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Featured: Sen. Lois W. Kolkhorst, R-Brenham, shown here on the floor of the Texas Senate Chamber during the Spring of 2019, authored Senate Bill 750, which changed the Government Code and Health and Safety Code to require the executive commissioner of Texas Health and Human Services by rule to 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. All Valley state lawmakers voted for Senate Bill 750, which was signed into law by Gov. Greg Abbott on Monday, June 10, 2019 and went into effect immediately.   Photograph By SENATE MEDIA

Featured: Sen. Lois W. Kolkhorst, R-Brenham, shown here on the floor of the Texas Senate Chamber during the Spring of 2019, authored Senate Bill 750, which changed the Government Code and Health and Safety Code to require the executive commissioner of Texas Health and Human Services by rule to 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. All Valley state lawmakers voted for Senate Bill 750, which was signed into law by Gov. Greg Abbott on Monday, June 10, 2019, and went into effect immediately.

Photograph By SENATE MEDIA

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Valley lawmakers, led by Sen. Lucio, helped pass Senate Bill 750 to increase preventive health and family planning services for low-income women

By DAVID A. DÍAZ
[email protected]

Rio Grande Valley state legislators, led by Sen. Eddie Lucio, Jr., D-Brownsville, helped pass a new state law in 2019 to increase preventive health and family planning services for low-income women, according to DHR Health.

All Valley state lawmakers voted for Senate Bill 750, which was signed into law by Gov. Greg Abbott on Monday, June 10, 2019, and went into effect immediately.

Senate Bill 750, authored by Sen. Lois W. Kolkhorst, R-Brenham, changed the Government Code and Health and Safety Code to require the executive commissioner of Texas Health and Human Services by rule to 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. 

Healthy Texas Women is a program dedicated to offering women’s health and family planning at no cost to eligible women in Texas. These services help women plan their families, whether it is to achieve, postpone, or prevent pregnancy. They also can have a positive effect on future pregnancy planning and general health.

https://www.healthytexaswomen.org/htw-program

Senate Bill 750 was part of a package of measures that Kolkhorst said in February 2019 that were needed to continue positive gains recently made in the state’s maternal mortality rate.

The maternal mortality rate typically is deaths that occur due to complications of pregnancy or childbirth, or within six weeks after giving birth, are recorded as maternal mortality.

https://www.health.harvard.edu/blog/a-soaring-maternal-mortality-rate-what-does-it-mean-for-you-2018101614914′

“Our state is making strides in the prevention of pregnancy-related deaths, but there is more work to do. That’s why this plan brings together our hospitals, health professionals and families to develop the best practices for protecting every mother and newborn in Texas,” said Kolkhorst, who also serves as Chair of the Senate Committee on Health and Human Services.

In a February 12, 2019 news release, Kolkhorst recalled previous legislative measures that resulted in her filing Senate Bill 750 during the 86th Texas Legislature, which held its 140-day regular session from Tuesday, January 8, 2019, through Monday, May 27, 2019.

In 2017, lawmakers passed Senate Bill 17, also written by Kolkhorst, which streamlined the way Texas maintains its maternal health data and reauthorized the Maternal Mortality and Morbidity Task Force. 

To build upon that effort, Kolkhorst in 2019 filed Senate Bill 750 seeking to maximize state efforts to address maternal mortality as detailed by the Health and Human Services Commission’s report, State Efforts to Address Maternal Mortality and Morbidity in Texas.

Senate Bill 750 addresses the findings and recommendations of the Maternal Mortality and Morbidity Task Force and update Texas law to align with new federal legislation on maternal morality review committees, she said.

As the author of Senate Bill 750, Kolkhorst is the legislator who filed the bill and guided it through the legislative process (also called the primary author). The Senate allows multiple primary authors for each bill or resolution. The House of Representatives allows only one primary author, the House member whose signature appears on the original measure and on the copies filed with the chief clerk. Both chambers also have coauthors, and the House of Representatives has joint authors.

Lucio, as a co-author of Senate Bill 750, is the legislator was authorized by the primary author of a bill or resolution to join in the authorship of the measure. Both the Senate and the House of Representatives allow an unlimited number of coauthors on a bill or resolution. A coauthor must be a member of the chamber in which the bill was filed.

The sponsor of Senate Bill 750 was Rep. Angie Button, R-Richardson.  The sponsor of a bill is the legislator who guides a bill through the legislative process after the bill has passed the originating chamber. The sponsor is a member of the opposite chamber of the one in which the bill was filed.

