85R10585 JG-D

By: Miles S.B. No. 1774

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.