September 1, 2013, Part 2

Me & My OBGAugust 30, 2013Articles

As we mentioned last week, on September 1, 2013 almost 700 bills passed during the regular session of the 83rd Legislature will take effect. Here we spotlight other new laws that will have a direct impact on Texas women and their health: the good, the bad, and the ugly.

HB 15 – Hospital Level of Care Designations for Neonatal and Maternal Care

House Bill (HB) 15, by Rep. Lois Kolkhorst and sponsored by Sen. Jane Nelson establishes a uniform statewide system for neonatal and maternal levels of care based on national practices.

  • The Good
    Mandating standards based on national best practices should improve the quality of care, decrease the number of premature births, and reduce infant and maternal mortality. Additionally, improved data collection will allow the Department of Social and Health Services (DSHS) to better evaluate changes in health outcomes.
  • The Bad
    In 2010, 51% of very low birth weight infants were not born in a hospital with an adequate level of care, putting Texas in the bottom 5% of the country on this quality measure.
  • The Ugly
    Very low birth weight infants who are not born at the appropriate hospital are about 1.5 times more likely to die than infants born in appropriate hospitals. Texas’ maternal mortality rate is also higher than the national average.

HB 1605 – Harris County Pregnancy Home Pilot Program

HB 1605 by Rep. Sarah Davis and sponsored by Sen. Joan Huffman creates a pilot program in Harris County to provide a pregnancy home and maternity care management to women enrolled in the Medicaid managed care program.

  • The Good
    A pregnancy medical home for a patient ensures coordinated access to a variety of medical services needed to provide comprehensive prenatal and postpartum care—increasing the number of healthy pregnancies.Each pilot program participant is assessed to determine whether her pregnancy is considered high- or low-risk; an individual pregnancy care plan is established for each participant based on the assessment; and the maternity management team follows the participant throughout her pregnancy in order to reduce poor birth outcomes.
  • The Bad
    Texas has many underserved populations within the state’s health care system. Pregnant women represent a significant percentage of the underserved. In Texas, only 50% of pregnant women get prenatal care early.
  • The Ugly
    Women lacking access to regular prenatal care and postpartum care often present in emergency rooms and deliver babies who need the NICU. Texas has seen a rise in utilization of emergency rooms by pregnant women.

HB 2620 – Domestic Violence Task Force

HB 2620 by Rep. Nicole Collier and sponsored by Sen. Bob Deuell creates a health systems response to domestic violence among pregnant and post-partum women.

  • The Good
    HB 2620 establishes a task force to examine and address the impact of domestic violence on the health of women and children during the perinatal period through the first two years of life. Pregnancy presents a unique opportunity for repeated contact with health care providers—for this reason, pregnancy can be an important and ideal window of opportunity for violence prevention and intervention.
  • The Bad
    Pregnant women are at nearly twice the risk of experiencing domestic violence.
  • The Ugly
    Physical trauma that stems from domestic violence perpetrated against the mother can result in many harmful fetal outcomes, including miscarriage, stillborn babies, preterm labor and delivery, direct fetal injury, fetal hemorrhage, and placental abruption.

These bills have great potential to improve women’s health in Texas. But they are all just a first step. We’ll need your help in the weeks and months ahead to help us monitor these initiatives and to keep advocating strongly for more progress on health care delivery for Texas women.

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