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A BILL TO BE ENTITLED
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AN ACT
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relating to a work group on the establishment of a maternal |
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mortality and morbidity data registry. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 34, Health and Safety Code, is amended by |
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adding Section 34.019 to read as follows: |
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Sec. 34.019. DEVELOPMENT OF WORK GROUP ON ESTABLISHMENT OF |
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MATERNAL MORTALITY AND MORBIDITY DATA REGISTRY. (a) In this |
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section, "maternal mortality and morbidity data registry" means an |
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Internet website or database established to collect individualized |
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patient information and aggregate statistical reports on the health |
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status, health behaviors, and service delivery needs of maternal |
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patients. |
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(b) The department shall establish a work group to provide |
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advice and consultation services to the department on the report |
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and recommendations required by Subsection (e). The work group |
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consists of the following members appointed by the commissioner |
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unless otherwise provided: |
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(1) one member with appropriate expertise appointed by |
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the governor; |
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(2) two members with appropriate expertise appointed |
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by the lieutenant governor; |
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(3) two members with appropriate expertise appointed |
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by the speaker of the house of representatives; |
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(4) the chair of the Texas Hospital Association or the |
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chair's designee; |
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(5) the president of the Texas Medical Association or |
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the president's designee; |
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(6) the president of the Texas Nurses Association or |
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the president's designee; |
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(7) one member who is a physician specializing in |
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obstetrics and gynecology; |
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(8) one member who is a physician specializing in |
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maternal and fetal medicine; |
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(9) one member who is a registered nurse specializing |
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in labor and delivery; |
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(10) one member who is a representative of a hospital |
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located in a rural area of this state; |
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(11) one member who is a representative of a hospital |
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located in a county with a population of four million or more; |
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(12) one member who is a representative of a hospital |
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located in an urban area of this state in a county with a population |
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of less than four million; |
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(13) one member who is a representative of a public |
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hospital; |
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(14) one member who is a representative of a private |
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hospital; |
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(15) one member who is an epidemiologist; |
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(16) one member who is a statistician; |
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(17) one member who is a public health expert; and |
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(18) any other member with appropriate expertise as |
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the commissioner determines necessary. |
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(c) The work group shall elect from among the membership a |
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presiding officer. |
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(d) The work group shall meet periodically and at the call |
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of the presiding officer. |
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(e) With the goals of improving the quality of maternal care |
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and combating maternal mortality and morbidity and with the advice |
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of the work group established under this section, the department |
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shall assess and prepare a report and recommendations on the |
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establishment of a secure maternal mortality and morbidity data |
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registry to record information submitted by participating health |
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care providers on the health status of maternal patients over |
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varying periods, including the frequency and characteristics of |
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maternal mortality and morbidity during pregnancy and the |
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postpartum period. |
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(f) In developing the report and recommendations required |
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by Subsection (e), the department shall: |
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(1) consider individual maternal patient information |
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related to health status and health care received over varying |
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periods that should be submitted to the registry; |
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(2) review existing and developing registries used in |
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and outside this state that serve the same or a similar purpose as a |
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maternal mortality and morbidity data registry; |
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(3) review ongoing health data collection efforts and |
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initiatives in this state to avoid duplication and ensure |
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efficiency; |
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(4) review and consider existing laws that govern data |
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submission and sharing, including laws governing the |
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confidentiality and security of individually identifiable health |
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information; and |
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(5) evaluate the clinical period during which known |
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and available information should be submitted to a maternal |
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mortality and morbidity data registry by a health care provider, |
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including information: |
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(A) from a maternal patient's first appointment |
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with an obstetrician and each subsequent appointment until the date |
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of delivery; |
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(B) for the 42 days following a patient's |
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delivery; and |
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(C) until the 364th day following a patient's |
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delivery. |
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(g) If the department recommends the establishment of a |
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maternal mortality and morbidity data registry, the report under |
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Subsection (e) must include specific recommendations on the |
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relevant individual patient information and categories of |
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information to be submitted to the registry, including |
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recommendations on the intervals for submission of information. |
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The categories of individual patient information described by this |
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subsection must include: |
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(1) notifiable maternal deaths, including |
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individualized patient data on: |
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(A) patients who die during pregnancy; and |
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(B) patients who were pregnant at any point in |
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the 12 months preceding their death; |
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(2) individualized patient information on each |
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pregnancy and birth; |
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(3) individualized patient data on the most common |
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high-risk conditions for maternal patients and severe cases of |
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maternal morbidity; |
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(4) nonidentifying demographic data from the |
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provider's patient admissions records, including age, race, and |
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patient health benefit coverage status; and |
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(5) a statistical summary based on an aggregate of |
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individualized patient data that includes the following: |
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(A) total live births; |
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(B) maternal age distributions; |
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(C) maternal race and ethnicity distributions; |
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(D) health benefit plan issuer distributions; |
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(E) incidence of diabetes, hypertension, and |
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hemorrhage among patients; |
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(F) gestational age distributions; |
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(G) birth weight distributions; |
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(H) total preterm birth rate; |
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(I) rate of vaginal deliveries; and |
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(J) rate of cesarean sections. |
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(h) If the department establishes a maternal mortality and |
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morbidity data registry, a health care provider submitting |
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information to the registry shall comply with all applicable |
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federal and state laws relating to patient confidentiality and |
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quality of health care information. |
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(i) The report and recommendations required under |
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Subsection (e) must outline potential uses of a maternal mortality |
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and morbidity data registry, including: |
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(1) periodic analysis by the department of information |
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submitted to the registry; and |
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(2) the feasibility of preparing and issuing reports, |
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using aggregated information, to each health care provider |
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participating in the registry to improve the quality of maternal |
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care. |
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(j) Not later than September 1, 2020, the department shall |
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prepare and submit to the governor, lieutenant governor, speaker of |
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the house of representatives, Legislative Budget Board, and each |
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standing committee of the legislature having primary jurisdiction |
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over the department and post on the department's Internet website |
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the report and recommendations required under Subsection (e). |
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(k) This section expires September 1, 2021. |
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SECTION 2. The executive commissioner of the Health and |
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Human Services Commission shall adopt rules as necessary to |
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implement Section 34.019, Health and Safety Code, as added by this |
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Act, not later than December 1, 2019. |
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SECTION 3. This Act takes effect September 1, 2019. |