Law:Title 3. Health Professions. Subtitle C. Other Professions Performing Medical Procedures from Chapter 203. Midwives (Texas)

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Subtitle C. Other Professions Performing Medical Procedures

Contents

Chapter 203. Midwives

Subchapter A. General Provisions

Section  203.001.  Short Title.

This chapter may be cited as the Texas Midwifery Act.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.002.  Definitions.

In this chapter:

(1)  Repealed by Acts 2005, 79th Leg., Ch. 1240, Sec. 56(1), eff. September 1, 2005.

(2)  "Certified nurse-midwife" means a person who is:

(A)  a registered nurse under Chapter 301;

(B)  recognized as an advanced nurse practitioner by the Texas Board of Nursing; and

(C)  certified by the American College of Nurse-Midwives.

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

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

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

(5)  "Local health department" means a department of health created by the governing body of a municipality or a county under Section 121.031, Health and Safety Code.

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

(7)  "Midwifery" means the practice of:

(A)  providing the necessary supervision, care, and advice to a woman during normal pregnancy, labor, and the postpartum period;

(B)  conducting a normal delivery of a child; and

(C)  providing normal newborn care.

(8)  "Newborn" means an infant from birth through the first six weeks of life.

(9)  "Normal" means, as applied to pregnancy, labor, delivery, the postpartum period, and the newborn period, and as defined by midwifery board rule, circumstances under which a midwife has determined that a client is at a low risk of developing complications.

(10)  "Postpartum period" means the first six weeks after a woman has given birth.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 1, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch. 1240, Sec. 56(1), eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch. 889, Sec. 35, eff. September 1, 2007.



Section  203.003.  Findings.

The legislature finds:

(1)  a parent has the responsibility and right to give birth where and with whom the parent chooses;

(2)  childbirth is a natural process of the human body and not a disease; and

(3)  midwifery has been practiced in this state since the days of the Republic.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.004.  Applicability.

This chapter does not apply to:

(1)  a certified nurse-midwife, a physician, or another health care professional licensed by the state and operating within the scope of the person's license;

(2)  a natural childbirth trainer; or

(3)  a person other than a midwife who assists childbirth in an emergency.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 2, eff. September 1, 2005.



Section 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 3, eff. September 1, 2005.



Subchapter B. Midwifery Board

Section 203.051.  Midwifery Board.

The commissioner shall appoint a midwifery board that reports directly to the commissioner.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 4, eff. September 1, 2005.



Section  203.052.  Appointment Of Midwifery Board.

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

(1)  five licensed midwife members each of whom has at least three years' experience in the practice of midwifery;

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

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

(4)  two 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.

(b)  Appointments to the midwifery board shall be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointee.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 5, eff. September 1, 2005.



Section  203.053.  Eligibility Of Public Members.

A person is not eligible for appointment as a public member of the midwifery board if the person or the person's spouse:

(1)  is registered, certified, or licensed by an occupational regulatory agency in the field of midwifery;

(2)  is employed by or participates in the management of a business entity or other organization regulated by the midwifery board or receiving funds from the midwifery board;

(3)  owns or controls, directly or indirectly, more than a 10 percent interest in a business entity or other organization regulated by or receiving funds from the midwifery board; or

(4)  uses or receives a substantial amount of tangible goods, services, or funds from the midwifery board, other than compensation or reimbursement authorized by law for midwifery board membership, attendance, or expenses.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section 203.054.  Membership And Employee Restrictions.

(a) In this section, "Texas trade association" means a 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 may not be a midwifery board member, 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.

(c)   A person may not be 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 6, eff. September 1, 2005.



Section  203.055.  Terms.

Members of the midwifery board serve for staggered terms of six years. The terms of three members expire on January 31 of each odd-numbered year.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section 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 other members of the midwifery board as vice presiding officer.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 7, eff. September 1, 2005.



Section  203.057.  Grounds For Removal.

