S.B. No. 750

	AN ACT
	relating to maternal and newborn health care and the quality of
	services provided to women in this state under certain health care
	programs.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subchapter B, Chapter 531, Government Code, is
	amended by adding Section 531.0738 to read as follows:
	Sec. 531.0738.  APPLICATION FOR FUNDING TO IMPLEMENT MODEL
	OF CARE FOR CERTAIN MEDICAID RECIPIENTS. (a)  The commission shall
	apply to the Centers for Medicare and Medicaid Services to receive
	any federal money available to implement a model of care that
	improves the quality and accessibility of care for:
	(1)  pregnant women with opioid use disorder enrolled
	in Medicaid during the prenatal and postpartum periods; and
	(2)  their children after birth.
	(b)  This section expires September 1, 2021.
	SECTION 2.  Chapter 31, Health and Safety Code, is amended by
	adding Section 31.018 to read as follows:
	Sec. 31.018.  REFERRAL FROM HEALTHY TEXAS WOMEN PROGRAM TO
	PRIMARY HEALTH CARE SERVICES PROGRAM. (a)  In this section,
	"Healthy Texas Women program" means a program operated by the
	commission that is substantially similar to the demonstration
	project operated under former Section 32.0248, Human Resources
	Code, and that is intended to expand access to preventive health and
	family planning services for women in this state.
	(b)  The executive commissioner by rule shall ensure that
	women receiving services under the Healthy Texas Women program are
	referred to and provided with information on the primary health
	care services program.
	SECTION 3.  Chapter 32, Health and Safety Code, is amended by
	adding Subchapters E and F to read as follows:
	SUBCHAPTER E. ENHANCED PRENATAL AND POSTPARTUM CARE SERVICES
	Sec. 32.101.  ENHANCED PRENATAL SERVICES FOR CERTAIN WOMEN.
	The commission, in collaboration with managed care organizations
	that contract with the commission to provide health care services
	to medical assistance recipients under Chapter 533, Government
	Code, shall develop and implement cost-effective, evidence-based,
	and enhanced prenatal services for high-risk pregnant women covered
	under the medical assistance program.
	Sec. 32.102.  EVALUATION AND ENHANCEMENT OF POSTPARTUM CARE
	SERVICES FOR CERTAIN WOMEN. (a)  In this section, "Healthy Texas
	Women program" means a program operated by the commission that is
	substantially similar to the demonstration project operated under
	former Section 32.0248, Human Resources Code, and that is intended
	to expand access to preventive health and family planning services
	for women in this state.
	(b)  The commission shall evaluate postpartum care services
	provided to women enrolled in the Healthy Texas Women program after
	the first 60 days of the postpartum period.
	(c)  Based on the commission's evaluation under Subsection
	(b), the commission shall develop an enhanced, cost-effective, and
	limited postpartum care services package for women enrolled in the
	Healthy Texas Women program to be provided:
	(1)  after the first 60 days of the postpartum period;
	and
	(2)  for a period of not more than 12 months after the
	date of enrollment in the Healthy Texas Women program.
	SUBCHAPTER F. DELIVERY AND IMPROVEMENT OF MATERNAL HEALTH CARE
	SERVICES INVOLVING MANAGED CARE ORGANIZATIONS
	Sec. 32.151.  DEFINITIONS. In this subchapter:
	(1)  "High-risk population" means the population of
	women most disproportionately affected by maternal morbidity and
	maternal mortality, as determined in the joint biennial report
	required under Section 34.015 including minority women.
	(2)  "Healthy Texas Women program" means a program
	operated by the commission that is substantially similar to the
	demonstration project operated under former Section 32.0248, Human
	Resources Code, and that is intended to expand access to preventive
	health and family planning services for women in this state.
	(3)  "Medicaid managed care organization" means a
	managed care organization as defined by Section 533.001, Government
	Code, that contracts with the commission under Chapter 533,
	Government Code, to provide health care services to medical
	assistance program recipients.
