H.B. No. 1535
AN ACT
relating to the continuation and functions of the Texas Midwifery
Board.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 203.002, Occupations Code, is amended by
amending Subdivisions (3), (4), and (6) and adding Subdivision
(4-a) to read as follows:
(3) "Commissioner" means the commissioner of state
health services [public health].
(4) "Department" means the Department of State Health
Services [Texas Department of Health].
(4-a) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(6) "Midwife" means a person who practices midwifery
and has met the licensing [documentation] requirements established
by this chapter and midwifery board rules.
SECTION 2. Section 203.005, Occupations Code, is amended to
read as follows:
Sec. 203.005. EFFECT ON LOCAL ORDINANCES. This chapter
does not prohibit a municipality from adopting a local ordinance or
rule to regulate the practice of midwifery in the municipality if
the ordinance or rule is compatible with and at least as strict as
this chapter and midwifery board rules.
SECTION 3. Section 203.006, Occupations Code, is amended to
read as follows:
Sec. 203.006. APPLICATION OF SUNSET ACT. The midwifery
board is subject to Chapter 325, Government Code (Texas Sunset
Act). Unless continued in existence as provided by that chapter,
the midwifery board is abolished and this chapter expires September
1, 2017 [2005].
SECTION 4. Section 203.051, Occupations Code, is amended to
read as follows:
Sec. 203.051. MIDWIFERY BOARD. The commissioner [board]
shall appoint a midwifery board that reports directly to the
commissioner [board].
SECTION 5. Section 203.052(a), Occupations Code, is amended
to read as follows:
(a) The midwifery board consists of nine members appointed
as follows:
(1) five licensed [three] midwife members each of whom
has at least three years' experience in the practice of midwifery
[and not more than one of whom is a licensed health care
professional];
(2) [one certified nurse-midwife member;
[(3)] one physician member who is certified by a
national professional organization of physicians that certifies
obstetricians and gynecologists;
(3) [(4)] one physician member who is certified by a
national professional organization of physicians that certifies
family practitioners or pediatricians; and
(4) two [(5) three] members who represent the public
and who are not practicing or trained in a health care profession,
one of whom is a parent with at least one child born with the
assistance of a midwife.
SECTION 6. Section 203.054, Occupations Code, is amended to
read as follows:
Sec. 203.054. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a)
In this section, "Texas trade association" means a [nonprofit,]
cooperative[,] and voluntarily joined statewide association of
business or professional competitors in this state designed to
assist its members and its industry or profession in dealing with
mutual business or professional problems and in promoting their
common interest.
(b) A person [An officer, employee, or paid consultant of a
Texas trade association in the field of midwifery] may not be a
midwifery board member, [or] an employee of the midwifery board, or
a department employee employed in a "bona fide executive,
administrative, or professional capacity," as that phrase is used
for purposes of establishing an exemption to the overtime
provisions of the federal Fair Labor Standards Act of 1938 (29
U.S.C. Section 201 et seq.) if:
(1) the person is an officer, employee, or paid
consultant of a Texas trade association in the field of health care;
or
(2) the person's spouse is an officer, manager, or paid
consultant of a Texas trade association in the field of health care
[who is exempt from the state's position classification plan or is
compensated at or above the amount prescribed by the General
Appropriations Act for step 1, salary group A17, of the position
classification salary schedule].
(c) [A person who is the spouse of an officer, manager, or
paid consultant of a Texas trade association in the field of
midwifery may not be a midwifery board member and may not be an
employee of the midwifery board who is exempt from the state's
position classification plan or is compensated at or above the
amount prescribed by the General Appropriations Act for step 1,
salary group A17, of the position classification salary schedule.
[(d)] A person may not be [serve as] a midwifery board
member or act as the general counsel to the midwifery board or the
department if the person is required to register as a lobbyist under
Chapter 305, Government Code, because of the person's activities
for compensation on behalf of a profession related to the operation
of the midwifery board.
SECTION 7. Section 203.056, Occupations Code, is amended to
read as follows:
Sec. 203.056. OFFICERS. The commissioner shall designate a
public member of the midwifery board as the presiding officer of the
midwifery board to serve in that capacity at the pleasure of the
commissioner. The midwifery board shall elect [one of the public
members of the midwifery board as presiding officer and] one of the
other members of the midwifery board as vice presiding officer.
SECTION 8. Sections 203.057(a) and (c), Occupations Code,
are amended to read as follows:
(a) It is a ground for removal from the midwifery board that
a member:
(1) does not have at the time of taking office
[appointment] the qualifications required by Section 203.052;
(2) does not maintain during service on the midwifery
board the qualifications required by Section 203.052;
(3) is ineligible for membership under [violates a
prohibition established by] Section 203.053 or 203.054;
(4) cannot, because of illness or disability,
discharge the member's duties for a substantial part of the member's
term; or
(5) is absent from more than half of the regularly
scheduled midwifery board meetings that the member is eligible to
attend during a calendar year without an excuse approved [unless
the absence is excused] by a majority vote of the midwifery board.
