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.