According to the bill analysis by the House Research Organization, which is the nonpartisan research arm of the Texas House of Representatives:

Among other provisions of Senate Bill 750, including provisions requiring Health and Human Services Commission to develop or enhance statewide initiatives to improve the quality of maternal health care services and outcomes for women in Texas, Senate Bill 750 sets out requirements:

• For the Health and Human Services Commission to develop and implement enhanced prenatal services for high-risk pregnant women covered under Medicaid; 

• To evaluate postpartum care services provided to women enrolled in the Healthy Texas Women program after the first 60 days of the postpartum period. (A postpartum (or postnatal) period begins immediately after the birth of a child as the mother’s body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium or puerperal period, or immediate postpartum period are commonly used to refer to the first six weeks following childbirth – https://en.wikipedia.org/wiki/Postpartum_period);

• To develop and implement strategies to ensure the continuity of care for women who transition from Medicaid and enroll in the Healthy Texas Women program; and

• To develop and implement a postpartum depression treatment network for women enrolled in Medicaid or in the Healthy Texas Women program.

Senate Bill 750 renamed the Maternal Mortality and Morbidity Task Force as the Texas Maternal Mortality and Morbidity Review Committee and continues the review committee until September 1, 2027. Implementation of a provision of this bill by the Health and Human Services Commission is mandatory only if a specific appropriation is made for that purpose.

The House Research Organization, in its publication, “Focus Report – Major Issues of the 86 Legislature”, provided the following detailed background on Senate Bill 750. That analyses, which was published by the House Research Organization on Wednesday, December 18, 2019, follows:

Senate Bill 750 requires the Health and Human Services Commission to expand prenatal and postpartum care services for certain women enrolled in the Healthy Texas Women program, which has been operated by Health and Human Services since 2016 to expand access to preventive health and family planning services for low-income women.

Senate Bill 750 also requires the Health and Human Services Commission to assess the feasibility of providing Healthy Texas Women program services through Medicaid managed care.

Prenatal and postpartum care 

The Health and Human Services Commission, in collaboration with its contracted Medicaid, managed care organizations, must develop and implement cost-effective, evidence-based, and enhanced prenatal services for high-risk pregnant women covered under Medicaid.

It must evaluate postpartum care services provided to women enrolled in the Healthy Texas Women program after the first 60 days postpartum. Based on the evaluation, the Health and Human Services Commission must develop a limited postpartum care services package to be provided for enrolled women after the first 60 days postpartum and for up to 12 months after their date of enrollment in Healthy Texas Women.

Maternal health

Senate Bill 750 requires the Health and Human Services Commission to assess the feasibility and cost-effectiveness of providing Healthy Texas Women program services through Medicaid managed care in one or more health care service regions if the Healthy Texas Women section 1115 demonstration waiver is approved by the federal government.

Using money from available sources and in collaboration with managed care organizations and health care providers who participate in the Healthy Texas Women program, the Health and Human Services Commission must develop and implement a postpartum depression treatment network for women enrolled in Medicaid or the program.

Statewide initiatives

The Health and Human Services Commission must develop or enhance statewide initiatives to improve maternal healthcare services and outcomes for women in the state. It must specify the initiatives that each contracted managed care organization had to include in the organization’s plans.

The initiatives may address:

• Prenatal and postpartum care rates;
• Maternal health disparities for minority women and other high-risk populations of women;
• Social determinants of health, defined as environmental conditions that affect an individual’s health and quality of life; and
• Other priorities specified by the Health and Human Services Commission.

Medicaid funds

As soon as practicable, the Health and Human Services Commission must 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 pregnant women with opioid use disorder enrolled in Medicaid during the prenatal and postpartum periods and their children after birth.

Review committee 

Senate Bill 750 changes the name of the “Maternal Mortality and Morbidity Task Force” to the “Texas Maternal Mortality and Morbidity Review Committee.” For cases of severe maternal mortality that the Department of State Health Services selects for the committee to review, Senate Bill 750 establishes that requested medical records must be submitted to the department within 30 days of the request. 

Senate Bill 750 also creates an exception under which certain confidential information acquired by the Department of State Health Services (DSHS) regarding a pregnancy-related death or severe maternal morbidity could be disclosed to an appropriate federal agency for the limited purpose of complying with applicable federal requirements.

Supporters said Senate Bill 750 would help decrease maternal mortality and childhood deaths in Texas by expanding programs to serve new, low-income mothers, especially those at greatest risk of complications. Expanding prenatal and postpartum care services was a recommendation in the 2018 joint report
by the Maternal Mortality and Morbidity Task Force and the Department of State Health Services. 

Reports have indicated that preventable or treatable conditions like infections and heart disease are the leading factors contributing to maternal mortality. Identifying high-risk women and providing prenatal and postpartum care through the Healthy Texas Women program could help them to effectively manage their pregnancies and prevent worsening morbidities or potential death.

Critics said Senate Bill 750 would allocate state funds to programs that were outside the core function of government and that should be used for other budget priorities.

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For more information, please contact Roberto Haddad, Vice President and Counsel for Government Affairs and Policy at DHR Health, or Jesse Ozuna, Government Affairs Officer at DHR Health, at 956/362-7165. For more on this and other Texas legislative news stories that affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (TitansoftheTexasLegislature.com).

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