(c) If the program coordinator has knowledge that a
potential ground for removal exists, the program coordinator shall
notify the presiding officer of the midwifery board of the
potential ground. The presiding officer shall then notify the
commissioner that a potential ground for removal exists. If the
potential ground for removal involves the presiding officer, the
program coordinator shall notify the next highest ranking member of
the midwifery board, who shall then notify the commissioner [The
program coordinator and presiding officer of the midwifery board
shall then notify the board] that a potential ground for removal
exists.
SECTION 9. Section 203.058, Occupations Code, is amended to
read as follows:
Sec. 203.058. [COMPENSATION;] REIMBURSEMENT. A midwifery
board member may receive reimbursement for travel expenses as
provided by the General Appropriations Act. [A member may not
receive compensation for service on the midwifery board. Each
member is entitled to receive $50 for each meeting the member
attends and the per diem and travel allowance authorized for state
employees.]
SECTION 10. Section 203.059(b), Occupations Code, is
amended to read as follows:
(b) The midwifery board shall meet at other times at the
call of the midwifery board or the commissioner [board].
SECTION 11. Subchapter B, Chapter 203, Occupations Code, is
amended by adding Section 203.060 to read as follows:
Sec. 203.060. TRAINING. (a) A person who is appointed to
and qualifies for office as a member of the midwifery board may not
vote, deliberate, or be counted as a member in attendance at a
meeting of the midwifery board until the person completes a
training program that complies with this section.
(b) The training program must provide the person with
information regarding:
(1) this chapter and the programs, functions, rules,
and budget of the midwifery board;
(2) the results of the most recent formal audit of the
midwifery board;
(3) the requirements of laws relating to open
meetings, public information, administrative procedure, and
conflicts of interest; and
(4) any applicable ethics policies adopted by the
midwifery board or the Texas Ethics Commission.
(c) A person appointed to the midwifery board is entitled to
reimbursement, as provided by the General Appropriations Act, for
the travel expenses incurred in attending the training program
regardless of whether the attendance at the program occurs before
or after the person qualifies for office.
SECTION 12. Section 203.101, Occupations Code, is amended
to read as follows:
Sec. 203.101. PROGRAM COORDINATOR. The department shall,
[with the approval of the board and] after consultation with the
midwifery board, employ a coordinator for the midwifery program and
the staff necessary to administer the program.
SECTION 13. Section 203.102, Occupations Code, is amended
to read as follows:
Sec. 203.102. DUTIES OF PROGRAM COORDINATOR. The program
coordinator shall supervise the staff in the performance of
administrative duties, including:
(1) keeping the minutes of midwifery board meetings;
and
(2) maintaining:
(A) records about basic midwifery education
courses and continuing midwifery education courses;
(B) a roster of midwives licensed [documented]
under Section 203.251; and
(C) a record of each person who is licensed
[receives documentation] under this chapter.
SECTION 14. The heading to Subchapter D, Chapter 203,
Occupations Code, is amended to read as follows:
SUBCHAPTER D. POWERS AND DUTIES OF MIDWIFERY BOARD,
EXECUTIVE COMMISSIONER [BOARD], AND DEPARTMENT
SECTION 15. Section 203.151, Occupations Code, is amended
to read as follows:
Sec. 203.151. RULEMAKING AUTHORITY OF MIDWIFERY BOARD. (a)
Subject to the approval of the executive commissioner [board], the
midwifery board shall:
(1) adopt substantive and procedural rules necessary
for the licensing [documentation] of midwives;
(2) adopt rules prescribing the standards for the
practice of midwifery in this state, including standards for:
(A) the delineation of findings that preclude a
woman or newborn from being classified as having a normal
pregnancy, labor, delivery, postpartum period, or newborn period;
and
(B) administration of oxygen by a midwife to a
mother or newborn;
(3) adopt rules prescribing:
(A) the type of courses and number of hours
required to meet the basic midwifery education course and
continuing midwifery education course requirements; and
(B) minimum standards for the approval and
revocation of approval of:
(i) basic midwifery education courses and
continuing midwifery education courses; and
(ii) instructors or facilities used in
basic midwifery education courses and continuing midwifery
education courses;
(4) adopt rules prescribing a procedure for reporting
and processing complaints relating to the practice of midwifery in
this state;
(5) adopt and implement substantive and procedural
rules as necessary to discipline midwives determined to be in
violation of this chapter or otherwise a threat to the public health
and safety;
(6) adopt rules as necessary to establish eligibility
for reciprocity for initial licensing [documentation] under this
chapter; and
(7) adopt other rules necessary to implement a duty
imposed on the executive commissioner [board] or the department
under this chapter.
