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Rep. Guerra begins work to shape laws affecting affect health of women and infants, rural medicine, behavioral health, and impact of opioids - Titans of the Texas Legislature

Featured: Rep. R.D. “Bobby” Guerra, D-McAllen, center, meets with area residents on Monday, October 21, 2019, during a public ceremony marking the first anniversary of the Texas A&M University Higher Education Center at McAllen, located at 6200 Tres Lagos Boulevard. 



Rep. Guerra begins work to shape laws affecting affect health of women and infants, rural medicine, behavioral health, and impact of opioids

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Speaker of the House Dennis Bonnen, R-Angleton, recently announced the issues that will be closely studied by all House committees during the next year, an assignment that is known as an interim charge, including a series of measures assigned to the House Committee on Public Health.

Rep. R.D. “Bobby” Guerra, D-McAllen, one of the more experienced members of that legislative panel, will be helping shape laws for acting by the 87th Texas Legislature that affect the health of women and infants, rural medicine, behavioral health, and the impact of opioids.

The interim is the period between regular legislative sessions.

Interim charges are a group of issues to be studied during the interim for the purpose of making recommendations to the next legislature.

“Building on our shared success and the legislative accomplishments of the 86th Regular Session, these charges focus primarily on the implementation and associated rulemaking of legislation passed earlier this year with an emphasis on ensuring the legislative intent of these measures is achieved,” Bonnen explained. “These changes also reflect the issues and priorities that many of you have requested to study and review in preparation for the 2021 legislative session. It is my hope that upon completion, each committee will bring forth recommendations for sound public policy benefiting the people of Texas.”

The interim charges for the House Committee on Public Health follow:

Monitor the agencies and programs under the committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 86th Legislature. Conduct active oversight of all associated rulemaking and other governmental actions taken to ensure the intended legislative outcome of all legislation, including the following:

Related to Women/Maternal/Infant Health

House Bill 253, which requires the Health and Human Services Commission (HHSC) to develop and implement a five-year strategic plan to address postpartum depression.

Monitor the development of the strategic plan to ensure it provides strategies to improve access to postpartum depression screening, referral, treatment, and support services.

Senate Bill 436, which requires the Department of State Health Services (DSHS), in conjunction with the Maternal Mortality and Morbidity Task Force, to develop and implement statewide initiatives to improve maternal and newborn health for women with opioid use disorder. 

Examine the process by which DSHS and the Task Force develop and implement the initiatives, and, if applicable, monitor the development of the optional pilot program authorized by the legislation.

Senate Bill 748, which creates a newborn screening preservation account and requires the development of a program to provide prenatal and postpartum care through telehealth or telemedicine in certain counties, a high-risk maternal care coordination services pilot program, and a pregnancy medical home pilot program. 

Monitor the rulemaking process at HHSC and conduct oversight of the creation of the newborn screening preservation account and the maternal health programs. Identify any challenges that arise in funding the account or implementing the programs. 

Ensure the required agencies are providing adequate data collection on maternal mortality rates, maternity care, and postpartum depression in the state.

Senate Bill 749, which relates to designating levels of neonatal and maternal care for hospitals and establishes an appeal process, waiver agreement, and telemedicine exceptions. Monitor HHSC’s rulemaking process.

Senate Bill 750, which directs HHSC to evaluate and develop a limited postpartum care package for new mothers enrolled in the Healthy Texas Women (HTW) program and to develop strategies to ensure continuity of care for new mothers who transition from Medicaid for Pregnant Women into HTW. 

3. Monitor HHSC’s rulemaking process and the evaluation and development of the postpartum care package in HTW.

Senate Bill 2132, which requires additional information to be provided to new mothers enrolled in HTW. 

Monitor HHSC’s rulemaking process.

Related to Controlled Substances/Opioids

House Bill 2174, which establishes limits on prescribing opioids for acute pain and institutes certain requirements for controlled substance prescription submissions and continuing education for prescribers.

House Bill 3284, which revises the circumstances under which the Texas State Board of Pharmacy (TSBP) may allow access to information relating to controlled substances prescriptions. 

Monitor the collaboration between TSBP and the State Board of Veterinary Medical Examiners in implementing the legislation.

House Bill 3285, which creates programs and initiatives to prevent and respond to opioid addiction, misuse, abuse, and overdose and identify and treat co-occurring substance use disorders and mental illness. Monitor the process by which the Governor’s Criminal Justice Division will award grants to law enforcement agencies for opioid antagonists. Conduct oversight of the process related to Medicaid reimbursement for medication-assisted treatment. Examine the impact of the opioid crisis on Texas’ seniors, and review any programs and services available to prevent and treat opioid misuse among that population.

HHSC Rider 34, which requires HHSC to evaluate opioid drug prescribing practices under Medicaid and assess the extent to which they align with the Centers for Disease Control and Prevention guidelines.

Related to Rural Health

House Bill 3934, which provides rural hospitals with the authority to establish a health care collaborative.

Senate Bill 170, which relates to the reimbursement of rural hospitals under Medicaid.

Monitor the reimbursement methodology developed by HHSC.

Senate Bill 633, which provides the authority to assemble local mental health authorities (LMHA) in rural areas into groups in order to ensure access to mental health services in those areas. Conduct oversight of the process of grouping individual LMHAs and the development of a plan for each group to increase capacity and access.

Senate Bill 1621, which creates a rural hospital strategic plan.