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

(1)  does not have at the time of taking office 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 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 by a majority vote of the midwifery board.

(b)  The validity of an action of the midwifery board is not affected by the fact that it is taken when a ground for removal of a midwifery board member exists.

(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 that a potential ground for removal exists.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 8, eff. September 1, 2005.



Section 203.058.  Reimbursement.

A midwifery board member may receive reimbursement for travel expenses as provided by the General Appropriations Act.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 9, eff. September 1, 2005.



Section  203.059.  Meetings.

(a) The midwifery board shall meet at least semiannually.

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

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 10, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 11, eff. September 1, 2005.



Subchapter C. Program Coordinator And Personnel

Section 203.101.  Program Coordinator.

The department shall, after consultation with the midwifery board, employ a coordinator for the midwifery program and the staff necessary to administer the program.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 12, eff. September 1, 2005.



Section 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 under Section 203.251; and

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

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 13, eff. September 1, 2005.



Section  203.103.  Division Of Responsibilities.

The midwifery board shall develop and implement policies that clearly define the respective responsibilities of the midwifery board and the staff of the midwifery board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.104.  Equal Employment Opportunity Policy; Report.

(a) The program coordinator or the program coordinator's designee shall prepare and maintain a written policy statement to ensure implementation of an equal employment opportunity program under which all personnel transactions are made without regard to race, color, disability, sex, religion, age, or national origin. The policy statement must include:

(1)  personnel policies, including policies related to recruitment, evaluation, selection, application, training, and promotion of personnel that are in compliance with Chapter 21, Labor Code;

(2)  a comprehensive analysis of the midwifery board workforce that meets federal and state guidelines;

(3)  procedures by which a determination can be made of significant underuse in the midwifery board workforce of all persons for whom federal or state guidelines encourage a more equitable balance; and

(4)  reasonable methods to appropriately address those areas of underuse.

(b)  A policy statement prepared under Subsection (a) must:

(1)  cover an annual period;

(2)  be updated annually;

(3)  be reviewed by the Commission on Human Rights for compliance with Subsection (a)(1); and

(4)  be filed with the governor.

(c)  The governor shall deliver a biennial report to the legislature based on the information received under Subsection (b). The report may be made separately or as a part of another biennial report made to the legislature.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Subchapter D. Powers And Duties Of Midwifery Board, Executive Commissioner, And Department

Section 203.151.  Rulemaking Authority Of Midwifery Board.

(a) Subject to the approval of the executive commissioner, the midwifery board shall:

(1)  adopt substantive and procedural rules necessary for the licensing 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 under this chapter; and

(7)  adopt other rules necessary to implement a duty imposed on the executive commissioner 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, and placement of a midwife on probation.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 15, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 16, eff. September 1, 2005.



Section  203.152.  Fees.

(a) Subject to the approval of the executive commissioner, 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.

(b)  The midwifery board may not set a fee for an amount less than the amount of that fee on September 1, 1993.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 17, eff. September 1, 2005.



Section  203.153.  Manuals.

(a) Subject to the approval of the department, 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 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.

(d)  The department may charge a fee for each manual not to exceed $10. The department shall make the manual available in English and Spanish.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 18, eff. September 1, 2005.



Section  203.154.  Annual Report; Reports On Midwifery.

(a) The department shall file annually with the governor and the presiding officer of each house of the legislature a complete and detailed written report accounting for all funds received and distributed by the midwifery board during the preceding fiscal year.

(b)  The report under Subsection (a) must be in the form and reported in the time provided by the General Appropriations Act.

(c)  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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 19, eff. September 1, 2005.



Section  203.155.  Complaint Procedure And Investigation.

(a) The midwifery board shall adopt rules concerning the investigation of a complaint filed with the midwifery board.

