Simmons Bill Widens Maternal Death Reviews To A Year After Pregnancy

The text as introduced · 1,767 words

89R11037 EAS-F

By: Simmons
H.B. No. 1989

A BILL TO BE ENTITLED

AN ACT

relating to the confidentiality and reporting of certain maternal

mortality information to the Department of State Health Services,

to an exception to certain reporting requirements for health care

providers reviewing certain information on maternal mortality and

morbidity, to the reimbursement of travel expenses incurred by

Texas Maternal Mortality and Morbidity Review Committee members,

and to a work group establishing a maternal mortality and morbidity

data registry.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. This Act shall be known as Tomara's Bill.

SECTION 2. Section 34.001, Health and Safety Code, is

amended by adding Subdivision (11-a) and amending Subdivision (12)

to read as follows:

(11-a) "Pregnancy-associated death" means the death

of a woman from any cause that occurs during or within one year of

delivery or end of pregnancy, regardless of the outcome or location

of the pregnancy.

(12) "Pregnancy-related death" means the death of a

woman while pregnant or within one year of delivery or end of

pregnancy, regardless of the outcome, duration , or location [ and

site ] of the pregnancy, from any cause related to or aggravated by

the pregnancy or its management, but not from accidental or

incidental causes.

SECTION 3. The heading to Section 34.002, Health and Safety

Code, is amended to read as follows:

Sec. 34.002. TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW

COMMITTEE ; REFERENCE IN LAW .

SECTION 4. Section 34.002, Health and Safety Code, is

amended by adding Subsection (a-1) and amending Subsection (e) to

read as follows:

(a-1) Notwithstanding any other law, a reference in this

chapter or other law to the Maternal Mortality and Morbidity Task

Force means the Texas Maternal Mortality and Morbidity Review

Committee.

(e) A member of the review committee appointed under

Subsection (b)(1) is not entitled to compensation for service on

the review committee , but may receive [ or ] reimbursement from the

department as provided by Section 2110.004, Government Code, for

travel [ or other ] expenses incurred by the member while conducting

the business of the review committee.

SECTION 5. Section 34.008, Health and Safety Code, is

amended by adding Subsection (e) to read as follows:

(e) Notwithstanding any other law and for purposes of this

chapter, a health care provider, including a nurse, who during the

review of information relevant to a case of pregnancy-associated

death, pregnancy-related death, or severe maternal morbidity

obtained under this chapter learns of conduct related to the

provider's profession that is subject to a reporting requirement is

exempt from that reporting requirement for the reviewed

information.

SECTION 6. Section 34.009(a), Health and Safety Code, is

amended to read as follows:

(a) Any information pertaining to a pregnancy-associated

death, a pregnancy-related death , or severe maternal morbidity is

confidential for purposes of this chapter.

SECTION 7. Section 34.014, Health and Safety Code, is

amended to read as follows:

Sec. 34.014. FUNDING. (a) The department may accept gifts

and grants from any source to fund the duties of the department and

the review committee under this chapter.

(b) The department may use only gifts, grants, or federal

funds to reimburse travel or other expenses incurred by a member of

the review committee in accordance with Section 34.002(e).

SECTION 8. Section 34.017, Health and Safety Code, is

amended by adding Subsections (c), (d), and (e) to read as follows:

(c) The department may allow voluntary and confidential

reporting to the department of pregnancy-associated deaths and

pregnancy-related deaths by health care professionals, health care

facilities, and persons who complete the medical certification for

a death certificate for deaths reviewed or analyzed by the review

committee.

(d) The department shall allow voluntary and confidential

reporting to the department of pregnancy-associated deaths and

pregnancy-related deaths by family members of or other appropriate

individuals associated with a deceased patient. The department

shall:

(1) post on the department's Internet website the

contact information of the person to whom a report may be submitted

under this subsection; and

(2) conduct outreach to local health organizations on

the availability of the review committee to review and analyze the

deaths described by this subsection.

(e) Information reported to the department under this

section is confidential in accordance with Section 34.009.

SECTION 9. Chapter 34, Health and Safety Code, is amended by

adding Section 34.022 to read as follows:

Sec. 34.022. DEVELOPMENT OF WORK GROUP ON ESTABLISHMENT OF

MATERNAL MORTALITY AND MORBIDITY DATA REGISTRY. (a) In this

section, "maternal mortality and morbidity data registry" means an

Internet website or database established to collect individualized

patient information and aggregate statistical reports on the health

status, health behaviors, and service delivery needs of maternal

patients.