	Sec. 32.152.  ASSESSING PROVISION OF HEALTHY TEXAS WOMEN
	PROGRAM SERVICES THROUGH MANAGED CARE. (a)  The commission shall
	assess:
	(1)  the feasibility and cost-effectiveness of
	contracting with Medicaid managed care organizations to provide
	Healthy Texas Women program services through managed care in one or
	more health care service regions in this state if the Healthy Texas
	Women Section 1115 Demonstration Waiver is approved; and
	(2)  the potential impact of that delivery model on
	women receiving services under the program.
	(b)  This section expires September 1, 2021.
	Sec. 32.153.  CONTINUITY OF CARE FOR CERTAIN WOMEN ENROLLING
	IN HEALTHY TEXAS WOMEN PROGRAM. The commission shall develop and
	implement strategies to ensure the continuity of care for women who
	transition from the medical assistance program and enroll in the
	Healthy Texas Women program. In developing and implementing
	strategies under this section, the commission may collaborate with
	health care providers participating in the Healthy Texas Women
	program and Medicaid managed care organizations that provide health
	care services to pregnant women.
	Sec. 32.154.  POSTPARTUM DEPRESSION TREATMENT NETWORK.
	Using money from an available source designated by the commission,
	the commission, in collaboration with Medicaid managed care
	organizations and health care providers participating in the
	Healthy Texas Women program, shall develop and implement a
	postpartum depression treatment network for women enrolled in the
	medical assistance or Healthy Texas Women program.
	Sec. 32.155.  STATEWIDE INITIATIVES TO IMPROVE QUALITY OF
	MATERNAL HEALTH CARE. (a)  In this section, "social determinants
	of health" means the environmental conditions in which an
	individual lives that affect the individual's health and quality of
	life.
	(b)  The commission shall develop or enhance statewide
	initiatives to improve the quality of maternal health care services
	and outcomes for women in this state. The commission shall specify
	the initiatives that each managed care organization that contracts
	with the commission to provide health care services in this state
	must incorporate in the organization's managed care plans. The
	initiatives may address:
	(1)  prenatal and postpartum care rates;
	(2)  maternal health disparities that exist for
	minority women and other high-risk populations of women in this
	state;
	(3)  social determinants of health; or
	(4)  other priorities specified by the commission.
	(c)  A managed care organization required to incorporate the
	initiatives in the organization's managed care plans under
	Subsection (b) may incorporate any additional initiatives to
	improve the quality of maternal health care services for women
	receiving health care services through the organization.
	(d)  The commission shall prepare and submit to the
	legislature and make available to the public an annual report that
	summarizes:
	(1)  the commission's progress in developing or
	enhancing initiatives under this section; and
	(2)  each managed care organization's progress in
	incorporating the required initiatives in the organization's
	managed care plans.
	(e)  The commission may submit the report required under
	Subsection (d) with the report required under Section 536.008,
	Government Code.
	SECTION 4.  The heading to Chapter 34, Health and Safety
	Code, is amended to read as follows:
	CHAPTER 34. TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW
	COMMITTEE [TASK FORCE]
	SECTION 5.  Section 34.001, Health and Safety Code, is
	amended by adding Subdivision (12-a) to read as follows:
	(12-a)  "Review committee" means the Texas Maternal
	Mortality and Morbidity Review Committee.
	SECTION 6.  Sections 34.002, 34.003, 34.004, and 34.005,
	Health and Safety Code, are amended to read as follows:
	Sec. 34.002.  TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW
	COMMITTEE [TASK FORCE]. (a)  The Texas Maternal Mortality and
	Morbidity Review Committee [Task Force] is administered by the
	department.