(b) The rules adopted under Subsection (a)(5) must include
rules relating to:
(1) warnings provided to midwives for a violation of
this chapter or rules adopted under this chapter;
(2) agreed orders for additional education by
midwives;
(3) recommendations or requirements for medical or
psychological treatment, including treatment related to substance
abuse by a midwife; and
(4) restrictions on the practice of a midwife,
including practice limitations and the suspension and revocation of
a license [documentation], and placement of a midwife on probation.
SECTION 16. Subchapter D, Chapter 203, Occupations Code, is
amended by adding Section 203.1515 to read as follows:
Sec. 203.1515. RULES ON CONSEQUENCES OF CRIMINAL
CONVICTION. (a) Subject to the approval of the executive
commissioner, the midwifery board shall adopt rules necessary to
comply with Chapter 53.
(b) In its proposed rules under this section, the midwifery
board shall list the specific offenses for which a conviction would
constitute grounds for the midwifery board to take action under
Section 53.021.
SECTION 17. Section 203.152(a), Occupations Code, is
amended to read as follows:
(a) Subject to the approval of the executive commissioner
[board], the midwifery board by rule shall establish reasonable and
necessary fees that, in the aggregate, produce sufficient revenue
to cover the costs of administering this chapter.
SECTION 18. Sections 203.153(a)-(c), Occupations Code, are
amended to read as follows:
(a) Subject to the approval of the department [board], the
midwifery board shall issue basic information manuals for the
practice of midwifery. The midwifery board shall approve the basic
information manuals and instructor manuals that may be used in
basic midwifery education courses.
(b) The department shall provide the manuals to each
licensed [documented] midwife and to any other person on request.
(c) A basic information manual must include information
about:
(1) the knowledge necessary to practice as a midwife;
(2) the basic education and continuing education
requirements for a midwife;
(3) the legal requirements and procedures relating to
midwifery;
(4) the standards of practice as a midwife; and
(5) other information or procedures required by the
midwifery board or the department [board].
SECTION 19. Section 203.154(c), Occupations Code, is
amended to read as follows:
(c) The [Subject to the approval of the board, the]
midwifery board shall prepare and publish reports on the practice
of midwifery in this state, including statistical reporting of
infant fetal morbidity and mortality.
SECTION 20. The heading to Section 203.156, Occupations
Code, is amended to read as follows:
Sec. 203.156. DUTIES OF MIDWIFERY BOARD AND DEPARTMENT.
SECTION 21. Section 203.156(c), Occupations Code, is
amended to read as follows:
(c) The department shall:
(1) establish a program for licensure [documentation]
as a midwife as prescribed by midwifery board rules;
(2) pay the salaries of the program coordinator and
any additional staff the department determines to be necessary; and
(3) provide office space and supplies for the program
coordinator and other staff.
SECTION 22. Sections 203.157(a) and (b), Occupations Code,
are amended to read as follows:
(a) The department shall maintain a roster of each person
licensed [documented] as a midwife in this state.
(b) The roster shall contain for each person the information
required on the licensure [documentation] form under this chapter
and other information the department determines necessary to
accurately identify each licensed [documented] midwife. The
information is public information as defined by Chapter 552,
Government Code.
SECTION 23. Subchapter D, Chapter 203, Occupations Code, is
amended by adding Sections 203.158, 203.159, 203.160, and 203.161
to read as follows:
Sec. 203.158. RULES RESTRICTING ADVERTISING OR COMPETITIVE
BIDDING. (a) The midwifery board may not propose rules restricting
advertising or competitive bidding by a licensed midwife except to
prohibit false, misleading, or deceptive practices.
(b) The midwifery board may not include in its proposed
rules to prohibit false, misleading, or deceptive practices by a
licensed midwife a rule that:
(1) restricts the licensed midwife's use of any
advertising medium;
(2) restricts the licensed midwife's personal
appearance or use of the licensed midwife's voice in an
advertisement;
(3) relates to the size or duration of an
advertisement by the licensed midwife; or
(4) restricts the licensed midwife's advertisement
under a trade name.
Sec. 203.159. BOARD COMMITTEES. (a) The midwifery board
may appoint committees to assist the midwifery board with its
functions under this chapter.
(b) Only a member of the midwifery board may serve as a
member of a midwifery board committee.
Sec. 203.160. USE OF TECHNOLOGY. Subject to the approval
of the executive commissioner, the midwifery board shall implement
a policy requiring the midwifery board to use appropriate
technological solutions to improve the midwifery board's ability to
perform its functions. The policy must ensure that the public is
able to interact with the midwifery board on the Internet.