(b) The department shall establish a work group to provide

advice and consultation services to the department on the report

and recommendations required by Subsection (e). The work group

consists of the following members appointed by the commissioner

unless otherwise provided:

(1) one member with appropriate expertise appointed by

the governor;

(2) two members with appropriate expertise appointed

by the lieutenant governor;

(3) two members with appropriate expertise appointed

by the speaker of the house of representatives;

(4) the chair of the Texas Hospital Association or the

chair's designee;

(5) the president of the Texas Medical Association or

the president's designee;

(6) the president of the Texas Nurses Association or

the president's designee;

(7) one member who is a physician specializing in

obstetrics and gynecology;

(8) one member who is a physician specializing in

maternal and fetal medicine;

(9) one member who is a registered nurse specializing

in labor and delivery;

(10) one member who is a representative of a hospital

located in a rural area of this state;

(11) one member who is a representative of a hospital

located in a county with a population of four million or more;

(12) one member who is a representative of a hospital

located in an urban area of this state in a county with a population

of less than four million;

(13) one member who is a representative of a public

hospital;

(14) one member who is a representative of a private

hospital;

(15) one member who is an epidemiologist;

(16) one member who is a statistician;

(17) one member who is a public health expert; and

(18) any other member with appropriate expertise as

the commissioner determines necessary.

(c) The work group shall elect from among the membership a

presiding officer.

(d) The work group shall meet periodically and at the call

of the presiding officer.

(e) With the goals of improving the quality of maternal care

and combating maternal mortality and morbidity and with the advice

of the work group established under this section, the department

shall assess and prepare a report and recommendations on the

establishment of a secure maternal mortality and morbidity data

registry to record information submitted by participating health

care providers on the health status of maternal patients over

varying periods, including the frequency and characteristics of

maternal mortality and morbidity during pregnancy and the

postpartum period.

(f) In developing the report and recommendations required

by Subsection (e), the department shall:

(1) consider individual maternal patient information

related to health status and health care received over varying

periods that should be submitted to the registry;

(2) review existing and developing registries used

within and outside this state that serve the same or a similar

purpose as a maternal mortality and morbidity data registry;

(3) review ongoing health data collection efforts and

initiatives in this state to avoid duplication and ensure

efficiency;

(4) review and consider existing laws that govern data

submission and sharing, including laws governing the

confidentiality and security of individually identifiable health

information; and

(5) evaluate the clinical period during which a health

care provider should submit to a maternal mortality and morbidity

data registry known and available information, including

information:

(A) from a maternal patient's first appointment

with an obstetrician and each subsequent appointment until the date

of delivery;

(B) for the 42 days following the date of a

patient's delivery; and

(C) until the 364th day following the date of a

patient's delivery.

(g) If the department recommends the establishment of a

maternal mortality and morbidity data registry, the report under

Subsection (e) must include specific recommendations on the

relevant individual patient information and categories of

information to be submitted to the registry, including

recommendations on the intervals for submission of information.

The categories must include:

(1) notifiable maternal deaths, including

individualized patient data on:

(A) patients who die during pregnancy; and

(B) patients who were pregnant at any point

during the 12 months preceding their death;

(2) individualized patient information on each

pregnancy and birth;

(3) individualized patient data on the most common

high-risk conditions for maternal patients and severe cases of

maternal morbidity;

(4) nonidentifying demographic data from the

provider's patient admissions records, including age, race, and

patient health benefit coverage status; and

(5) a statistical summary based on an aggregate of

individualized patient data that includes the following:

(A) total live births;

(B) maternal age distributions;

(C) maternal race and ethnicity distributions;

(D) health benefit plan issuer distributions;

(E) incidence of diabetes, hypertension, and

hemorrhage among patients;

(F) gestational age distributions;

(G) birth weight distributions;

(H) total preterm birth rate;

(I) rate of vaginal deliveries; and

(J) rate of cesarean sections.

(h) If the department establishes a maternal mortality and

morbidity data registry, a health care provider submitting

information to the registry shall comply with all applicable

federal and state laws relating to patient confidentiality and

quality of health care information.

(i) The report and recommendations required under

Subsection (e) must outline potential uses of a maternal mortality

and morbidity data registry, including:

(1) periodic department analysis of information

submitted to the registry; and

(2) the feasibility of preparing and issuing reports,

using aggregated information, to each health care provider

participating in the registry to improve the quality of maternal

care.

(j) Not later than September 1, 2026, the department shall

prepare and submit to the governor, the lieutenant governor, the

speaker of the house of representatives, the Legislative Budget

Board, and each standing committee of the legislature having

primary jurisdiction over the department and post on the

department's Internet website the report and recommendations

required under Subsection (e).

(k) This section expires September 1, 2027.

SECTION 10. Not later than December 1, 2025, the executive

commissioner of the Health and Human Services Commission shall

adopt rules as necessary to implement Section 34.022, Health and

Safety Code, as added by this Act.

SECTION 11. This Act takes effect September 1, 2025.