	(b)  The review committee [task force] is a
	multidisciplinary advisory committee within the department and is
	composed of the following 17 members:
	(1)  15 members appointed by the commissioner as
	follows:
	(A)  four physicians specializing in obstetrics,
	at least one of whom is a maternal fetal medicine specialist;
	(B)  one certified nurse-midwife;
	(C)  one registered nurse;
	(D)  one nurse specializing in labor and delivery;
	(E)  one physician specializing in family
	practice;
	(F)  one physician specializing in psychiatry;
	(G)  one physician specializing in pathology;
	(H)  one epidemiologist, biostatistician, or
	researcher of pregnancy-related deaths;
	(I)  one social worker or social service provider;
	(J)  one community advocate in a relevant field;
	(K)  one medical examiner or coroner responsible
	for recording deaths; and
	(L)  one physician specializing in critical care;
	(2)  a representative of the department's family and
	community health programs; and
	(3)  the state epidemiologist for the department or the
	epidemiologist's designee.
	(c)  In appointing members to the review committee [task
	force], the commissioner shall:
	(1)  include members:
	(A)  working in and representing communities that
	are diverse with regard to race, ethnicity, immigration status, and
	English proficiency; and
	(B)  from differing geographic regions in the
	state, including both rural and urban areas;
	(2)  endeavor to include members who are working in and
	representing communities that are affected by pregnancy-related
	deaths and severe maternal morbidity and by a lack of access to
	relevant perinatal and intrapartum care services; and
	(3)  ensure that the composition of the review
	committee [task force] reflects the racial, ethnic, and linguistic
	diversity of this state.
	(d)  The commissioner shall appoint from among the review
	committee [task force] members a presiding officer.
	(e)  A member of the review committee [task force] appointed
	under Subsection (b)(1) is not entitled to compensation for service
	on the review committee [task force] or reimbursement for travel or
	other expenses incurred by the member while conducting the business
	of the review committee [task force].
	(f)  In carrying out its duties, the review committee [task
	force] may use technology, including teleconferencing or
	videoconferencing, to eliminate travel expenses.
	Sec. 34.003.  TERMS; VACANCY. (a)  Review committee [Task
	force] members appointed by the commissioner serve staggered
	six-year terms, with the terms of four or five members, as
	appropriate, expiring February 1 of each odd-numbered year.
	(b)  A review committee [task force] member may serve more
	than one term.
	(c)  A vacancy on the review committee [task force] shall be
	filled for the unexpired term in the same manner as the original
	appointment.
	Sec. 34.004.  MEETINGS. (a)  The review committee [task
	force] shall meet at least quarterly. The review committee [task
	force] may meet at other times at the call of the commissioner.
	(b)  Meetings of the review committee [task force] are
	subject to Chapter 551, Government Code, except that the review
	committee [task force] shall conduct a closed meeting to review
	cases under Section 34.007.
	(c)  The review committee [task force] shall:
	(1)  allow for public comment during at least one
	public meeting each year;
	(2)  present in open session recommendations made under
	Section 34.005 to help reduce the incidence of pregnancy-related
	deaths and severe maternal morbidity in this state; and
	(3)  post public notice for meetings conducted for the
	sole purpose of reviewing cases for selection under Section 34.007.
	Sec. 34.005.  DUTIES OF REVIEW COMMITTEE [TASK FORCE]. The
	review committee [task force] shall:
	(1)  study and review:
	(A)  cases of pregnancy-related deaths;
	(B)  trends, rates, or disparities in
	pregnancy-related deaths and 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 review committee
	[task force] studying cases of severe maternal morbidity; and
	(4)  in consultation with the Perinatal Advisory
	Council, make recommendations to help reduce the incidence of
	pregnancy-related deaths and severe maternal morbidity in this
	state.
	SECTION 7.  Section 34.0055(a), Health and Safety Code, is
	amended to read as follows:
	(a)  Using existing resources, the commission, in
	consultation with the review committee [task force], shall:
	(1)  make available to physicians and other persons
	licensed or certified to conduct a substance use screening and
	domestic violence screening of pregnant women information that
	includes:
	(A)  guidance regarding best practices for
	verbally screening a pregnant woman for substance use and verbally
	screening a pregnant woman for domestic violence using a validated
	screening tool; and
	(B)  a list of substance use treatment resources
	and domestic violence prevention and intervention 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 and on domestic
	violence prevention and intervention during pregnancy.
