(a) The committee. The Maternal Mortality and Morbidity Review Committee (MMMRC) is appointed under and governed by this subchapter. The MMMRC is established under Texas Health and Safety Code (THSC) §§34.001 - 34.018.(b) Purpose. The MMMRC studies cases of pregnancy-related deaths and trends in severe maternal morbidity and makes recommendations to reduce the incidence of pregnancy-related deaths and severe maternal morbidity in Texas.(c) Tasks. The MMMRC:(1) studies and reviews:(A) cases of pregnancy-related deaths;(B) trends, rates, or disparities in pregnancy-related deaths and severe maternal morbidity;(C) health conditions and factors that disproportionately affect the most at-risk populations as determined in the joint biennial report required under THSC §34.015; and(D) best practices and programs operating in states with reduced rates of pregnancy-related deaths;(2) compares rates of pregnancy-related deaths based on the socioeconomic status of the mother;(3) determines the feasibility of the MMMRC studying severe maternal morbidity cases;(4) in consultation with the Perinatal Advisory Council, makes recommendations reducing the incidence of pregnancy-related deaths and severe maternal morbidity in this state; and(5) adopts bylaws guiding MMMRC operations.(d) Reporting requirements. No later than September 1 of each even-numbered year, the MMMRC and the Texas Department of State Health Services (DSHS) must submit a joint biennial written report to the Governor, Lieutenant Governor, Speaker of the House of Representatives, and appropriate committees of the Texas Legislature.(1) The report must include:(A) MMMRC findings related to the study and review of cases and trends in pregnancy-related deaths and severe maternal morbidity in this state; and(B) policy recommendations made to the Texas Health and Human Services Commission (HHSC) Executive Commissioner reducing the incidence of pregnancy-related deaths and severe maternal morbidity.(2) DSHS must send the report to state professional associations and organizations listed in THSC §34.006(b).(e) Composition.(1) The MMMRC is composed of 23 members.(2) Twenty-one voting members appointed by the DSHS Commissioner include:(A) four physicians specializing in obstetrics, at least one of whom is a maternal fetal medicine specialist;(B) one certified nurse-midwife;(C) one registered nurse;(D) one nurse specializing in labor and delivery;(E) one physician specializing in family practice;(F) one physician specializing in psychiatry;(G) one physician specializing in pathology;(H) one epidemiologist, biostatistician, or researcher of pregnancy-related deaths;(I) one social worker or social service provider;(J) two community members with experience in a relevant health care field, including a field involving the analysis of health care data, one of whom must represent an urban area of this state and one of whom must represent a rural area of this state;(K) one medical examiner or coroner responsible for recording deaths;(L) one physician specializing in critical care;(M) one physician specializing in emergency care;(N) one physician specializing in cardiology;(O) one physician specializing in anesthesiology;(P) one physician specializing in oncology; and(Q) one representative of a managed care organization.(3) Two voting ex-officio members include:(A) a DSHS representative from the Community Health Improvement Division and(B) the state epidemiologist for DSHS or the epidemiologist's designee.(4) In appointing members to the MMMRC, the DSHS Commissioner:(A) includes members working in and representing diverse communities with regard to race, ethnicity, immigration status, and English proficiency;(B) includes members from differing geographic regions in the state, including both rural and urban areas;(C) endeavors to include members working in and representing communities affected by pregnancy-related deaths and severe maternal morbidity and a lack of access to relevant perinatal and intrapartum care services; and(D) ensures the composition of the MMMRC reflects the racial, ethnic, and linguistic diversity of Texas.(5) Terms of office.(A) MMMRC members are appointed for staggered six-year terms, with one-third or as near as possible to one-third of the MMMRC members' terms expiring February 1st of each odd-numbered year. Regardless of the term limit, an MMMRC member serves until a replacement has been appointed. This guarantees sufficient and appropriate MMMRC member representation.(B) Exceptions may be necessary to stagger terms so the term of each member is six years. An MMMRC member may apply to serve more than one term.(C) If a vacancy occurs, the DSHS Commissioner will appoint a person to serve the unexpired portion of a term.(f) Officers. The DSHS Commissioner appoints from among the MMMRC members a presiding officer.(1) The presiding officer presides at all MMMRC meetings at which he or she is in attendance, calls meetings in accordance with this section, appoints subcommittees of the MMMRC as necessary, and ensures proper reports to the HHSC Executive Commissioner. The presiding officer may serve as an ex officio member of any MMMRC subcommittee.(2) The MMMRC may reference the presiding officer by another term, such as chairperson.(g) Meetings. The MMMRC meets at least quarterly to conduct business, or at the call of the DSHS Commissioner.(1) Meeting arrangements are made by DSHS staff.