(b)  The rules adopted under Subsection (a) must:

(1)  distinguish among categories of complaints;

(2)  ensure that a person who files a complaint has an opportunity to explain the allegations made in the complaint; and

(3)  provide for the release of any relevant midwifery or medical record to the midwifery board, without the necessity of consent by the midwife's client, as necessary to conduct an investigation of a complaint.

(c)  The midwifery board by rule shall:

(1)  adopt a form to standardize information concerning complaints made to the midwifery board; and

(2)  prescribe information to be provided to a person when the person files a complaint with the midwifery board.

(d)  The midwifery board shall provide reasonable assistance to a person who wishes to file a complaint with the midwifery board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section 203.156.  Duties Of Midwifery Board And Department.

(a) Repealed by Acts 2005, 79th Leg., Ch. 1240, Sec. 56(2), eff. September 1, 2005.

(b)  The department, with the recommendation of the midwifery board, shall:

(1)  implement rules governing:

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

(B)  approval of instructors or facilities used in offering basic midwifery education courses and continuing midwifery education courses;

(2)  prepare and distribute basic midwifery information and instructor manuals; and

(3)  enter into agreements necessary to carry out this chapter.

(c)  The department shall:

(1)  establish a program for licensure 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 20, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch. 1240, Sec. 21, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch. 1240, Sec. 56(2), eff. September 1, 2005.



Section  203.157.  Roster; Notice To County Officials.

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

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

(c)  The department shall provide each county clerk and each local registrar of births in a county with the name of each midwife practicing in the county.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 22, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 23, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 23, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 23, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 23, eff. September 1, 2005.



Subchapter E. Public Interest Information And Complaint Procedures

Section  203.201.  Public Interest Information.

(a) The midwifery board shall prepare information of public interest describing the functions of the midwifery board and the procedures by which complaints are filed with and resolved by the midwifery board.

(b)  The midwifery board shall make the information available to the public and appropriate state agencies.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.202.  Complaints.

(a) The midwifery board by rule shall establish methods by which consumers and service recipients are notified of the name, mailing address, and telephone number of the midwifery board for the purpose of directing complaints to the midwifery board. The midwifery board may provide for that notice:

(1)  on each registration form, application, or disclosure and informed consent form of a person regulated by the midwifery board;

(2)  on a sign prominently displayed in the place of business of each person regulated by the midwifery board; or

(3)  in a bill for service provided by a person regulated by the midwifery board.

(b)  The midwifery board shall list with its regular telephone number the toll-free telephone number established under other state law that may be called to present a complaint about a health professional.

(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.

(d)  The midwifery board shall make information available describing its procedures for complaint investigation and resolution.

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

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 24, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 25, eff. September 1, 2005.



Section  203.203.  Public Participation.

(a) The midwifery board shall develop and implement policies that provide the public with a reasonable opportunity to appear before the midwifery board and to speak on any issue under the midwifery board's jurisdiction.

(b)  The midwifery board shall prepare and maintain a written plan that describes how a person who does not speak English may be provided reasonable access to the midwifery board's programs.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Subchapter F. Licensure Requirements

Section 203.251.  License Required.

(a) A person may not practice midwifery unless the person holds a license issued under this chapter.

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

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 27, eff. September 1, 2005.



Section 203.252.  Qualifications For Initial License.

(a) A person qualifies to become a licensed midwife under this chapter if the person provides 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 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 begins on the date the requirements are met and extends through December 31 of the year in which the initial license is issued.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 28, eff. September 1, 2005.



Section 203.253.  License Application.

A person who practices midwifery must apply to the department to be licensed as a midwife.  The application must:

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

(2)  include information required by midwifery board rules.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 29, eff. September 1, 2005.



Section 203.254.  Basic Midwifery Education.

Subject to the approval of the executive commissioner, the midwifery board shall establish requirements for basic midwifery education.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 30, eff. September 1, 2005.



Section  203.255.  Examination.

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

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

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

(b)  The midwifery board shall have an independent testing professional validate any written portion of the examination.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 31, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 32, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 32, eff. September 1, 2005.