	SECTION 8.  Section 34.006, Health and Safety Code, is
	amended to read as follows:
	Sec. 34.006.  CONSULTATIONS AND AGREEMENTS WITH OUTSIDE
	PARTIES. (a)  The department and review committee [task force] may
	consult with any relevant experts and stakeholders, including:
	(1)  anesthesiologists;
	(2)  intensivists or critical care physicians;
	(3)  nutritionists;
	(4)  substance abuse treatment specialists;
	(5)  hospital staff or employees;
	(6)  representatives of the state Medicaid program;
	(7)  paramedics or other emergency medical response
	personnel;
	(8)  hospital-based risk management specialists;
	(9)  representatives of local health departments and
	public health districts in this state;
	(10)  public health experts;
	(11)  government representatives or officials; and
	(12)  law enforcement officials.
	(b)  In gathering information, the department and review
	committee [task force] may consult with representatives of any
	relevant state professional associations and organizations,
	including:
	(1)  District XI of the American Congress of
	Obstetricians and Gynecologists;
	(2)  the Texas Association of Obstetricians and
	Gynecologists;
	(3)  the Texas Nurses Association;
	(4)  the Texas Section of the Association of Women's
	Health, Obstetric and Neonatal Nurses;
	(5)  the Texas Academy of Family Physicians;
	(6)  the Texas Pediatric Society;
	(7)  the Consortium of Texas Certified Nurse-Midwives;
	(8)  the Association of Texas Midwives;
	(9)  the Texas Hospital Association;
	(10)  the Texas Medical Association; and
	(11)  the Texas Public Health Association.
	(c)  In consulting with individuals or organizations under
	Subsection (a) or (b), a member of the review committee [task force]
	or employee of the department may not disclose any identifying
	information of a patient or health care provider.
	(d)  The department on behalf of the review committee [task
	force] may enter into agreements with institutions of higher
	education or other organizations consistent with the duties of the
	department or review committee [task force] under this chapter.
	SECTION 9.  Sections 34.007(a) and (c), 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 review committee [task force] to review under this
	subsection to reflect a cross-section of pregnancy-related deaths
	in this state.
	(c)  If feasible, the department may select cases of severe
	maternal morbidity for review. In selecting cases under this
	subsection, the department shall randomly select cases for the
	review committee [task force] to review to reflect trends
	identified under Subsection (b).
	SECTION 10.  Section 34.008, Health and Safety Code, is
	amended by amending Subsections (a) and (b) and adding Subsection
	(c-1) to read as follows:
	(a)  On selecting a case of pregnancy-related death or severe
	maternal morbidity for review, the department shall, in accordance
	with this section, obtain information relevant to the case to
	enable the review committee [task force] to review the case. The
	department shall provide the information to the review committee
	[task force].
	(b)  The information provided to the review committee [task
	force] may not include identifying information of a patient or
	health care provider, including:
	(1)  the name, address, or date of birth of the patient
	or a member of the patient's family; or
	(2)  the name or specific location of a health care
	provider that treated the patient.
	(c-1)  Not later than the 30th business day after receiving a
	request from the department for records regarding a
	pregnancy-related death for a specific patient, a hospital,
	birthing center, or other custodian of the records shall submit the
	records to the department. A request made under this subsection to
	a hospital or birthing center must be limited to a patient's medical
	records.
	SECTION 11.  Section 34.009, Health and Safety Code, is
	amended by amending Subsections (b), (c), (d), (e), and (h) and
	adding Subsection (b-1) to read as follows:
	(b)  Except as provided by Subsection (b-1), confidential
	[Confidential] information that is acquired by the department and
	that includes identifying information of an individual or health
	care provider is privileged and may not be disclosed to any person.