Sec. 203.161. NEGOTIATED RULEMAKING AND ALTERNATIVE
DISPUTE RESOLUTION POLICY. (a) Subject to the approval of the
executive commissioner, the midwifery board shall develop and
implement a policy to encourage the use of:
(1) negotiated rulemaking procedures under Chapter
2008, Government Code, for the adoption of midwifery board rules;
and
(2) appropriate alternative dispute resolution
procedures under Chapter 2009, Government Code, to assist in the
resolution of internal and external disputes under the midwifery
board's jurisdiction.
(b) The midwifery board's procedures relating to
alternative dispute resolution must conform, to the extent
possible, to any model guidelines issued by the State Office of
Administrative Hearings for the use of alternative dispute
resolution by state agencies.
(c) The department shall designate a trained person to:
(1) coordinate the implementation of the policy
adopted under Subsection (a);
(2) serve as a resource for any training needed to
implement the procedures for negotiated rulemaking or alternative
dispute resolution; and
(3) collect data concerning the effectiveness of those
procedures, as implemented by the midwifery board.
SECTION 24. Section 203.202, Occupations Code, is amended
by amending Subsections (c) and (d) and adding Subsection (e) to
read as follows:
(c) The midwifery board shall maintain a system to promptly
and efficiently act on complaints filed with the midwifery board.
The midwifery board shall maintain:
(1) information about the parties to the complaint and
the subject matter of the complaint;
(2) a summary of the results of the review or
investigation of the complaint; and
(3) information about the disposition of the complaint
[keep an information file about each complaint filed with the
midwifery board].
(d) The midwifery board shall make information available
describing its procedures for complaint investigation and
resolution [board's information file shall be kept current and
contain a record for each complaint of:
[(1) each person contacted in relation to the
complaint;
[(2) a summary of findings made at each step of the
complaint process; and
[(3) other relevant information].
(e) The midwifery board shall periodically notify the
parties of the status of the complaint until final disposition of
the complaint.
SECTION 25. Subchapter E, Chapter 203, Occupations Code, is
amended by adding Section 203.2021 to read as follows:
Sec. 203.2021. COMPLAINT COMMITTEE. The midwifery board
shall appoint at least one public member of the midwifery board to
any midwifery board committee established to review a complaint
filed with the midwifery board or review an enforcement action
against a licensed midwife related to a complaint filed with the
midwifery board.
SECTION 26. The heading to Subchapter F, Chapter 203,
Occupations Code, is amended to read as follows:
SUBCHAPTER F. LICENSURE [DOCUMENTATION] REQUIREMENTS
SECTION 27. Section 203.251, Occupations Code, is amended
to read as follows:
Sec. 203.251. LICENSE [DOCUMENTATION] REQUIRED. (a) A
person may not practice midwifery unless the person holds a license
[documentation letter] issued under this chapter.
(b) The department shall provide a license [documentation
letter] to each person who fulfills the licensing [documentation]
requirements.
SECTION 28. Section 203.252, Occupations Code, is amended
to read as follows:
Sec. 203.252. QUALIFICATIONS FOR INITIAL LICENSE
[DOCUMENTATION]. (a) A person qualifies to become a licensed
midwife under this chapter if the person provides [At the time of
initial documentation, an applicant for documentation must
provide] the program coordinator with documentary evidence that the
person has:
(1) satisfied each requirement for basic midwifery
education; and
(2) passed the comprehensive midwifery examination
and jurisprudence examination required by this chapter.
(b) The initial license [documentation] must be issued
before the midwife begins to practice midwifery and may be issued at
any time during the year.
(c) The term of the initial license [documentation] begins
on the date the requirements are met and extends through December 31
of the year in which the initial license [documentation] is issued.
SECTION 29. Section 203.253, Occupations Code, is amended
to read as follows:
Sec. 203.253. LICENSE [DOCUMENTATION] APPLICATION. A
person who practices midwifery must apply to the department to be
licensed [documented] as a midwife. The application must:
(1) be accompanied by a nonrefundable application fee;
and
(2) include information required by midwifery board
rules.
SECTION 30. Section 203.254, Occupations Code, is amended
to read as follows:
Sec. 203.254. BASIC MIDWIFERY EDUCATION. Subject to the
approval of the executive commissioner [board], the midwifery board
shall establish requirements for basic midwifery education.
SECTION 31. Section 203.255(a), Occupations Code, is
amended to read as follows:
(a) The midwifery board, with the approval of the executive
commissioner [board], shall:
(1) adopt a comprehensive midwifery examination for
persons regulated under this chapter that must be passed before the
initial license may be issued [documentation]; and
(2) establish eligibility requirements for persons
taking a comprehensive midwifery examination.