Section  203.256.  Training In Newborn Screening And Basic Life Support Cardiopulmonary Resuscitation.

A person who practices midwifery in this state must provide the program coordinator with satisfactory evidence that the person:

(1)  is trained to perform the newborn screening tests under Section 203.354 or has made arrangements for the performance of those tests; and

(2)  holds:

(A)  a current certificate issued by the American Heart Association in basic life support cardiopulmonary resuscitation; or

(B)  another form of certification acceptable to the department that demonstrates proficiency in basic life support cardiopulmonary resuscitation for adults and children.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Subchapter G. License Renewal

Section 203.301.  Application For License Renewal. An

applicant for renewal of a license under this chapter must apply biennially as provided in Section 203.253.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 34, eff. September 1, 2005.



Section 203.302.  Procedure 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.

(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.

(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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 35, eff. September 1, 2005.



Section 203.303.  Staggered Renewal Dates.

(a) The midwifery board by rule may adopt a system under which licenses expire on various dates during the year.

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

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

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 36, eff. September 1, 2005.



Section  203.304.  Continuing Midwifery Education.

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

(b)  On renewal of the license, 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.

(c)  The midwifery board by rule shall develop a process to evaluate and approve continuing education courses.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 37, eff. September 1, 2005.



Section 203.305.  Required Attendance At Specific Midwifery Education Courses.

The midwifery board may assess the continuing education needs of licensed midwives and may require licensed midwives to attend continuing midwifery education courses specified by the midwifery board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 38, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 39, eff. September 1, 2005.



Subchapter H. Practice By Midwife

Section  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 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 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.

(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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 40, eff. September 1, 2005.



Section  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 midwifery board 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.353.  Prevention Of Ophthalmia Neonatorum.

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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  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.  Subject to the approval of the executive commissioner, the midwifery 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.

(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, Sec. 41, eff. September 1, 2005.



Section  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 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, Sec. 42, eff. September 1, 2005.



Section  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 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, Sec. 43, eff. September 1, 2005.



Section  203.357.  Additional Information Required.

(a) The midwifery board 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 midwifery board may not require information regarding any act that is prohibited under this chapter.

(b)  With the approval of the midwifery board, 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.



Subchapter I. Prohibited Practices And Grounds For Disciplinary Action

Section 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 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 44, eff. September 1, 2005.



Section 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 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 Medical Board;

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

(4)  except as authorized by rules adopted by the Texas Board of Nursing, 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2003, 78th Leg., ch. 553, Sec. 2.015, eff. Feb. 1, 2004.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 45, eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch. 889, Sec. 36, eff. September 1, 2007.



Section  203.403.  Prohibited Use Of Title.

(a) A midwife certified by the North American Registry of Midwives who uses "certified" as part of the midwife's title in an identification statement or advertisement must include in the statement or advertisement a statement that the midwife is certified by the North American Registry of Midwives.

(b)  A midwife may not use an identification statement or advertisement that would lead a reasonable person to believe that the midwife is certified by a governmental entity.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section 203.404.  Grounds For Disciplinary Action.

(a) The midwifery board may discipline a licensed midwife, refuse to renew a midwife's license, or refuse to issue a license to an applicant if the person:

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

(2)  submits false or misleading information to the midwifery 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 midwife and may refuse to issue a license 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.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 46, eff. September 1, 2005.



Section  203.405.  Emergency Suspension.

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

(b)  A license 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.

(c)  The State Office of Administrative Hearings shall hold a preliminary hearing not later than the 14th day after the date of the temporary suspension to determine if there is probable cause to believe that a continuing and imminent threat to the public welfare still exists. A final hearing on the matter shall be held not later than the 61st day after the date of the temporary suspension.

Added by Acts 2003, 78th Leg., ch. 326, Sec. 1, eff. Sept. 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 47, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 48, eff. September 1, 2005.



