By: Kolkhorst, et al. S.B. No. 17
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to maternal health and safety, pregnancy-related deaths,
  and maternal morbidity, including postpartum depression.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 34.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 34.005.  DUTIES OF TASK FORCE. The task force shall:
               (1)  study and review:
                     (A)  cases of pregnancy-related deaths; [and]
                     (B)  trends, rates, or disparities in
  pregnancy-related deaths and [in] severe maternal morbidity;
                     (C)  health conditions and factors that
  disproportionately affect the most at-risk population as
  determined in the joint biennial report required under Section
  34.015; and
                     (D)  best practices and programs operating in
  other states that have reduced rates of pregnancy-related deaths;
               (2)  compare rates of pregnancy-related deaths based on
  the socioeconomic status of the mother;
               (3)  determine the feasibility of the task force
  studying cases of severe maternal morbidity; and
               (4)  in consultation with the Perinatal Advisory
  Council, [(3)] make recommendations to help reduce the incidence of
  pregnancy-related deaths and severe maternal morbidity in this
  state.
         SECTION 2.  Chapter 34, Health and Safety Code, is amended by
  adding Section 34.0055 to read as follows:
         Sec. 34.0055.  SCREENING AND EDUCATIONAL MATERIALS FOR
  SUBSTANCE USE.  (a)  The task force, in coordination with the
  department, shall:
               (1)  make available to physicians and other persons
  licensed or certified to conduct a substance use screening of
  pregnant women information that includes:
                     (A)  guidance regarding best practices for
  verbally screening a pregnant woman for substance use using a
  validated screening tool; and
                     (B)  a list of substance use treatment resources
  in each geographic region of this state; and
               (2)  review and promote the use of educational
  materials on the consequences of opioid drug use during pregnancy.
         (b)  The department shall make the information and
  educational materials described by Subsection (a) available on the
  department's Internet website.
         SECTION 3.  Sections 34.007(a) and (b), Health and Safety
  Code, are amended to read as follows:
         (a)  The department shall determine a statistically
  significant number of cases of pregnancy-related deaths for review.  
  The department shall either randomly select cases or select all
  cases for the task force to review under this subsection to reflect
  a cross-section of pregnancy-related deaths in this state.
         (b)  The department shall statistically analyze aggregate
  data of pregnancy-related deaths and severe maternal morbidity in
  this state to identify any trends, rates, or disparities.
         SECTION 4.  Section 34.015(b), Health and Safety Code, is
  amended to read as follows:
         (b)  The report must include the task force's
  recommendations under Section 34.005(4) [34.005(3)].
         SECTION 5.  Chapter 34, Health and Safety Code, is amended by
  adding Sections 34.0155, 34.0156, and 34.0157 to read as follows:
         Sec. 34.0155.  REPORT ON PREGNANCY-RELATED DEATHS, SEVERE
  MATERNAL MORBIDITY, AND POSTPARTUM DEPRESSION. The commission
  shall: 
               (1)  evaluate options for reducing pregnancy-related
  deaths, focusing on the most prevalent causes of pregnancy-related
  deaths as identified in the joint biennial report required under
  Section 34.015, and for treating postpartum depression in
  economically disadvantaged women;
               (2)  in coordination with the department and the task
  force, identify strategies to:
                     (A)  lower costs of providing medical assistance
  under Chapter 32, Human Resources Code, related to severe maternal
  morbidity and chronic illness; and
                     (B)  improve quality outcomes related to the
  underlying causes of severe maternal morbidity and chronic illness;
  and
               (3)  not later than December 1 of each even-numbered
  year, submit to the governor, the lieutenant governor, the speaker
  of the house of representatives, the Legislative Budget Board, and
  the appropriate standing committees of the legislature a written
  report that includes:
                     (A)  a summary of the commission's and
  department's efforts to accomplish the tasks described by
  Subdivisions (1) and (2); and
                     (B)  a summary of the report required by Section
  34.0156.
         Sec. 34.0156.  MATERNAL HEALTH AND SAFETY INITIATIVE.
  (a)  Using existing resources, the department, in collaboration
  with the task force, shall promote and facilitate the use among
  health care providers in this state of maternal health and safety
  informational materials, including tools and procedures related to
  best practices in maternal health and safety.
         (b)  Not later than December 1 of each even-numbered year,
  the department shall submit a report to the executive commissioner
  that includes:
               (1)  a summary of the initiative's implementation and
  outcomes; and
               (2)  recommendations for improving the effectiveness
  of the initiative.
         Sec. 34.0157.  FEASIBILITY STUDY RELATED TO MATERNAL HEALTH
  AND SAFETY INITIATIVE. (a)  Using existing resources and not later
  than December 1, 2018, the commission shall study and determine the
  feasibility of adding a provider's use of procedures included in
  the maternal health and safety initiative described by Section
  34.0156 as an indicator of quality for commission data and medical
  assistance quality-based payment purposes.
         (b)  The department shall collaborate with the commission in
  compiling available data and information needed to complete the
  feasibility study.
         (c)  The commission shall include the commission's
  determination from the feasibility study in the report required by
  Section 34.0155.
         (d)  This section expires May 1, 2019.
         SECTION 6.  Section 34.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 34.018.  SUNSET PROVISION. The task force is subject to
  Chapter 325, Government Code (Texas Sunset Act). Unless continued
  in existence as provided by that chapter, the task force is
  abolished and this chapter expires September 1, 2023 [2019].
         SECTION 7.  Subchapter D, Chapter 1001, Health and Safety
  Code, is amended by adding Section 1001.0712 to read as follows:
         Sec. 1001.0712.  CAUSE OF DEATH DATA IMPROVEMENT.  (a)  Not
  later than December 1 of each even-numbered year, the department
  shall submit to the governor, lieutenant governor, speaker of the
  house of representatives, and appropriate standing committees of
  the legislature a report on the processes and procedures for
  collecting cause of death information, including any challenges to
  collecting accurate information relating to maternal mortality.
         (b)  In preparing the report, the department may examine:
               (1)  issues relating to the quality of the death
  information being collected, including the accuracy and
  completeness of the information;
               (2)  the role of medical certifiers in death
  information collection;
               (3)  the perceptions of the individuals collecting the
  death information regarding the information's integrity;
               (4)  the training required for the individuals
  collecting death information; and
               (5)  the structural, procedural, and technological
  issues of collecting the information.
         (c)  The department, in consultation with the Maternal
  Mortality and Morbidity Task Force, shall examine national
  standards regarding the collection of death information and may
  convene a panel of experts to advise the department and the task
  force in developing recommendations for improving the collection of
  accurate information related to cause of death.
         (d)  The report may be included as part of another report the
  department is required to submit to the legislature.
         (e)  This section expires September 1, 2021.
         SECTION 8.  Not later than June 1, 2018, the Maternal
  Mortality and Morbidity Task Force, in coordination with the
  Department of State Health Services, shall develop and make
  available the information and educational materials described by
  Section 34.0055, Health and Safety Code, as added by this Act.
         SECTION 9.  If before implementing any provision of this Act
  a state agency determines that an additional waiver or additional
  authorization from a federal agency is necessary for implementation
  of that provision, the agency affected by the provision shall
  request the waiver or authorization and may delay implementing that
  provision until the waiver or authorization is granted.
         SECTION 10.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.  
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect on the 91st day after the last day of
  the legislative session.