SECTION 32. Subchapter F, Chapter 203, Occupations Code, is
amended by adding Sections 203.2555 and 203.2556 to read as
follows:
Sec. 203.2555. JURISPRUDENCE EXAMINATION. (a) The
midwifery board shall develop and administer at least twice each
calendar year a jurisprudence examination to determine an
applicant's knowledge of this chapter, midwifery board rules, and
any other applicable laws of this state affecting the applicant's
midwifery practice.
(b) Subject to the approval of the executive commissioner,
the midwifery board shall adopt rules to implement this section,
including rules related to the development and administration of
the examination, examination fees, guidelines for reexamination,
grading the examination, and providing notice of examination
results.
Sec. 203.2556. EXAMINATION RESULTS. (a) The midwifery
board shall notify each examinee of the examination results not
later than the 30th day after the date on which the examination is
administered. If an examination is graded or reviewed by a national
testing service, the midwifery board shall notify each examinee of
the examination results not later than the 14th day after the date
the midwifery board receives the results from the testing service.
(b) If the notice of the examination results graded or
reviewed by a national testing service will be delayed for more than
90 days after the examination date, the midwifery board shall
notify the examinee of the reason for the delay before the 90th day.
(c) The midwifery board may require a testing service to
notify an examinee of the examination results.
(d) If requested in writing by a person who fails an
examination administered under this chapter, the midwifery board
shall furnish the person with an analysis of the person's
performance on the examination.
SECTION 33. The heading to Subchapter G, Chapter 203,
Occupations Code, is amended to read as follows:
SUBCHAPTER G. LICENSE [DOCUMENTATION] RENEWAL
SECTION 34. Section 203.301, Occupations Code, is amended
to read as follows:
Sec. 203.301. APPLICATION FOR LICENSE [DOCUMENTATION]
RENEWAL. An applicant for renewal of a license under this chapter
[documentation] must apply biennially [annually] as provided in
Section 203.253.
SECTION 35. Section 203.302, Occupations Code, is amended
to read as follows:
Sec. 203.302. PROCEDURE [LATE APPLICATION] FOR RENEWAL.
(a) A licensed midwife is responsible for renewing a license before
the expiration date of the license. A person whose license has
expired may not engage in activities that require a license until
the license has been renewed. [The department may accept an
application for documentation renewal that is filed not later than
the expiration date of a grace period established by board rule.
The grace period may not exceed the 60th day after the expiration
date of a person's documentation.]
(b) A person may renew an unexpired license by paying the
required renewal fee to the midwifery board before the expiration
date of the license [The department may charge a late filing fee
that must be paid in addition to the application fee].
(c) A person whose license has been expired for 90 days or
less may renew the license by paying to the midwifery board a fee
that is equal to 1-1/4 times the amount of the renewal fee.
(d) If a person's license has been expired for more than 90
days but less than one year, the person may renew the license by
paying to the midwifery board a fee that is equal to 1-1/2 times the
amount of the renewal fee.
(e) A person whose license has been expired for one year or
more may not renew the license. The person may obtain a new license
by submitting to reexamination and complying with the requirements
and procedures for obtaining an initial license.
(f) Not later than the 30th day before the date a person's
license is scheduled to expire, the midwifery board shall send
written notice of the impending expiration to the person at the
person's last known address according to the records of the
midwifery board.
SECTION 36. Section 203.303, Occupations Code, is amended
to read as follows:
Sec. 203.303. STAGGERED RENEWAL DATES. (a) The midwifery
board by rule may adopt a system under which licenses
[documentations] expire on various dates during the year.
(b) For the year in which the license [documentation]
expiration date is changed, license [documentation] fees payable on
the original expiration date shall be prorated on a monthly basis so
that each licensed [documented] midwife pays only that portion of
the license [documentation] fee that is allocable to the number of
months during which the license [documentation] is valid.
(c) On renewal of the license [documentation] on the new
expiration date, the total license [documentation] renewal fee is
payable.
SECTION 37. Sections 203.304(a) and (b), Occupations Code,
are amended to read as follows:
(a) Subject to the approval of the executive commissioner
[board], the midwifery board shall establish requirements for
continuing midwifery education, including a minimum number of hours
of continuing education required to renew a license [documentation]
under this chapter.
(b) On renewal of the license [documentation], a midwife
must provide the program coordinator with evidence, acceptable
under midwifery board rules, of completion of continuing midwifery
education as prescribed by the midwifery board.
SECTION 38. Section 203.305, Occupations Code, is amended
to read as follows:
Sec. 203.305. REQUIRED ATTENDANCE AT SPECIFIC MIDWIFERY
EDUCATION COURSES. The midwifery board may assess the continuing
education needs of licensed [documented] midwives and may require
licensed [documented] midwives to attend continuing midwifery
education courses specified by the midwifery board.