Subchapter J. Administrative Penalty

Section  203.451.  Imposition Of Administrative Penalty.

The midwifery board may impose an administrative penalty on a person who violates this chapter or a rule adopted under this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.452.  Amount Of Administrative Penalty.

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

(b)  The amount shall be based on:

(1)  the seriousness of the violation;

(2)  the history of previous violations;

(3)  the amount necessary to deter a future violation;

(4)  efforts made to correct the violation; and

(5)  any other matter that justice may require.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 49, eff. September 1, 2005.



Section  203.453.  Notice Of Violation And Penalty.

(a) If, after investigation of a possible violation and the facts surrounding that possible violation, the midwifery board or its designee determines that a violation has occurred, the midwifery board or its designee shall give written notice of the violation to the person alleged to have committed the violation.

(b)  The notice must:

(1)  include a brief summary of the alleged violation;

(2)  state the amount of the proposed administrative penalty; and

(3)  inform the person of the person's right to a hearing on the occurrence of the violation, the amount of the penalty, or both.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.454.  Penalty To Be Paid Or Hearing Requested.

(a) Not later than the 20th day after the date the person receives the notice under Section 203.453, the person may:

(1)  accept the midwifery board or its designee's determination and the proposed administrative penalty; or

(2)  make a written request for a hearing on that determination.

(b)  If the person accepts the midwifery board or its designee's determination, the midwifery board by order shall approve the determination and require the person to pay the proposed penalty.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.455.  Hearing.

(a) If the person timely requests a hearing, the midwifery board or its designee shall set a hearing and give written notice of the hearing to the person. The midwifery board or its designee may employ a hearings examiner for this purpose.

(b)  The hearings examiner shall make findings of fact and conclusions of law and promptly issue to the midwifery board a proposal for decision as to the occurrence of the violation and the amount of the proposed administrative penalty.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.456.  Decision By Midwifery Board.

(a) Based on the findings of fact, conclusions of law, and proposal for decision, the midwifery board by order may determine that:

(1)  a violation has occurred and impose an administrative penalty; or

(2)  a violation did not occur.

(b)  The midwifery board shall give notice of the midwifery board's order to the person. The notice must include:

(1)  separate statements of the findings of fact and conclusions of law;

(2)  the amount of any penalty assessed; and

(3)  a statement of the right of the person to judicial review of the midwifery board's order.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.457.  Options Following Decision: Pay Or Appeal.

(a) Not later than the 30th day after the date the midwifery board's order becomes final, the person shall:

(1)  pay the administrative penalty;

(2)  pay the penalty and file a petition for judicial review contesting the fact of the violation, the amount of the penalty, or both; or

(3)  without paying the penalty, file a petition for judicial review contesting the fact of the violation, the amount of the penalty, or both.

(b)  Within the 30-day period, a person who acts under Subsection (a)(3) may:

(1)  stay enforcement of the penalty by:

(A)  paying the penalty to the court for placement in an escrow account; or

(B)  giving to the court a supersedeas bond that is approved by the court and that:

(i)  is for the amount of the penalty; and

(ii)  is effective until judicial review of the order is final; or

(2)  request the court to stay enforcement of the penalty by:

(A)  filing with the court a sworn affidavit of the person stating that the person is financially unable to pay the amount of the penalty and is financially unable to give the supersedeas bond; and

(B)  giving a copy of the affidavit to the midwifery board by certified mail.

(c)  If the midwifery board receives a copy of an affidavit under Subsection (b)(2), the midwifery board may file with the court a contest to the affidavit not later than the fifth day after the date the copy is received.

(d)  The court shall hold a hearing on the facts alleged in the affidavit as soon as practicable and shall stay the enforcement of the penalty on finding that the alleged facts are true. The person who files an affidavit has the burden of proving that the person is financially unable to pay the penalty and to give a supersedeas bond.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.458.  Collection Of Penalty.