	Information that may not be disclosed under this subsection
	includes:
	(1)  the name and address of a patient or a member of
	the patient's family;
	(2)  any service received by the patient or a member of
	the patient's family;
	(3)  the social and economic condition of the patient
	or a member of the patient's family;
	(4)  medical, dental, and mental health care
	information related to the patient or a member of the patient's
	family, including diagnoses, conditions, diseases, or disability;
	and
	(5)  the identity of a health care provider that
	provided any services to the patient or a member of the patient's
	family.
	(b-1)  Confidential information that is acquired by the
	department under this section that includes identifying
	information of an individual or health care provider may be
	securely disclosed to an appropriate federal agency for the limited
	purpose of complying with applicable requirements under the federal
	Preventing Maternal Deaths Act of 2018 (Pub. L. No. 115-344).
	(c)  Review committee [Task force] work product or
	information obtained by the department under this chapter,
	including information contained in an electronic database
	established and maintained under Section 34.012, or any other
	document or record, is confidential. This subsection does not
	prevent the review committee [task force] or department from
	releasing information described by Subsection (d) or (e) or from
	submitting the report required by Section 34.015.
	(d)  Information is not confidential under this section if
	the information is general information that cannot be connected
	with any specific individual, case, or health care provider, such
	as:
	(1)  total expenditures made for specified purposes;
	(2)  the number of families served by particular health
	care providers or agencies;
	(3)  aggregated data on social and economic conditions;
	(4)  medical data and information related to health
	care services that do not include any identifying information
	relating to a patient or the patient's family;
	(5)  information, including the source, value, and
	purpose, related to gifts, grants, or donations to or for use by the
	review committee [task force]; and
	(6)  other statistical information.
	(e)  The review committee [task force] may publish
	statistical studies and research reports based on information that
	is confidential under this section, provided that the information:
	(1)  is published in the aggregate;
	(2)  does not identify a patient or the patient's
	family;
	(3)  does not include any information that could be
	used to identify a patient or the patient's family; and
	(4)  does not identify a health care provider.
	(h)  The review committee [task force] and the department
	shall comply with all state and federal laws and rules relating to
	the transmission of health information, including the Health
	Insurance Portability and Accountability Act of 1996 (Pub. L.
	No. 104-191) and rules adopted under that Act.
	SECTION 12.  Section 34.010, Health and Safety Code, is
	amended to read as follows:
	Sec. 34.010.  SUBPOENA AND DISCOVERY. Review committee
	[Task force] work product or information that is confidential under
	Section 34.009 is privileged, is not subject to subpoena or
	discovery, and may not be introduced into evidence in any
	administrative, civil, or criminal proceeding against a patient, a
	member of the family of a patient, or a health care provider.
	SECTION 13.  Section 34.011(a), Health and Safety Code, is
	amended to read as follows:
	(a)  A member of the review committee [task force] or a
	person employed by or acting in an advisory capacity to the review
	committee [task force] and who provides information, counsel, or
	services to the review committee [task force] is not liable for
	damages for an action taken within the scope of the functions of the
	review committee [task force].
	SECTION 14.  Sections 34.012(a) and (c), Health and Safety
	Code, are amended to read as follows:
	(a)  The department may establish and maintain an electronic
	database to track cases of pregnancy-related deaths and severe
	maternal morbidity to assist the department and review committee
	[task force] in performing functions under this chapter.
	(c)  The database may be accessed only by the department and
	the review committee [task force] for the purposes described in
	this chapter.
	SECTION 15.  Section 34.014, Health and Safety Code, is
	amended to read as follows:
	Sec. 34.014.  FUNDING. The department may accept gifts and
	grants from any source to fund the duties of the department and the
	review committee [task force] under this chapter.
	SECTION 16.  Sections 34.015(a) and (b), Health and Safety
	Code, are amended to read as follows:
	(a)  Not later than September 1 of each even-numbered year,
	the review committee [task force] and the department shall submit a
	joint report on the findings of the review committee [task force]
	under this chapter to the governor, lieutenant governor, speaker of
	the house of representatives, and appropriate committees of the
	legislature.