SECTION 39. Subchapter G, Chapter 203, Occupations Code, is
amended by adding Section 203.306 to read as follows:
Sec. 203.306. GROUNDS FOR REFUSING RENEWAL. The midwifery
board may refuse to renew the license of a person who fails to pay an
administrative penalty imposed under Subchapter J, unless
enforcement of the penalty is stayed or a court has ordered that the
administrative penalty is not owed.
SECTION 40. Section 203.351(b), Occupations Code, is
amended to read as follows:
(b) The midwifery board shall prescribe the form of the
informed choice and disclosure statement required to be used by a
midwife under this chapter. The form must include:
(1) statistics of the midwife's experience as a
midwife;
(2) the date the midwife's license [documentation]
expires;
(3) the date the midwife's cardiopulmonary
resuscitation certification expires;
(4) the midwife's compliance with continuing education
requirements;
(5) a description of medical backup arrangements; and
(6) the legal responsibilities of a midwife, including
statements concerning newborn blood screening, ophthalmia
neonatorum prevention, and prohibited acts under Sections
203.401-203.403.
SECTION 41. Section 203.354(b), Occupations Code, is
amended to read as follows:
(b) A midwife may collect blood specimens for the newborn
screening tests if the midwife has been approved by the department
to collect the specimen. Subject to the approval of the executive
commissioner, the midwifery [The] board shall adopt rules
establishing the standards for approval. The standards must
recognize completion of a course of instruction that includes the
blood specimen collection procedure or verification by
appropriately trained health care providers that the midwife has
been instructed in the blood collection procedures.
SECTION 42. Section 203.355(e), Occupations Code, is
amended to read as follows:
(e) If available, appropriately trained personnel from
local health departments, public health districts, and local health
units shall instruct licensed [documented] midwives in the approved
techniques for collecting blood specimens to be used to perform
newborn screening tests.
SECTION 43. Section 203.356(b), Occupations Code, is
amended to read as follows:
(b) A physician who issues an order directing or instructing
a midwife is immune from liability arising out of the failure or
refusal of the midwife to comply with the order if, before the
issuance of the order, the midwife provided the physician with
evidence satisfactory to the department [board] of compliance with
this chapter.
SECTION 44. Section 203.401, Occupations Code, is amended
to read as follows:
Sec. 203.401. PROHIBITED PRACTICES. A midwife may not:
(1) provide midwifery care in violation of midwifery
board rule, except in an emergency that poses an immediate threat to
the life of a woman or newborn;
(2) administer a prescription drug to a client other
than:
(A) a drug administered under the supervision of
a licensed physician in accordance with state law;
(B) prophylaxis approved by the department
[board] to prevent ophthalmia neonatorum; or
(C) oxygen administered in accordance with
midwifery board rule;
(3) use forceps or a surgical instrument for a
procedure other than cutting the umbilical cord or providing
emergency first aid during delivery;
(4) remove placenta by invasive techniques;
(5) use a mechanical device or medicine to advance or
retard labor or delivery; or
(6) make on a birth certificate a false statement or
false record in violation of Section 195.003, Health and Safety
Code.
SECTION 45. Section 203.402, Occupations Code, is amended
to read as follows:
Sec. 203.402. PROHIBITED REPRESENTATION. A midwife may
not:
(1) except as provided by Section 203.403, use in
connection with the midwife's name a title, abbreviation, or
designation tending to imply that the midwife is a "registered" or
"certified" midwife as opposed to one who is licensed [documented]
under this chapter;
(2) advertise or represent that the midwife is a
physician or a graduate of a medical school unless the midwife is
licensed to practice medicine by the Texas State Board of Medical
Examiners;
(3) use advertising or an identification statement
that is false, misleading, or deceptive; or
(4) except as authorized by rules adopted by the Board
of Nurse Examiners, use in combination with the term "midwife" the
term "nurse" or another title, initial, or designation that implies
that the midwife is licensed as a registered nurse or vocational
nurse.
SECTION 46. Section 203.404, Occupations Code, is amended
to read as follows:
Sec. 203.404. GROUNDS FOR DISCIPLINARY ACTION. (a) The
midwifery board may discipline a licensed [documented] midwife,
refuse to renew a midwife's license, or [and may] refuse to issue a
license [letter of documentation] to an applicant if the person
[who]:
(1) violates this chapter or a rule adopted under this
chapter;
(2) submits false or misleading information to the
midwifery board[, the board,] or the department;
(3) is convicted of a misdemeanor involving moral
turpitude or a felony;
(4) uses alcohol or drugs intemperately;
(5) engages in unprofessional or dishonorable conduct
that may reasonably be determined to deceive or defraud the public;
(6) is unable to practice midwifery with reasonable
skill and safety because of illness, disability, or psychological
impairment;
(7) is determined by a court judgment to be mentally
impaired;
(8) submits a birth or death certificate known by the
person to be false or fraudulent or engages in another act that
violates Title 3, Health and Safety Code, or a rule adopted under
that title;
(9) violates Chapter 244, Health and Safety Code, or a
rule adopted under that chapter; or
(10) fails to practice midwifery in a manner
consistent with the public health and safety.