(2) The MMMRC is subject to the Open Meetings Act, Texas Government Code Chapter 551, except when the MMMRC conducts a closed meeting to review cases under THSC §34.007. Meetings may be conducted in person, through teleconference call, or by means of other technology.(3) A simple majority of the appointed MMMRC members, identified in subsection (e)(2) and (3) of this section, constitutes a quorum for the purpose of transacting official business.(4) The MMMRC is authorized to conduct business only when in a legally constituted meeting with a quorum present.(5) The agenda for each MMMRC meeting must include an opportunity for new business or for any member to address the MMMRC on matters relating to MMMRC business.(6) The MMMRC must allow for public comment during at least one public meeting each year.(7) The MMMRC must present in open session recommendations made under THSC §34.005, reducing the incidence of pregnancy-related deaths and severe maternal morbidity in this state.(8) The MMMRC must post public notice for meetings conducted for the sole purpose of reviewing cases for selection under THSC §34.007.(h) Attendance. Members must attend MMMRC meetings as scheduled.(1) An MMMRC member must notify the presiding officer or appropriate DSHS staff if unable to attend a scheduled meeting.(2) It is grounds for removal from the MMMRC if an MMMRC member cannot conduct MMMRC member duties for a substantial part of the term for which the MMMRC member is appointed because of illness or disability, is absent from more than half of the MMMRC meetings during a calendar year, or is absent from at least three consecutive MMMRC meetings.(3) The validity of an action of the MMMRC is not affected by the fact that it is taken when grounds for removal of a member exists.(i) Staff. Staff support for the MMMRC is provided by DSHS staff.(j) Confidentiality.(1) Any information pertaining to a pregnancy-related death or severe maternal morbidity is confidential.(2) Confidential information acquired by DSHS, including identifying information of an individual or health care provider, is confidential and may not be disclosed to any person.(3) Information is not confidential under this section if the information is general information that cannot be connected with any specific individual, case, or health care provider.(4) The MMMRC may publish statistical studies and research reports based on confidential information under this section, provided the information:(A) is published in the aggregate;(B) does not identify a patient or the patient's family;(C) does not include any information that could be used to identify a patient or the patient's family; and(D) does not identify a health care provider.(5) DSHS will adopt and implement practices and procedures confirming confidential information is not disclosed in violation of state and federal confidentiality laws.(6) As required by THSC §34.009, information held by DSHS or the MMMRC pertaining to pregnancy-related death or severe maternal morbidity is confidential and not subject to disclosure under the Public Information Act, Texas Government Code Chapter 552.(7) The MMMRC and DSHS must comply with all state and federal laws and rules relating to the transmission of health information, including the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted under that Act.(k) Statements by members.(1) HHSC, DSHS, and the MMMRC are not bound in any way by any statement, recommendation, or action on the part of any MMMRC member, except when a statement or action is in pursuit of specific instructions from HHSC, DSHS, or the MMMRC.(2) The MMMRC and MMMRC members may not participate in legislative activity in the name of HHSC, DSHS, or the MMMRC except with approval through the DSHS legislative process. MMMRC members are not prohibited from representing themselves or other entities in the legislative process.(3) An MMMRC member must not accept or solicit any benefit that might reasonably influence the member in the conduct of the member's official duties.(4) An MMMRC member must not disclose confidential information acquired through MMMRC membership.(5) An MMMRC member must not knowingly solicit, accept, or agree to accept any benefit for having exercised the member's official powers or duties in favor of another person.(6) An MMMRC member with a personal or private interest in a matter pending before the MMMRC must publicly disclose the fact in an MMMRC meeting and may not vote or otherwise participate in the matter. The phrase "personal or private interest" means the MMMRC member has a direct monetary interest in the matter but does not include the MMMRC member's engagement in a profession, trade, or occupation when the member's interest is the same as all others similarly engaged in the profession, trade, or occupation.(l) Required Training. Each MMMRC member must complete training on relevant statutes and rules; Texas Government Code Chapters 551, 552, and 2110; the Health and Human Services (HHS) Ethics Policy; the Advisory Committee Member Code of Conduct; and other relevant HHS policies. DSHS will provide the training.(m) Travel Reimbursement.(1) Unless permitted by the current General Appropriations Act, MMMRC members are not paid to participate in the MMMRC nor reimbursed for travel to and from meetings.(2) In carrying out duties, the MMMRC may use technology, including teleconferencing or videoconferencing, to eliminate travel expenses.(n) Sunset Provision. The MMMRC is subject to Texas Government Code Chapter 325 (Texas Sunset Act). Unless continued in existence as provided by that chapter, the MMMRC is abolished and this subchapter expires September 1, 2027.