Dr. Emily Briggs led the meeting, since Chairman Eugene Toy was not able to attend. The advisory committee held a public meeting to discuss the following agenda items:
Letter Recommendations from Chairman Toy
- Formation of the Rural and Family Medicine Subcommittee chaired by Dr. Briggs
- Subcommittee would provide a more comprehensive view to the council
- Two rural representatives as proposed by TORCH and two representatives as proposed by the Texas Academy of Family Physicians – two nursing representatives were also added to list
- Subcommittee was adopted
- Formation of the General Ob/Gyn Physicians in Private Practice Subcommittee chaired by Dr. Toy
- Subcommittee would provide input from the realm of generalist obstetricians, particularly those in private practice and in medium/smaller communities
- Two general Ob/Gyn physicians as proposed by the American Congress of Ob/Gyns and two nursing representatives (one of the nurses to be a certified midwife) – specifically from small, rural areas
- Clarification of the legislative intent of the Perinatal Advisory Council regarding HB 15
- The Perinatal Advisory Council is specifically tasked to define minimal standards for neonatal and maternity care in all levels, to coordinate care without dictating referral patterns, and to encourage care for pregnant women and newborns
- Consideration in developing Texas specific standards
- National maternity standards should not simply be adopted too blindly or quickly
- Propose “some” and not all of the nationally published standards and concentrate on those that are indisputably associated with better outcomes for upcoming designation deadline of 2019
Maternal Levels of Care
- Texas’ mortality rate is higher than the national average according to Vital Statistics – attention must be paid to pregnant women
- Pregnancy-related death identification in Texas is rising
- 145 deaths in 2011; 150 in 2012
- There is a shocking racial disparity in maternal mortality rates in Texas – especially in black and Hispanic women
- 67.3% of black women compared to 13.7% of white women in 2011
- Prenatal care and obesity show significant relations with severe morbidity
- Advisory council should place more emphasis on providing mothers with prenatal care, but the greatest challenge is communicating with pregnant mothers to seek care
- (Baylor) interested in reducing number of late term deliveries by placing stricter guidelines on C-sections
- Vital Statistics will provide more in-depth studies within the next two years to analyze causes and solutions
Status of Draft Rules proposed for Neonatal Levels of Care
5/28 HHSC 1ST review
6/17 SHSC Work Session – open to the public
6/18 SHSC Meeting
Jane Guerrero, Director, EMS and Trauma Systems Coordination Office
- Budget will be finalized once surveyor organization – surveyors will not be state employees
- Estimate of 200+ hospitals to be surveyed every three years – not a feasible goal
- Potential for hospitals to be designated on a first-come, first-serve basis based on completing the application
- Hospital might be placed on Level II for one year and then re-enroll for Level III for three years
- If there are noticeable concerns at one of these facilities, the state has the right to step in at any time
- Discrepancy within the room on data outcome collection – several stakeholders wanted to establish a unified data collection registry while others wanted hospitals to continue using databases already set in place
- Consensus that universal data points would create additional burden on hospitals – surveyor organization must distinctly clarify definitions when collecting data across varying databases
- HB 15 designation programs – estimated 250 hospital provide Ob/Gyn services
- Designation fee to the state every three years – could be pro-rated in the beginning and does not include fee of the surveyor organization
- Level I – small (<100 beds) $250; large (>100 beds) $750
- Level II – $1500
- Level III – $2000
- Level IV – $3000
- Designation fee to the state every three years – could be pro-rated in the beginning and does not include fee of the surveyor organization
Next meeting will be June 1.