(b) The midwifery board may discipline a licensed
[documented] midwife and may refuse to issue a license [letter of
documentation] to an applicant for a disciplinary action taken by
another jurisdiction that affects the person's authority to
practice midwifery, including a suspension, a revocation, or
another action.
SECTION 47. Sections 203.405(a) and (b), Occupations Code,
are amended to read as follows:
(a) The midwifery board or a three-member committee of
midwifery board members designated by the midwifery board shall
temporarily suspend the license [letter of documentation] of a
licensed [documented] midwife if the midwifery board or committee
determines from the evidence or information presented to it that
continued practice by the licensed [documented] midwife would
constitute a continuing and imminent threat to the public welfare.
(b) A license [letter of documentation] may be suspended
under this section without notice or hearing on the complaint if:
(1) action is taken to initiate proceedings for a
hearing before the State Office of Administrative Hearings
simultaneously with the temporary suspension; and
(2) a hearing is held as soon as practicable under this
chapter and Chapter 2001, Government Code.
SECTION 48. Subchapter I, Chapter 203, Occupations Code, is
amended by adding Section 203.406 to read as follows:
Sec. 203.406. REFUND. (a) Subject to Subsection (b), the
midwifery board may order a licensed midwife to pay a refund to a
consumer as provided in an agreement resulting from an informal
settlement conference instead of or in addition to imposing an
administrative penalty under this chapter.
(b) The amount of a refund ordered as provided in an
agreement resulting from an informal settlement conference may not
exceed the amount the consumer paid to the licensed midwife for a
service regulated by this chapter. The midwifery board may not
require payment of other damages or estimate harm in a refund order.
SECTION 49. Section 203.452(a), Occupations Code, is
amended to read as follows:
(a) The amount of the administrative penalty may not exceed
$5,000 [$1,000] for each violation. Each day a violation continues
is a separate violation.
SECTION 50. Section 203.501(a), Occupations Code, is
amended to read as follows:
(a) A person is liable for a civil penalty if the person is
required to be licensed [documented] under this chapter and the
person knowingly or intentionally practices midwifery:
(1) without a license [documentation] or while the
license [documentation] is suspended or revoked; or
(2) in violation of a midwifery board order.
SECTION 51. Section 203.504(a), Occupations Code, is
amended to read as follows:
(a) A person commits an offense if the person is required to
be licensed [documented] under this chapter and the person
knowingly practices midwifery without a license [documentation].
SECTION 52. Subchapter K, Chapter 203, Occupations Code, is
amended by adding Section 203.505 to read as follows:
Sec. 203.505. CEASE AND DESIST ORDER. (a) If it appears to
the midwifery board that a person who is not licensed under this
chapter is violating this chapter, a rule adopted under this
chapter, or another state statute or rule relating to the practice
of midwifery, the midwifery board after notice and opportunity for
a hearing may issue a cease and desist order prohibiting the person
from engaging in the activity.
(b) A violation of an order under this section constitutes
grounds for imposing an administrative penalty under Subchapter J.
SECTION 53. Section 157.004(c), Occupations Code, is
amended to read as follows:
(c) A physician who issues a standing delegation order to a
midwife under Chapter 203 is not liable in connection with an act
performed under that standing delegation order if the midwife
provides proof of licensure [documentation] under that chapter
before the order is issued.
SECTION 54. Section 483.001(13), Health and Safety Code, is
amended to read as follows:
(13) "Prescription" means an order from a
practitioner, or an agent of the practitioner designated in writing
as authorized to communicate prescriptions, or an order made in
accordance with Subchapter B, Chapter 157, Occupations Code, or
Section 203.353, Occupations Code, to a pharmacist for a dangerous
drug to be dispensed that states:
(A) the date of the order's issue;
(B) the name and address of the patient;
(C) if the drug is prescribed for an animal, the
species of the animal;
(D) the name and quantity of the drug prescribed;
(E) the directions for the use of the drug;
(F) the intended use of the drug unless the
practitioner determines the furnishing of this information is not
in the best interest of the patient;
(G) the name, address, and telephone number of
the practitioner at the practitioner's usual place of business,
legibly printed or stamped; and
(H) the name, address, and telephone number of
the licensed [documented] midwife, registered nurse, or physician
assistant, legibly printed or stamped, if signed by a licensed
[documented] midwife, registered nurse, or physician assistant.