Related to General Monitoring

House Bill 871, which authorizes certain rural hospitals to satisfy trauma facility designation requirements through the use of telemedicine. Monitor HHSC’s rulemaking process.

House Bill 1501, which creates the Texas Behavioral Health Executive Council. 

Monitor the transfer of the regulation of psychologists, marriage and family therapists, professional counselors, and social workers to the new council.

House Bill 1504, which continues the Texas Medical Board until September 1, 2031. Review and identify any challenges related to the processing of complaints, including due process concerns and the independence of the Board. Make recommendations for additional modifications to address these challenges.

House Bill 3148, which establishes provisions related to the administration and oversight of investigational adult stem cell treatments. Monitor the creation of the investigational stem cell registry.

House Bill 3703, which expands eligibility for low-THC cannabis prescriptions. 

Monitor HHSC’s rulemaking process.

House Bill 4455, which authorizes a health professional to provide a mental health service via telemedicine or telehealth services to a patient located outside of Texas.

Senate Bill 21, which raises the age to purchase tobacco from 18 to 21.

Senate Bill 670, which relates to ensuring reimbursement of telemedicine and telehealth services and expanding which facilities may receive reimbursement for those services.

Related to Behavioral Health (Joint charge with Committee on Public Education)

House Bill 18, which enhances school safety and mental health resources for students and school personnel and works to reduce the stigma around mental health conditions. Monitor the process by which state agencies coordinate to implement the legislation and their compliance with various requirements, including providing required guidelines and resources to schools.

House Bill 19, which places non-physician mental health professionals at education service centers to provide resources for educators and administrators in school districts and charter schools.

House Bill 906, which creates the Collaborative Task Force on Public School Mental Health Services.

Senate Bill 11, which creates the Texas Child Mental Health Care Consortium to facilitate access to mental health care services through telehealth and expands the mental health workforce through training and funding opportunities. 

Monitor the creation of the consortium and agencies’ rulemaking processes. Review how school districts are spending their school safety allotment.

Review how Texas is preparing for state and federal budgetary changes that impact the state’s health programs, including the Family First Prevention Services Act; the next phase of the 1115 Healthcare Transformation and Quality Improvement Program Waiver; Texas’ Targeted Opioid Response Grant; the Centers for Medicare and Medicaid Services proposed Medicaid Fiscal Accountability Rule, and the Healthy Texas Women Section 1115 Demonstration Waiver. (Joint charge with the House Committee on Appropriations and the House Committee on Human Services)

Review behavioral health capacity in the state, with a focus on suicide prevention efforts and the provision of behavioral health care services to individuals with intellectual and developmental disabilities. 

Review suicide prevention programs and initiatives across state agencies, evaluate their effectiveness and identify opportunities for greater coordination. Identify gaps in the continuum of care for individuals with disabilities and challenges for those providing care to them. Additionally, identify any existing administrative and licensing barriers that negatively affect overall behavioral health capacity in the state.

Monitor the State Auditor’s review of agencies and programs under the Committee’s jurisdiction. The Chair shall seek input and periodic briefings on completed audits for the 2019 and 2020 fiscal years and bring forth pertinent issues for full committee consideration.


Professor Helene Krouse, Ph.D., RN, FAAN, and Associate Dean for Interprofessional Education (IPE) at the University of Texas Rio Grande Valley School of Medicine, on Monday, December 9, 2019, was conferred as a Fellow Ad Eundem in the Royal College of Surgeons in Ireland, Faculty of Nursing and Midwifery in Dublin, Ireland.

Krouse received this prestigious honor in recognition of her numerous accomplishments as a leader and scholar in advancing nursing knowledge, particularly otorhinolaryngology and head-neck nursing practice and research. 

Otorhinolaryngology is the medical discipline involving the assessment, diagnosis, treatment, and management of diseases, abnormalities, and other health problems affecting the ears, nose, and throat, as well as the head and neck, mouth, sinuses, and voice box (larynx).


Founded as the national training body for surgery in Ireland, the Royal College of Surgeons in Ireland has been at the forefront of healthcare education since its establishment in 1784. Today, it is an innovative, world-leading international health sciences education and research institution offering education and training at the undergraduate, postgraduate and professional level.


Krouse oversees the development and implementation of Interprofessional Education (IPE) programs throughout the School of Medicine and the UTRGV Division of Health Affairs, goals that will evolve to ever-increasing importance in the future of UTRGV and its School of Medicine.

She is a fellow of the American Academy of Nursing, a board-certified adult nurse practitioner and a certified otorhinolaryngology nurse. She earned her doctorate in educational psychology from Boston College in Massachusetts and a Master of Science in Nursing-Family Nurse Adult Practitioner Track, from the University of Rochester in New York.

Other of her credits include more than 100 publications consisting of book chapters and articles in nursing, medical- and health-related journals, and national and international prominence as an author on several clinical practice guidelines and consensus statements within the field of otolaryngology.

Krouse also has been an advocate for patient education and shared decision-making as the primary author of Plain Language Summaries in the area of Allergic Rhinitis and Cerumen Impaction.

She is a past president of the Society of Otorhinolaryngology and Head-Neck Nurses and is a fellow in the American Academy of Nursing. She also sits on the editorial boards of ORL-Head and Neck Nursing and OTO Open.

Krouse is married to John H. Krouse, MD, Executive Vice President for Health Affairs, University of Texas Rio Grande Valley and Dean, UTRGV School of Medicine.


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