HB4553 - Relating to the mandatory reporting of birth outcomes by licensed midwives in the State of Texas.

      By: Ordaz H.B. No. 4553       A BILL TO BE ENTITLED   AN ACT   relating to the mandatory reporting of birth outcomes by licensed   midwives in the State of Texas.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  This Act may be cited as Malik's Law.          SECTION 2.  Section 203.154(b), Occupations Code, is amended   to read as follows:   SUBCHAPTER H. PRACTICE BY MIDWIFE          Sec. 203.351.  INFORMED CHOICE AND DISCLOSURE REQUIREMENTS.   (a) A midwife shall disclose in oral and written form to a   prospective client the limitations of the skills and practices of a   midwife.          (b)  The department 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 of the midwife's original licensure and   date of expiration;                (3)  the date the midwife's cardiopulmonary   resuscitation certification expires;                (4)  the midwife's compliance with continuing education   requirements;                (5)  intermittent auscultation certification if   applicable                (6)  a description of medical backup arrangements; and                (7)  the legal responsibilities of a midwife, including   statements concerning newborn blood screening, ophthalmia   neonatorum prevention, and prohibited acts under Sections   203.401-203.403.          (c)  The informed choice statement must include a statement   that state law requires a newborn child to be tested for certain   heritable diseases and hypothyroidism. The midwife shall disclose   to a client whether the midwife is approved to collect blood   specimens to be used to perform the tests. If the midwife is not   approved to collect the blood specimens, the disclosure must inform   the client of the midwife's duty to refer the client to an   appropriate health care facility or physician for the collection of   the specimens.          (d)  The disclosure of legal requirements required by this   section may not exceed 500 words and must be in English and Spanish.          (e)  A midwife shall disclose to a prospective or actual   client the procedure for reporting complaints to the department.           (f)   a midwife shall disclose if they are under active   investigation by the department before client consents to care.     Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended   by:          Acts 2005, 79th Leg., Ch. 1240 (H.B. 1535), Sec. 40, eff.   September 1, 2005.          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.027,   eff. September 1, 2015.            Sec. 203.352.  PRENATAL AND CERTAIN MEDICAL CARE ENCOURAGED.   A midwife shall encourage a client to seek:                (1)  prenatal care; and                (2)  medical care through consultation or referral, as   specified by commission rules, if the midwife determines that the   pregnancy, labor, delivery, postpartum period, or newborn period of   a woman or newborn may not be classified as normal for purposes of   this chapter.                 (3)   Medical terms and practices addressed in this   chapter pertaining to maternal and neonatal health will reflect   definitions and practice standards as defined by the American   College of Obstetrics and Gynecology as well as the International   Confederation of Midwives, the American Academy of Pediatrics and   CDC guidelines.       Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.028,   eff. September 1, 2015.            Sec. 203.353.  PREVENTION OF OPHTHALMIA NEONATORUM. (a)   Subject to Subsection (b), unless the newborn child is immediately   transferred to a hospital because of an emergency, a midwife who   attends the birth of the child shall comply with Section 81.091,   Health and Safety Code.          (b)  A midwife in attendance at childbirth who is unable to   apply prophylaxis as required by Section 81.091, Health and Safety   Code, due to the objection of the parent, managing conservator, or   guardian of the newborn child does not commit an offense under that   section and is not subject to any criminal, civil, or   administrative liability or any professional disciplinary action   for failure to administer the prophylaxis. The midwife in   attendance at childbirth shall ensure that the objection of the   parent, managing conservator, or guardian is entered into the   medical record of the child.       Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2017, 85th Leg., R.S., Ch. 1105 (H.B. 4007), Sec. 1.002,   eff. September 1, 2017.              Sec. 203.354.  NEWBORN SCREENING. (a) Each midwife who   attends the birth of a child shall cause the newborn screening tests   to be performed on blood specimens taken from the child as required   by Chapter 33, Health and Safety Code.          (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. The commission 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.          (c)  A midwife who is not approved to collect blood specimens   for newborn screening tests shall refer a client and her newborn to   an appropriate health care facility or physician for the collection   of the blood specimen and submission of the specimen to the   department.          (d)  If the midwife has been approved by the department to   collect blood specimens under this section, the collection by the   midwife of blood specimens for the required newborn screening tests   does not constitute the practice of medicine as defined by   Subtitle B.       Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2005, 79th Leg., Ch. 1240 (H.B. 1535), Sec. 41, eff.   September 1, 2005.          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.029,   eff. September 1, 2015.            Sec. 203.355.  SUPPORT SERVICES. (a) In this section:                (1)  "Clinical services" include prenatal, postpartum,   child health, and family planning services.                (2)  "Local health unit" means a division of a   municipal or county government that provides limited public health   services under Section 121.004, Health and Safety Code.                (3)  "Public health district" means a district created   under Subchapter E, Chapter 121, Health and Safety Code.          (b)  The Department of State Health Services and a local   health department, a public health district, or a local health unit   shall provide clinical and laboratory support services to a   pregnant woman or a newborn who is a client of a midwife if the   midwife is required to provide the services under this chapter.          (c)  The laboratory services must include the performance of   the standard serological tests for syphilis and the collection of   blood specimens for newborn screening tests for phenylketonuria,   hypothyroidism, and other heritable diseases as required by law.          (d)  The provider may charge a reasonable fee for the   services. A person may not be denied the services because of   inability to pay.          (e)  If available, appropriately trained personnel from   local health departments, public health districts, and local health   units shall instruct licensed midwives in the approved techniques   for collecting blood specimens to be used to perform newborn   screening tests.       Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2005, 79th Leg., Ch. 1240 (H.B. 1535), Sec. 42, eff.   September 1, 2005.          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.030,   eff. September 1, 2015.            Sec. 203.356.  IMMUNITY. (a) A physician, a registered   nurse, or other person who, on the order of a physician, instructs a   midwife in the approved techniques for collecting blood specimens   to be used for newborn screening tests is immune from liability   arising out of the failure or refusal of the midwife to:                (1)  collect the specimens in the approved manner; or                (2)  submit the specimens to the Department of State   Health Services in a timely manner.          (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 of compliance with this   chapter.       Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2005, 79th Leg., Ch. 1240 (H.B. 1535), Sec. 43, eff.   September 1, 2005.          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.031,   eff. September 1, 2015.            Sec. 203.357.  ADDITIONAL INFORMATION REQUIRED. (a) The   department may require information in addition to that required by   Section 203.253 if it determines the additional information is   necessary and appropriate to ascertain the nature and extent of   midwifery in this state. The department may not require   information regarding any act that is prohibited under this   chapter.          (b)  The department shall prescribe forms for the additional   information and shall distribute those forms directly to each   midwife. Each midwife must complete and return the forms to the   department as requested.          (c)  Information received under this section may not be made   public in a manner that discloses the identity of any person to whom   the information relates. The information is not public information   as defined by Chapter 552, Government Code.     Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.   Amended by:          Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 1.032,   eff. September 1, 2015.   Sec. 203.358.  MANDATORY REPORTING OF BIRTH OUTCOMES.   (a)  Reporting Requirement.   (1)     A licensed midwife shall submit a Birth & Outcomes Report to   the Department of State Health Services (DSHS) Vital Statistics   and Texas Department of Licensing and Regulation within 10 days of   attending any birth in a home, birthing center, or other   non-hospital setting.   (2)     The report shall be mandatory for every birth attended by a   midwife, regardless of whether:          a.  The newborn or mother survives;          b.  The newborn or mother is transferred to a hospital;         &#x [Text truncated for display. Full text available on Congress.gov.]