	(b)  The report must include the review committee's [task
	force's] recommendations under Section 34.005(4).
	SECTION 17.  Section 34.0155, Health and Safety Code, is
	amended 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 review
	committee [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.
	SECTION 18.  Section 34.0156(a), Health and Safety Code, is
	amended to read as follows:
	(a)  Using existing resources, the department, in
	collaboration with the review committee [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.
	SECTION 19.  Section 34.017(b), Health and Safety Code, is
	amended to read as follows:
	(b)  The department may not disclose the information
	described by Subsection (a) to the review committee [task force] or
	any other person.
	SECTION 20.  Section 34.018, Health and Safety Code, is
	amended to read as follows:
	Sec. 34.018.  SUNSET PROVISION. (a)  The review committee
	[task force] is subject to Chapter 325, Government Code (Texas
	Sunset Act). Unless continued in existence as provided by that
	chapter, the review committee [task force] is abolished and this
	chapter expires September 1, 2027 [2023].
	(b)  The Sunset Advisory Commission shall review the review
	committee during the two-year period preceding the date the
	department is scheduled for abolition under Section 1001.003, but
	the review committee is continued in existence until the date
	provided by Subsection (a). This subsection expires September 1,
	2025.
	SECTION 21.  Section 1001.0712(c), Health and Safety Code,
	is amended to read as follows:
	(c)  The department, in consultation with the Texas Maternal
	Mortality and Morbidity Review Committee [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 review committee [task force] in developing
	recommendations for improving the collection of accurate
	information related to cause of death.
	SECTION 22.  Section 34.001(14), Health and Safety Code, is
	repealed.
	SECTION 23.  (a)  In this section, "Healthy Texas Women
	program" means a program operated by the Health and Human Services
	Commission that is substantially similar to the demonstration
	project operated under former Section 32.0248, Human Resources
	Code, and that is intended to expand access to preventive health and
	family planning services for women in this state.
	(b)  If the Centers for Medicare and Medicaid Services
	approves the waiver submitted by the executive commissioner of the
	Health and Human Services Commission under Section 1115 of the
	federal Social Security Act (42 U.S.C. Section 1315) for the
	Healthy Texas Women Section 1115 Demonstration Waiver, the
	executive commissioner shall, as soon as practicable after the
	waiver is granted, seek an amendment to the waiver to provide
	enhanced services under the Healthy Texas Women program.
	SECTION 24.  As soon as practicable after the effective date
	of this Act:
	(1)  the executive commissioner of the Health and Human
	Services Commission shall adopt rules as necessary to implement the
	changes in law made by this Act; and
	(2)  the Health and Human Services Commission shall
	apply for any federal money available to implement the model of care
	described by Section 531.0738, Government Code, as added by this
	Act.
	SECTION 25.  On the effective date of this Act:
	(1)  the Maternal Mortality and Morbidity Task Force is
	renamed the Texas Maternal Mortality and Morbidity Review
	Committee; and
	(2)  a reference in law to the task force means the
	review committee.
	SECTION 26.  If before implementing any provision of this
	Act a state agency determines that a waiver or 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 27.  The Health and Human Services Commission is
	required to implement a provision of this Act only if the
	legislature appropriates money specifically for that purpose. If
	the legislature does not appropriate money specifically for that
	purpose, the commission may, but is not required to, implement a
	provision of this Act using other appropriations available for that
	purpose.
	SECTION 28.  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 September 1, 2019.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I hereby certify that S.B. No. 750 passed the Senate on
	April 16, 2019, by the following vote: Yeas 31, Nays 0; and that
	the Senate concurred in House amendments on May 23, 2019, by the
	following vote: Yeas 31, Nays 0.
	______________________________
	Secretary of the Senate
	I hereby certify that S.B. No. 750 passed the House, with
	amendments, on May 21, 2019, by the following vote: Yeas 144,
	Nays 2, one present not voting.
	______________________________
	Chief Clerk of the House
	Approved:
	______________________________
	Date
	______________________________
	Governor