SECTION 55. Section 483.041(c), Health and Safety Code, is
amended to read as follows:
(c) Subsection (a) does not apply to the possession of a
dangerous drug in the usual course of business or practice or in the
performance of official duties by the following persons or an agent
or employee of the person:
(1) a pharmacy licensed by the board;
(2) a practitioner;
(3) a person who obtains a dangerous drug for lawful
research, teaching, or testing, but not for resale;
(4) a hospital that obtains a dangerous drug for
lawful administration by a practitioner;
(5) an officer or employee of the federal, state, or
local government;
(6) a manufacturer or wholesaler licensed by the
Department of State Health Services [commissioner of health] under
Chapter 431 (Texas Food, Drug, and Cosmetic Act);
(7) a carrier or warehouseman;
(8) a home and community support services agency
licensed under and acting in accordance with Chapter 142;
(9) a licensed [documented] midwife who obtains oxygen
for administration to a mother or newborn or who obtains a dangerous
drug for the administration of prophylaxis to a newborn for the
prevention of ophthalmia neonatorum in accordance with Section
203.353, Occupations Code; or
(10) a salvage broker or salvage operator licensed
under Chapter 432.
SECTION 56. The following sections are repealed:
(1) Section 203.002(1), Occupations Code; and
(2) Section 203.156(a), Occupations Code.
SECTION 57. (a) Not later than January 1, 2006, the Texas
Midwifery Board shall:
(1) adopt the policies required by Sections 203.160
and 203.161, Occupations Code, as added by this Act; and
(2) adopt the rules required by Chapter 203,
Occupations Code, as amended by this Act.
(b) Not later than March 1, 2006, the Texas Midwifery Board
shall develop the jurisprudence examination required by Section
203.2555, Occupations Code, as added by this Act.
SECTION 58. (a) The changes in law made by Section 203.052,
Occupations Code, as amended by this Act, regarding the composition
of the Texas Midwifery Board do not affect the entitlement of a
member serving on the board immediately before September 1, 2005,
to continue to serve and function as a member of the board for the
remainder of the member's term. Members appointed to fill
vacancies on the board occurring on or after the effective date of
this Act must be appointed in accordance with Section 203.052(a),
Occupations Code, as amended by this Act.
(b) The changes in law made by Sections 203.052, 203.054,
and 203.057, Occupations Code, as amended by this Act, and Section
203.060, Occupations Code, as added by this Act, regarding the
prohibitions on or qualifications of members of the Texas Midwifery
Board do not affect the entitlement of a member serving on the board
immediately before September 1, 2005, to continue to serve and
function as a member of the board for the remainder of the member's
term. The changes in law made by those sections apply only to a
member appointed on or after September 1, 2005.
(c) The changes in law made by this Act related to the filing
or investigation of a complaint under Chapter 203, Occupations
Code, as amended by this Act, apply only to a complaint filed with
the Texas Midwifery Board on or after the effective date of this
Act. A complaint filed before the effective date of this Act is
governed by the law as it existed immediately before that date, and
the former law is continued in effect for that purpose.
(d) The changes in law made by this Act governing the
eligibility of a person for a license under Chapter 203,
Occupations Code, apply only to an application for a license filed
with the Texas Midwifery Board under Chapter 203, Occupations Code,
as amended by this Act, on or after the effective date of this Act.
An application for documentation as a midwife filed before the
effective date of this Act is governed by the law in effect at the
time the application was filed, and the former law is continued in
effect for that purpose.
(e) The change in law made by this Act with respect to
conduct that is grounds for imposition of a disciplinary sanction,
including a refund or cease and desist order, applies only to
conduct that occurs on or after the effective date of this Act.
Conduct that occurs before the effective date of this Act is
governed by the law in effect on the date the conduct occurred, and
the former law is continued in effect for that purpose.
(f) The changes in law made by Section 203.252(a),
Occupations Code, as amended by this Act, and Section 203.2555,
Occupations Code, as added by this Act, regarding the jurisprudence
examination, apply only to an application for a license filed with
the Texas Midwifery Board under Chapter 203, Occupations Code, as
amended by this Act, on or after September 1, 2006.
SECTION 59. Notwithstanding Section 203.302, Occupations
Code, as amended by this Act, the fees for an applicant renewing an
expired license or documentation letter under Chapter 203,
Occupations Code, before September 1, 2007, 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. An applicant
who renews an expired license or documentation letter under Chapter
203, Occupations Code, on or after September 1, 2007, is subject to
the fees provided by Section 203.302, Occupations Code, as amended
by this Act.
SECTION 60. This Act takes effect September 1, 2005.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 1535 was passed by the House on May
10, 2005, by a non-record vote.
______________________________
Chief Clerk of the House
I certify that H.B. No. 1535 was passed by the Senate on May
25, 2005, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor