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From the 2005 Regular Session of the Texas Legislature

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	H.B. No. 1535



AN ACT



relating to the continuation and functions
of the Texas Midwifery Board.


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


SECTION 1.  Section 203.002, Occupations
Code, is amended by amending Subdivisions (3), (4),
and (6) and adding Subdivision (4-a) to read as follows:


	(3)  "Commissioner" means the commissioner
of state health services public health.


	(4)  "Department" means the Department
of State Health Services Texas Department
of Health.


	(4-a)  "Executive commissioner" means
the executive commissioner of the Health and Human
Services Commission.


	(6)  "Midwife" means a person who practices
midwifery and has met the licensing documentation
requirements established by this chapter and midwifery
board rules.


SECTION 2.  Section 203.005, Occupations
Code, is amended to read as follows:


Sec. 203.005.  EFFECT ON LOCAL ORDINANCES.
 This chapter does not prohibit a municipality from
adopting a local ordinance or rule to regulate the
practice of midwifery in the municipality if the ordinance
or rule is compatible with and at least as strict as
this chapter and midwifery board rules.


SECTION 3.  Section 203.006, Occupations
Code, is amended to read as follows:


Sec. 203.006.  APPLICATION OF SUNSET ACT.
 The midwifery board is subject to Chapter 325, Government
Code (Texas Sunset Act). Unless continued in existence
as provided by that chapter, the midwifery board is
abolished and this chapter expires September 1, 2017
2005.


SECTION 4.  Section 203.051, Occupations
Code, is amended to read as follows:


Sec. 203.051.  MIDWIFERY BOARD.  The commissioner
board shall appoint a midwifery
board that reports directly to the commissioner
board.


SECTION 5.  Section 203.052(a), Occupations
Code, is amended to read as follows:


(a)  The midwifery board consists of nine
members appointed as follows:


	(1)  five licensed three
midwife members each of whom has at least three years'
experience in the practice of midwifery and
not more than one of whom is a licensed health care
professional;


	(2)  one certified nurse-midwife
member;


	(3)  one physician member
who is certified by a national professional organization
of physicians that certifies obstetricians and gynecologists;


	(3) (4)  one
physician member who is certified by a national professional
organization of physicians that certifies family practitioners
or pediatricians; and


	(4)  two (5) three
members who represent the public and who are not practicing
or trained in a health care profession, one of whom
is a parent with at least one child born with the assistance
of a midwife.


SECTION 6.  Section 203.054, Occupations
Code, is amended to read as follows:


Sec. 203.054.  MEMBERSHIP AND EMPLOYEE
RESTRICTIONS.  (a)  In this section, "Texas trade association"
means a nonprofit, cooperative,
and voluntarily joined statewide association
of business or professional competitors in this state
designed to assist its members and its industry or
profession in dealing with mutual business or professional
problems and in promoting their common interest.


(b)  A person An officer,
employee, or paid consultant of a Texas trade association
in the field of midwifery may not be a midwifery
board member, or an employee
of the midwifery board, or a department employee
employed in a "bona fide executive, administrative,
or professional capacity," as that phrase is used for
purposes of establishing an exemption to the overtime
provisions of the federal Fair Labor Standards Act
of 1938 (29 U.S.C. Section 201 et seq.) if:


	(1)  the person is an officer, employee,
or paid consultant of a Texas trade association in
the field of health care; or


	(2)  the person's spouse is an officer,
manager, or paid consultant of a Texas trade association
in the field of health care who is exempt
from the state's position classification plan or is
compensated at or above the amount prescribed by the
General Appropriations Act for step 1, salary group
A17, of the position classification salary schedule.


(c)  A person who is the spouse
of an officer, manager, or paid consultant of a Texas
trade association in the field of midwifery may not
be a midwifery board member and may not be an employee
of the midwifery board who is exempt from the state's
position classification plan or is compensated at or
above the amount prescribed by the General Appropriations
Act for step 1, salary group A17, of the position classification
salary schedule.


(d)  A person may not
be serve as a midwifery board
member or act as the general counsel to the midwifery
board or the department if the person is required
to register as a lobbyist under Chapter 305, Government
Code, because of the person's activities for compensation
on behalf of a profession related to the operation
of the midwifery board.


SECTION 7.  Section 203.056, Occupations
Code, is amended to read as follows:


Sec. 203.056.  OFFICERS.  The commissioner
shall designate a public member of the midwifery board
as the presiding officer of the midwifery board to
serve in that capacity at the pleasure of the commissioner.
 The midwifery board shall elect one of the
public members of the midwifery board as presiding
officer and one of the other members of the
midwifery board as vice presiding officer.


SECTION 8.  Sections 203.057(a) and (c),
Occupations Code, are amended to read as follows:


(a)  It is a ground for removal from the
midwifery board that a member:


	(1)  does not have at the time of taking
office appointment the qualifications
required by Section 203.052;


	(2)  does not maintain during service on
the midwifery board the qualifications required by
Section 203.052;


	(3)  is ineligible for membership under
violates a prohibition established by
Section 203.053 or 203.054;


	(4)  cannot, because of illness or disability,
discharge the member's duties for a substantial part
of the member's term; or


	(5)  is absent from more than half of the
regularly scheduled midwifery board meetings that the
member is eligible to attend during a calendar year
without an excuse approved unless the
absence is excused by a majority vote
of the midwifery board.


(c)  If the program coordinator has knowledge
that a potential ground for removal exists, the program
coordinator shall notify the presiding officer of the
midwifery board of the potential ground.  The
presiding officer shall then notify the commissioner
that a potential ground for removal exists.  If the
potential ground for removal involves the presiding
officer, the program coordinator shall notify the next
highest ranking member of the midwifery board, who
shall then notify the commissioner The
program coordinator and presiding officer of the midwifery
board shall then notify the board that a
potential ground for removal exists.


SECTION 9.  Section 203.058, Occupations
Code, is amended to read as follows:


Sec. 203.058.  COMPENSATION;
REIMBURSEMENT.  A midwifery board member may receive
reimbursement for travel expenses as provided by the
General Appropriations Act.  A member
may not receive compensation for service on the midwifery
board.  Each member is entitled to receive $50 for
each meeting the member attends and the per diem and
travel allowance authorized for state employees.


SECTION 10.  Section 203.059(b), Occupations
Code, is amended to read as follows:


(b)  The midwifery board shall meet at
other times at the call of the midwifery board or the
commissioner board.


SECTION 11.  Subchapter B, Chapter 203,
Occupations Code, is amended by adding Section 203.060
to read as follows:


Sec. 203.060.  TRAINING.  (a)  A person
who is appointed to and qualifies for office as a member
of the midwifery board may not vote, deliberate, or
be counted as a member in attendance at a meeting of
the midwifery board until the person completes a training
program that complies with this section.


(b)  The training program must provide
the person with information regarding:


	(1)  this chapter and the programs,
functions, rules, and budget of the midwifery board;


	(2)  the results of the most recent
formal audit of the midwifery board;


	(3)  the requirements of laws relating
to open meetings, public information, administrative
procedure, and conflicts of interest; and


	(4)  any applicable ethics policies
adopted by the midwifery board or the Texas Ethics
Commission.


(c)  A person appointed to the midwifery
board is entitled to reimbursement, as provided by
the General Appropriations Act, for the travel expenses
incurred in attending the training program regardless
of whether the attendance at the program occurs before
or after the person qualifies for office.


SECTION 12.  Section 203.101, Occupations
Code, is amended to read as follows:


Sec. 203.101.  PROGRAM COORDINATOR.  The
department shall, with the approval of the
board and after consultation with the midwifery
board, employ a coordinator for the midwifery program
and the staff necessary to administer the program.


SECTION 13.  Section 203.102, Occupations
Code, is amended to read as follows:


Sec. 203.102.  DUTIES OF PROGRAM COORDINATOR.
 The program coordinator shall supervise the staff
in the performance of administrative duties, including:


	(1)  keeping the minutes of midwifery board
meetings; and


	(2)  maintaining:


		(A)  records about basic midwifery education
courses and continuing midwifery education courses;


		(B)  a roster of midwives licensed
documented under Section 203.251;
and


		(C)  a record of each person who is
licensed receives documentation
under this chapter.


SECTION 14.  The heading to Subchapter
D, Chapter 203, Occupations Code, is amended to read
as follows:







EXECUTIVE COMMISSIONER
BOARD, AND DEPARTMENT



SECTION 15.  Section 203.151, Occupations
Code, is amended to read as follows:


Sec. 203.151.  RULEMAKING AUTHORITY OF
MIDWIFERY BOARD.  (a)  Subject to the approval of the
executive commissioner board,
the midwifery board shall:


	(1)  adopt substantive and procedural rules
necessary for the licensing documentation
of midwives;


	(2)  adopt rules prescribing the standards
for the practice of midwifery in this state, including
standards for:


		(A)  the delineation of findings that preclude
a woman or newborn from being classified as having
a normal pregnancy, labor, delivery, postpartum period,
or newborn period; and


		(B)  administration of oxygen by a midwife
to a mother or newborn;


	(3)  adopt rules prescribing:


		(A)  the type of courses and number of
hours required to meet the basic midwifery education
course and continuing midwifery education course requirements;
and


		(B)  minimum standards for the approval
and revocation of approval of:


			(i)  basic midwifery education courses
and continuing midwifery education courses; and


			(ii)  instructors or facilities used in
basic midwifery education courses and continuing midwifery
education courses;


	(4)  adopt rules prescribing a procedure
for reporting and processing complaints relating to
the practice of midwifery in this state;


	(5)  adopt and implement substantive and
procedural rules as necessary to discipline midwives
determined to be in violation of this chapter or otherwise
a threat to the public health and safety;


	(6)  adopt rules as necessary to establish
eligibility for reciprocity for initial licensing
documentation under this chapter;
and


	(7)  adopt other rules necessary to implement
a duty imposed on the executive commissioner
board or the department under this
chapter.


(b)  The rules adopted under Subsection
(a)(5) must include rules relating to:


	(1)  warnings provided to midwives for
a violation of this chapter or rules adopted under
this chapter;


	(2)  agreed orders for additional education
by midwives;


	(3)  recommendations or requirements for
medical or psychological treatment, including treatment
related to substance abuse by a midwife; and


	(4)  restrictions on the practice of a
midwife, including practice limitations and the suspension
and revocation of a license documentation,
and placement of a midwife on probation.


SECTION 16.  Subchapter D, Chapter 203,
Occupations Code, is amended by adding Section 203.1515
to read as follows:


Sec. 203.1515.  RULES ON CONSEQUENCES
OF CRIMINAL CONVICTION.  (a)  Subject to the approval
of the executive commissioner, the midwifery board
shall adopt rules necessary to comply with Chapter
53.


(b)  In its proposed rules under this
section, the midwifery board shall list the specific
offenses for which a conviction would constitute grounds
for the midwifery board to take action under Section
53.021.


SECTION 17.  Section 203.152(a), Occupations
Code, is amended to read as follows:


(a)  Subject to the approval of the executive
commissioner board, the midwifery
board by rule shall establish reasonable and necessary
fees that, in the aggregate, produce sufficient revenue
to cover the costs of administering this chapter.


SECTION 18.  Sections 203.153(a)-(c), Occupations
Code, are amended to read as follows:


(a)  Subject to the approval of the department
board, the midwifery board shall
issue basic information manuals for the practice of
midwifery.  The midwifery board shall approve the basic
information manuals and instructor manuals that may
be used in basic midwifery education courses.


(b)  The department shall provide the manuals
to each licensed documented
midwife and to any other person on request.


(c)  A basic information manual must include
information about:


	(1)  the knowledge necessary to practice
as a midwife;


	(2)  the basic education and continuing
education requirements for a midwife;


	(3)  the legal requirements and procedures
relating to midwifery;


	(4)  the standards of practice as a midwife;
 and


	(5)  other information or procedures required
by the midwifery board or the department board.


SECTION 19.  Section 203.154(c), Occupations
Code, is amended to read as follows:


(c)  The Subject to the
approval of the board, the midwifery board
shall prepare and publish reports on the practice of
midwifery in this state, including statistical reporting
of infant fetal morbidity and mortality.


SECTION 20.  The heading to Section 203.156,
Occupations Code, is amended to read as follows:


Sec. 203.156.  DUTIES OF MIDWIFERY
BOARD AND DEPARTMENT.


SECTION 21.  Section 203.156(c), Occupations
Code, is amended to read as follows:


(c)  The department shall:


	(1)  establish a program for licensure
documentation as a midwife as prescribed
by midwifery board rules;


	(2)  pay the salaries of the program coordinator
and any additional staff the department determines
to be necessary; and


	(3)  provide office space and supplies
for the program coordinator and other staff.


SECTION 22.  Sections 203.157(a) and (b),
Occupations Code, are amended to read as follows:


(a)  The department shall maintain a roster
of each person licensed documented
as a midwife in this state.


(b)  The roster shall contain for each
person the information required on the licensure
documentation form under this chapter
and other information the department determines necessary
to accurately identify each licensed documented
midwife.  The information is public information as
defined by Chapter 552, Government Code.


SECTION 23.  Subchapter D, Chapter 203,
Occupations Code, is amended by adding Sections 203.158,
203.159, 203.160, and 203.161 to read as follows:


Sec. 203.158.  RULES RESTRICTING ADVERTISING
OR COMPETITIVE BIDDING.  (a)  The midwifery board may
not propose rules restricting advertising or competitive
bidding by a licensed midwife except to prohibit false,
misleading, or deceptive practices.


(b)  The midwifery board may not include
in its proposed rules to prohibit false, misleading,
or deceptive practices by a licensed midwife a rule
that:


	(1)  restricts the licensed midwife's
use of any advertising medium;


	(2)  restricts the licensed midwife's
personal appearance or use of the licensed midwife's
voice in an advertisement;


	(3)  relates to the size or duration
of an advertisement by the licensed midwife; or


	(4)  restricts the licensed midwife's
advertisement under a trade name.


Sec. 203.159.  BOARD COMMITTEES.  (a)
 The midwifery board may appoint committees to assist
the midwifery board with its functions under this chapter.


(b)  Only a member of the midwifery
board may serve as a member of a midwifery board committee.


Sec. 203.160.  USE OF TECHNOLOGY.  Subject
to the approval of the executive commissioner, the
midwifery board shall implement a policy requiring
the midwifery board to use appropriate technological
solutions to improve the midwifery board's ability
to perform its functions.  The policy must ensure that
the public is able to interact with the midwifery board
on the Internet.


Sec. 203.161.  NEGOTIATED RULEMAKING
AND ALTERNATIVE DISPUTE RESOLUTION POLICY.  (a)  Subject
to the approval of the executive commissioner, the
midwifery board shall develop and implement a policy
to encourage the use of:


	(1)  negotiated rulemaking procedures
under Chapter 2008, Government Code, for the adoption
of midwifery board rules; and


	(2)  appropriate alternative dispute
resolution procedures under Chapter 2009, Government
Code, to assist in the resolution of internal and external
disputes under the midwifery board's jurisdiction.


(b)  The midwifery board's procedures
relating to alternative dispute resolution must conform,
to the extent possible, to any model guidelines issued
by the State Office of Administrative Hearings for
the use of alternative dispute resolution by state
agencies.


(c)  The department shall designate
a trained person to:


	(1)  coordinate the implementation of
the policy adopted under Subsection (a);


	(2)  serve as a resource for any training
needed to implement the procedures for negotiated rulemaking
or alternative dispute resolution; and


	(3)  collect data concerning the effectiveness
of those procedures, as implemented by the midwifery
board.


SECTION 24.  Section 203.202, Occupations
Code, is amended by amending Subsections (c) and (d)
and adding Subsection (e) to read as follows:


(c)  The midwifery board shall maintain
a system to promptly and efficiently act on complaints
filed with the midwifery board.  The midwifery board
shall maintain:


	(1)  information about the parties to
the complaint and the subject matter of the complaint;


	(2)  a summary of the results of the
review or investigation of the complaint; and


	(3)  information about the disposition
of the complaint keep an information file
about each complaint filed with the midwifery board.


(d)  The midwifery board shall make
information available describing its procedures for
complaint investigation and resolution board's
information file shall be kept current and contain
a record for each complaint of:


	(1)  each person contacted in
relation to the complaint;


	(2)  a summary of findings made
at each step of the complaint process; and


	(3)  other relevant information.


(e)  The midwifery board shall periodically
notify the parties of the status of the complaint until
final disposition of the complaint.


SECTION 25.  Subchapter E, Chapter 203,
Occupations Code, is amended by adding Section 203.2021
to read as follows:


Sec. 203.2021.  COMPLAINT COMMITTEE.
 The midwifery board shall appoint at least one public
member of the midwifery board to any midwifery board
committee established to review a complaint filed with
the midwifery board or review an enforcement action
against a licensed midwife related to a complaint filed
with the midwifery board.


SECTION 26.  The heading to Subchapter
F, Chapter 203, Occupations Code, is amended to read
as follows:






SECTION 27.  Section 203.251, Occupations
Code, is amended to read as follows:


Sec. 203.251.  LICENSE DOCUMENTATION
REQUIRED.  (a)  A person may not practice midwifery
unless the person holds a license documentation
letter issued under this chapter.


(b)  The department shall provide a license
documentation letter to each person
who fulfills the licensing documentation
requirements.


SECTION 28.  Section 203.252, Occupations
Code, is amended to read as follows:


Sec. 203.252.  QUALIFICATIONS FOR
INITIAL LICENSE DOCUMENTATION.
 (a)  A person qualifies to become a licensed midwife
under this chapter if the person provides At
the time of initial documentation, an applicant for
documentation must provide the program coordinator
with documentary evidence that the person has:


	(1)  satisfied each requirement for basic
midwifery education; and


	(2)  passed the comprehensive midwifery
examination and jurisprudence examination required
by this chapter.


(b)  The initial license documentation
must be issued before the midwife begins to practice
midwifery and may be issued at any time during the
year.


(c)  The term of the initial license
documentation begins on the date
the requirements are met and extends through December
31 of the year in which the initial license
documentation is issued.


SECTION 29.  Section 203.253, Occupations
Code, is amended to read as follows:


Sec. 203.253.  LICENSE DOCUMENTATION
APPLICATION.  A person who practices midwifery must
apply to the department to be licensed documented
as a midwife.  The application must:


	(1)  be accompanied by a nonrefundable
application fee; and


	(2)  include information required by midwifery
board rules.


SECTION 30.  Section 203.254, Occupations
Code, is amended to read as follows:


Sec. 203.254.  BASIC MIDWIFERY EDUCATION.
 Subject to the approval of the executive commissioner
board, the midwifery board shall
establish requirements for basic midwifery education.


SECTION 31.  Section 203.255(a), Occupations
Code, is amended to read as follows:


(a)  The midwifery board, with the approval
of the executive commissioner board,
shall:


	(1)  adopt a comprehensive midwifery examination
for persons regulated under this chapter that must
be passed before the initial license may
be issued documentation; and


	(2)  establish eligibility requirements
for persons taking a comprehensive midwifery examination.


SECTION 32.  Subchapter F, Chapter 203,
Occupations Code, is amended by adding Sections 203.2555
and 203.2556 to read as follows:


Sec. 203.2555.  JURISPRUDENCE EXAMINATION.
 (a)  The midwifery board shall develop and administer
at least twice each calendar year a jurisprudence examination
to determine an applicant's knowledge of this chapter,
midwifery board rules, and any other applicable laws
of this state affecting the applicant's midwifery practice.


(b)  Subject to the approval of the
executive commissioner, the midwifery board shall adopt
rules to implement this section, including rules related
to the development and administration of the examination,
examination fees, guidelines for reexamination, grading
the examination, and providing notice of examination
results.


Sec. 203.2556.  EXAMINATION RESULTS.
 (a)  The midwifery board shall notify each examinee
of the examination results not later than the 30th
day after the date on which the examination is administered.
 If an examination is graded or reviewed by a national
testing service, the midwifery board shall notify each
examinee of the examination results not later than
the 14th day after the date the midwifery board receives
the results from the testing service.


(b)  If the notice of the examination
results graded or reviewed by a national testing service
will be delayed for more than 90 days after the examination
date, the midwifery board shall notify the examinee
of the reason for the delay before the 90th day.


(c)  The midwifery board may require
a testing service to notify an examinee of the examination
results.


(d)  If requested in writing by a person
who fails an examination administered under this chapter,
the midwifery board shall furnish the person with an
analysis of the person's performance on the examination.


SECTION 33.  The heading to Subchapter
G, Chapter 203, Occupations Code, is amended to read
as follows:






SECTION 34.  Section 203.301, Occupations
Code, is amended to read as follows:


Sec. 203.301.  APPLICATION FOR LICENSE
DOCUMENTATION RENEWAL.  An applicant
for renewal of a license under this chapter
documentation must apply biennially
annually as provided in Section
203.253.


SECTION 35.  Section 203.302, Occupations
Code, is amended to read as follows:


Sec. 203.302.  PROCEDURE LATE
APPLICATION FOR RENEWAL.  (a)  A licensed
midwife is responsible for renewing a license before
the expiration date of the license.  A person whose
license has expired may not engage in activities that
require a license until the license has been renewed.
The department may accept an application for
documentation renewal that is filed not later than
the expiration date of a grace period established by
board rule.  The grace period may not exceed the 60th
day after the expiration date of a person's documentation.


(b)  A person may renew an unexpired
license by paying the required renewal fee to the midwifery
board before the expiration date of the license
The department may charge a late filing fee
that must be paid in addition to the application fee.


(c)  A person whose license has been
expired for 90 days or less may renew the license by
paying to the midwifery board a fee that is equal to
1-1/4 times the amount of the renewal fee.


(d)  If a person's license has been
expired for more than 90 days but less than one year,
the person may renew the license by paying to the midwifery
board a fee that is equal to 1-1/2 times the amount
of the renewal fee.


(e)  A person whose license has been
expired for one year or more may not renew the license.
 The person may obtain a new license by submitting
to reexamination and complying with the requirements
and procedures for obtaining an initial license.


(f)  Not later than the 30th day before
the date a person's license is scheduled to expire,
the midwifery board shall send written notice of the
impending expiration to the person at the person's
last known address according to the records of the
midwifery board.


SECTION 36.  Section 203.303, Occupations
Code, is amended to read as follows:


Sec. 203.303.  STAGGERED RENEWAL DATES.
 (a)  The midwifery board by rule may adopt a system
under which licenses documentations
expire on various dates during the year.


 (b) For the year in which the license
documentation expiration date is
changed, license documentation
fees payable on the original expiration date shall
be prorated on a monthly basis so that each licensed
documented midwife pays only that
portion of the license documentation
fee that is allocable to the number of months during
which the license documentation
is valid.


(c)  On renewal of the license documentation
on the new expiration date, the total license
documentation renewal fee is payable.


SECTION 37.  Sections 203.304(a) and (b),
Occupations Code, are amended to read as follows:


(a)  Subject to the approval of the executive
commissioner board, the midwifery
board shall establish requirements for continuing midwifery
education, including a minimum number of hours of continuing
education required to renew a license documentation
under this chapter.


(b)  On renewal of the license documentation,
a midwife must provide the program coordinator with
evidence, acceptable under midwifery board rules,
of completion of continuing midwifery education as
prescribed by the midwifery board.


SECTION 38.  Section 203.305, Occupations
Code, is amended to read as follows:


Sec. 203.305.  REQUIRED ATTENDANCE AT SPECIFIC
MIDWIFERY EDUCATION COURSES.  The midwifery board may
assess the continuing education needs of licensed
documented midwives and may require
licensed documented midwives
to attend continuing midwifery education courses specified
by the midwifery board.


SECTION 39.  Subchapter G, Chapter 203,
Occupations Code, is amended by adding Section 203.306
to read as follows:


Sec. 203.306.  GROUNDS FOR REFUSING
RENEWAL.  The midwifery board may refuse to renew the
license of a person who fails to pay an administrative
penalty imposed under Subchapter J, unless enforcement
of the penalty is stayed or a court has ordered that
the administrative penalty is not owed.


SECTION 40.  Section 203.351(b), Occupations
Code, is amended to read as follows:


(b)  The midwifery board 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 the midwife's license
documentation expires;


	(3)  the date the midwife's cardiopulmonary
resuscitation certification expires;


	(4)  the midwife's compliance with continuing
education requirements;


	(5)  a description of medical backup arrangements;
and


	(6)  the legal responsibilities of a midwife,
including statements concerning newborn blood screening,
ophthalmia neonatorum prevention, and prohibited acts
under Sections 203.401-203.403.


SECTION 41.  Section 203.354(b), Occupations
Code, is amended to read as follows:


(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.
 Subject to the approval of the executive commissioner,
the midwifery The board 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.


SECTION 42.  Section 203.355(e), Occupations
Code, is amended to read as follows:


(e)  If available, appropriately trained
personnel from local health departments, public health
districts, and local health units shall instruct licensed
documented midwives in the approved
techniques for collecting blood specimens to be used
to perform newborn screening tests.


SECTION 43.  Section 203.356(b), Occupations
Code, is amended to read as follows:


(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 board of
compliance with this chapter.


SECTION 44.  Section 203.401, Occupations
Code, is amended to read as follows:


Sec. 203.401.  PROHIBITED PRACTICES.  A
midwife may not:


	(1)  provide midwifery care in violation
of midwifery board rule, except in an emergency that
poses an immediate threat to the life of a woman or
newborn;


	(2)  administer a prescription drug to
a client other than:


		(A)  a drug administered under the supervision
of a licensed physician in accordance with state law;


		(B)  prophylaxis approved by the department
board to prevent ophthalmia neonatorum;
or


		(C)  oxygen administered in accordance
with midwifery board rule;


	(3)  use forceps or a surgical instrument
for a procedure other than cutting the umbilical cord
or providing emergency first aid during delivery;


	(4)  remove placenta by invasive techniques;


	(5)  use a mechanical device or medicine
to advance or retard labor or delivery; or


	(6)  make on a birth certificate a false
statement or false record in violation of Section 195.003,
Health and Safety Code.


SECTION 45.  Section 203.402, Occupations
Code, is amended to read as follows:


Sec. 203.402.  PROHIBITED REPRESENTATION.
 A midwife may not:


	(1)  except as provided by Section 203.403,
use in connection with the midwife's name a title,
abbreviation, or designation tending to imply that
the midwife is a "registered" or "certified" midwife
as opposed to one who is licensed documented
under this chapter;


	(2)  advertise or represent that the midwife
is a physician or a graduate of a medical school unless
the midwife is licensed to practice medicine by the
Texas State Board of Medical Examiners;


	(3)  use advertising or an identification
statement that is false, misleading, or deceptive;
or


	(4)  except as authorized by rules adopted
by the Board of Nurse Examiners, use in combination
with the term "midwife" the term "nurse" or another
title, initial, or designation that implies that the
midwife is licensed as a registered nurse or vocational
nurse.


SECTION 46.  Section 203.404, Occupations
Code, is amended to read as follows:


Sec. 203.404.  GROUNDS FOR DISCIPLINARY
ACTION.  (a)  The midwifery board may discipline a
licensed documented midwife,
refuse to renew a midwife's license, or and
may refuse to issue a license letter
of documentation to an applicant if the
person who:


	(1)  violates this chapter or a rule adopted
under this chapter;


	(2)  submits false or misleading information
to the midwifery board, the board,
or the department;


	(3)  is convicted of a misdemeanor involving
moral turpitude or a felony;


	(4)  uses alcohol or drugs intemperately;


	(5)  engages in unprofessional or dishonorable
conduct that may reasonably be determined to deceive
or defraud the public;


	(6)  is unable to practice midwifery with
reasonable skill and safety because of illness, disability,
or psychological impairment;


	(7)  is determined by a court judgment
to be mentally impaired;


	(8)  submits a birth or death certificate
known by the person to be false or fraudulent or engages
in another act that violates Title 3, Health and Safety
Code, or a rule adopted under that title;


	(9)  violates Chapter 244, Health and Safety
Code, or a rule adopted under that chapter; or


	(10)  fails to practice midwifery in a
manner consistent with the public health and safety.


(b)  The midwifery board may discipline
a licensed documented midwife
and may refuse to issue a license letter
of documentation to an applicant for a disciplinary
action taken by another jurisdiction that affects the
person's authority to practice midwifery, including
a suspension, a revocation, or another action.


SECTION 47.  Sections 203.405(a) and (b),
Occupations Code, are amended to read as follows:


(a)  The midwifery board or a three-member
committee of midwifery board members designated by
the midwifery board shall temporarily suspend the license
letter of documentation of a licensed
documented midwife if the midwifery
board or committee determines from the evidence or
information presented to it that continued practice
by the licensed documented
midwife would constitute a continuing and imminent
threat to the public welfare.


(b)  A license letter of
documentation may be suspended under this
section without notice or hearing on the complaint
if:


	(1)  action is taken to initiate proceedings
for a hearing before the State Office of Administrative
Hearings simultaneously with the temporary suspension;
and


	(2)  a hearing is held as soon as practicable
under this chapter and Chapter 2001, Government Code.


SECTION 48.  Subchapter I, Chapter 203,
Occupations Code, is amended by adding Section 203.406
to read as follows:


Sec. 203.406.  REFUND.  (a)  Subject
to Subsection (b), the midwifery board may order a
licensed midwife to pay a refund to a consumer as provided
in an agreement resulting from an informal settlement
conference instead of or in addition to imposing an
administrative penalty under this chapter.


(b)  The amount of a refund ordered
as provided in an agreement resulting from an informal
settlement conference may not exceed the amount the
consumer paid to the licensed midwife for a service
regulated by this chapter.  The midwifery board may
not require payment of other damages or estimate harm
in a refund order.


SECTION 49.  Section 203.452(a), Occupations
Code, is amended to read as follows:


(a)  The amount of the administrative penalty
may not exceed $5,000 $1,000
for each violation.  Each day a violation continues
is a separate violation.


SECTION 50.  Section 203.501(a), Occupations
Code, is amended to read as follows:


(a)  A person is liable for a civil penalty
if the person is required to be licensed documented
under this chapter and the person knowingly or intentionally
practices midwifery:


	(1)  without a license documentation
or while the license documentation
is suspended or revoked; or


	(2)  in violation of a midwifery board
order.


SECTION 51.  Section 203.504(a), Occupations
Code, is amended to read as follows:


(a)  A person commits an offense if the
person is required to be licensed documented
under this chapter and the person knowingly practices
midwifery without a license documentation.


SECTION 52.  Subchapter K, Chapter 203,
Occupations Code, is amended by adding Section 203.505
to read as follows:


Sec. 203.505.  CEASE AND DESIST ORDER.
 (a)  If it appears to the midwifery board that a person
who is not licensed under this chapter is violating
this chapter, a rule adopted under this chapter, or
another state statute or rule relating to the practice
of midwifery, the midwifery board after notice and
opportunity for a hearing may issue a cease and desist
order prohibiting the person from engaging in the activity.


(b)  A violation of an order under this
section constitutes grounds for imposing an administrative
penalty under Subchapter J.


SECTION 53.  Section 157.004(c), Occupations
Code, is amended to read as follows:


(c)  A physician who issues a standing
delegation order to a midwife under Chapter 203 is
not liable in connection with an act performed under
that standing delegation order if the midwife provides
proof of licensure documentation
under that chapter before the order is issued.


SECTION 54.  Section 483.001(13), Health
and Safety Code, is amended to read as follows:


	(13)  "Prescription" means an order from
a practitioner, or an agent of the practitioner designated
in writing as authorized to communicate prescriptions,
or an order made in accordance with Subchapter B, Chapter
157, Occupations Code, or Section 203.353, Occupations
Code, to a pharmacist for a dangerous drug to be dispensed
that states:


		(A)  the date of the order's issue;


		(B)  the name and address of the patient;


		(C)  if the drug is prescribed for an animal,
the species of the animal;


		(D)  the name and quantity of the drug
prescribed;


		(E)  the directions for the use of the
drug;


		(F)  the intended use of the drug unless
the practitioner determines the furnishing of this
information is not in the best interest of the patient;


		(G)  the name, address, and telephone number
of the practitioner at the practitioner's usual place
of business, legibly printed or stamped; and


		(H)  the name, address, and telephone number
of the licensed documented
midwife, registered nurse, or physician assistant,
legibly printed or stamped, if signed by a licensed
documented midwife, registered nurse,
or physician assistant.


SECTION 55.  Section 483.041(c), Health
and Safety Code, is amended to read as follows:


(c)  Subsection (a) does not apply to the
possession of a dangerous drug in the usual course
of business or practice or in the performance of official
duties by the following persons or an agent or employee
of the person:


	(1)  a pharmacy licensed by the board;


	(2)  a practitioner;


	(3)  a person who obtains a dangerous drug
for lawful research, teaching, or testing, but not
for resale;


	(4)  a hospital that obtains a dangerous
drug for lawful administration by a practitioner;


	(5)  an officer or employee of the federal,
state, or local government;


	(6)  a manufacturer or wholesaler licensed
by the Department of State Health Services commissioner
of health under Chapter 431 (Texas Food,
Drug, and Cosmetic Act);


	(7)  a carrier or warehouseman;


	(8)  a home and community support services
agency licensed under and acting in accordance with
Chapter 142;


	(9)  a licensed documented
midwife who obtains oxygen for administration to a
mother or newborn or who obtains a dangerous drug for
the administration of prophylaxis to a newborn for
the prevention of ophthalmia neonatorum in accordance
with Section 203.353, Occupations Code; or


	(10)  a salvage broker or salvage operator
licensed under Chapter 432.


SECTION 56.  The following sections are
repealed:


	(1)  Section 203.002(1), Occupations Code;
and


	(2)  Section 203.156(a), Occupations Code.


SECTION 57.  (a)  Not later than January
1, 2006, the Texas Midwifery Board shall:


	(1)  adopt the policies required by Sections
203.160 and 203.161, Occupations Code, as added by
this Act; and


	(2)  adopt the rules required by Chapter
203, Occupations Code, as amended by this Act.


(b)  Not later than March 1, 2006, the
Texas Midwifery Board shall develop the jurisprudence
examination required by Section 203.2555, Occupations
Code, as added by this Act.


SECTION 58.  (a)  The changes in law made
by Section 203.052, Occupations Code, as amended by
this Act, regarding the composition of the Texas Midwifery
Board do not affect the entitlement of a member serving
on the board immediately before September 1, 2005,
to continue to serve and function as a member of the
board for the remainder of the member's term.  Members
appointed to fill vacancies on the board occurring
on or after the effective date of this Act must be
appointed in accordance with Section 203.052(a), Occupations
Code, as amended by this Act.


(b)  The changes in law made by Sections
203.052, 203.054, and 203.057, Occupations Code, as
amended by this Act, and Section 203.060, Occupations
Code, as added by this Act, regarding the prohibitions
on or qualifications of members of the Texas Midwifery
Board do not affect the entitlement of a member serving
on the board immediately before September 1, 2005,
to continue to serve and function as a member of the
board for the remainder of the member's term.  The
changes in law made by those sections apply only to
a member appointed on or after September 1, 2005.


(c)  The changes in law made by this Act
related to the filing or investigation of a complaint
under Chapter 203, Occupations Code, as amended by
this Act, apply only to a complaint filed with the
Texas Midwifery Board on or after the effective date
of this Act.  A complaint filed before the effective
date of this Act is governed by the law as it existed
immediately before that date, and the former law is
continued in effect for that purpose.


(d)  The changes in law made by this Act
governing the eligibility of a person for a license
under Chapter 203, Occupations Code, apply only to
an application for a license filed with the Texas Midwifery
Board under Chapter 203, Occupations Code, as amended
by this Act, on or after the effective date of this
Act.  An application for documentation as a midwife
filed before the effective date of this Act is governed
by the law in effect at the time the application was
filed, and the former law is continued in effect for
that purpose.


(e)  The change in law made by this Act
with respect to conduct that is grounds for imposition
of a disciplinary sanction, including a refund or cease
and desist order, applies only to conduct that occurs
on or after the effective date of this Act.  Conduct
that occurs before the effective date of this Act is
governed by the law in effect on the date the conduct
occurred, and the former law is continued in effect
for that purpose.


(f)  The changes in law made by Section
203.252(a), Occupations Code, as amended by this Act,
and Section 203.2555, Occupations Code, as added by
this Act, regarding the jurisprudence examination,
apply only to an application for a license filed with
the Texas Midwifery Board under Chapter 203, Occupations
Code, as amended by this Act, on or after September
1, 2006.


SECTION 59.  Notwithstanding Section 203.302,
Occupations Code, as amended by this Act, the fees
for an applicant renewing an expired license or documentation
letter under Chapter 203, Occupations Code, before
September 1, 2007, is governed by the law in effect
immediately before the effective date of this Act,
and the former law is continued in effect for that
purpose.  An applicant who renews an expired license
or documentation letter under Chapter 203, Occupations
Code, on or after September 1, 2007, is subject to
the fees provided by Section 203.302, Occupations Code,
as amended by this Act.


SECTION 60.  This Act takes effect September
1, 2005.




______________________________	______________________________


   President of the Senate	Speaker of the
House      


I certify that H.B. No. 1535 was passed
by the House on May 10, 2005, by a non-record vote.



______________________________




Chief Clerk of the
House   



I certify that H.B. No. 1535 was passed
by the Senate on May 25, 2005, by the following vote:
 Yeas 31, Nays 0.



______________________________




Secretary of the Senate
   



APPROVED:  _____________________


                    Date          


           _____________________


                  Governor