(a) If the person on whom the administrative penalty is imposed does not comply with Section 203.457, the penalty may be collected.

(b)  The midwifery board may assess reasonable expenses and costs against a person in an administrative hearing if, as a result of the hearing, an administrative penalty is assessed against the person. The person shall pay expenses and costs assessed under this subsection not later than the 30th day after the date the order of the midwifery board requiring the payment of expenses and costs is final. The midwifery board may refer the matter to the attorney general for collection of the expenses and costs.

(c)  If the attorney general brings an action against a person to enforce an administrative penalty assessed under this chapter and the person is found liable for an administrative penalty, the attorney general may recover, on behalf of the attorney general, the midwifery board, and the department, reasonable expenses and costs.

(d)  In this section, reasonable expenses and costs includes expenses incurred by the department, the midwifery board, and the attorney general in the investigation, initiation, or prosecution of an action, including reasonable investigative costs, court costs, attorney's fees, witness fees, and deposition expenses.

(e)  Costs and expenses collected under this section shall be deposited in the state treasury to the credit of a special account that may be appropriated only to the department. Section 403.095, Government Code, does not apply to the account.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.459.  Determination By Court.

(a) If a court sustains the determination that a violation occurred, the court may uphold or reduce the amount of the administrative penalty and order the person to pay the full or reduced penalty.

(b)  If the court does not sustain the determination that a violation occurred, the court shall order that a penalty is not owed.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.460.  Remittance Of Penalty And Interest.

(a) If, after judicial review, the administrative penalty is reduced or not imposed by the court, the court shall:

(1)  order the midwifery board to remit to the person the appropriate amount, plus accrued interest, if the person paid the penalty; or

(2)  order the release of the bond in full if the penalty is not imposed or order the release of the bond after the person pays the penalty imposed if the person posted a supersedeas bond.

(b)  The interest paid under Subsection (a)(1) is accrued at the rate charged on loans to depository institutions by the New York Federal Reserve Bank. The interest shall be paid for the period beginning on the date the penalty is paid and ending on the date the penalty is remitted.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.461.  Administrative Procedure.

A proceeding under this subchapter to impose an administrative penalty is subject to Chapter 2001, Government Code.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Subchapter K. Other Penalties And Enforcement Provisions

Section  203.501.  Civil Penalty.

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

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

(2)  in violation of a midwifery board order.

(b)  A civil penalty under this section may not exceed $250 for each violation. Each day of violation may constitute a separate violation for purposes of penalty assessment. In determining the amount of the penalty, the court shall consider:

(1)  the person's history of previous violations;

(2)  the seriousness of the violation;

(3)  any hazard to the health and safety of the public; and

(4)  the demonstrated good faith of the person charged.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 50, eff. September 1, 2005.



Section  203.502.  Injunctions.

(a) In this section, "health authority" means a physician who administers state and local laws regulating public health under Chapter 121, Health and Safety Code.

(b)  If the commissioner or a health authority determines that a person has violated this chapter and that the violation creates an immediate threat to the health and safety of the public, the commissioner or the health authority, with the concurrence of the commissioner, may request the attorney general or a district, county, or city attorney to bring an action in a district court for a restraining order to restrain the violation.

(c)  If a person has violated this chapter, the commissioner or a health authority, with the concurrence of the commissioner, may bring an action in a district court for an injunction to prohibit the person from continuing the violation.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.503.  Venue.

(a) Venue for a civil action brought under Section 203.451 or 203.452 is in the county in which the defendant resides or in the county in which the violation occurred.

(b)  Venue for the civil action may be changed only after a good faith effort has been made to address the violation in the county in which venue is proper.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.



Section  203.504.  Criminal Penalty.

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

(b)  An offense under this section is a Class C misdemeanor.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 1240, Sec. 51, eff. September 1, 2005.



Section 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.

Added by Acts 2005, 79th Leg., Ch. 1240, Sec. 52, eff. September 1, 2005.


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