act, before March 1, 2018. |
|
|
(d) The Department of State Health Services shall develop |
|
|
and make available the educational materials under Section |
|
|
107A.004, Occupations Code, as added by this Act, not later than |
|
|
December 1, 2017. Chapter 107A, Occupations Code, as added by this |
|
|
Act applies only to a prescription issued on or after January 1, |
|
|
2018. A prescription issued before January 1, 2018, is governed by |
|
|
the law in effect immediately before the effective date of this Act, |
|
|
and the former law is continued in effect for that purpose. |
|
|
SECTION 8. This Act takes effect September 1, 2017. |