Newborn Genetic Screening
| Human Cloning/Stem Cell Research |
TMA Council on Cardiovascular Disease and Stroke |
Statewide Stroke System |
Medical Science Near Miss
Newborn Genetic Screening
HB 790 by Rep. Myra Crownover (R-Denton) and Sen. Jane Nelson
(R-Lewisville) requires the Texas Department of State Health
Services (DSHS) to conduct a study by March 1, 2006, to determine
the most cost-effective method of conducting newborn screening
(including screening for disorders listed in the core uniform panel
of newborn screening conditions recommended in the 2005 report by
the American College of Medical Genetics (ACMG) titled, Newborn
Screening: Toward a Uniform Screening Panel and System); and to
maximize the number of newborn screenings that may be conducted
with the funding available for the screening. By Oct. 1, 2005, DSHS
shall review and study the National Newborn Screening and Genetics
Resource Center's assessment of the screening program in this
state. DSHS must file a written report of the study's results and
conclusions with the governor's office by March 1, 2006. DSHS may
adjust the amounts charged for newborn screening fees, including
fees assessed for follow-up services, tracking confirmatory
testing, and diagnosis. No later than Nov. 1, 2006, DSHS shall
implement the expanded program using the most cost-effective
methods. TMA's major concerns were to ensure the ACMG report would
be the basis for expansion and that the state infrastructure be
shored up prior to actually expanding the screening. The Texas
Pediatrics Society joined TMA in lobbying for those aspects and
supplying legislators with several iterations of substitute
legislation language.
Human Cloning/Stem Cell Research
Thirteen bills were filed this session relating to human cloning
and/or stem cell research. None passed. TMA policy supports stem
cell research, including embryonic, umbilical cord blood, and adult
stem cells. Filed bills were a mixed lot, with some promoting
scientific research while banning human cloning; others would have
greatly restricted Texas' health science centers from conducting
promising medical research in this area. Given the intense state
and national interest in stem cell research, this issue will remain
a hot legislative topic and surely will be revisited in 2007.
Cloning/Stem Cell Bills TMA Supported
HB 1929 by Rep. Beverly Woolley (R-Houston) and its companion SB
1733 by Sen. Eliot Shapleigh (D-El Paso) defined "human cloning,"
"human somatic cell," "nuclear transplantation," "nucleus,"
"oocyte," "regenerative or reparative medial therapy or treatment,"
and "unfertilized blastocyst." Both bills specifically prohibited
human cloning and prohibited a person from maintaining unfertilized
blastocyst
for more than 14 days. Penalties were named, and research was
required to have Institutional Review Board oversight. The bills
would have established an advisory committee on research to develop
regenerative or reparative medical therapies or treatments, under
the authority of the HHSC commissioner. TMA supported these bills
because they did not restrict scientific research, including
nuclear transplantation, in order to develop regenerative or
reparative medical therapies or treatments. The bills mandated
committee adoption of research guidelines by June, 2006. Neither
bill passed.
HB 2948 by Reps. David Swinford (R-Dumas) would have prohibited
human cloning and the shipping of the product of nuclear
transplantation for the purpose of cloning, exporting unfertilized
blastocysts to a foreign country that does not prohibit cloning,
and conducting nuclear transplantation on fertilized eggs. Included
was wording for protection of research involving nuclear
transplantation. Unfertilized blastocysts could not be maintained
for more than 14 days. Oocytes used in nuclear transplant were
required to be donated voluntarily, and nuclear transplantation
could not be done in a laboratory in which human oocytes are
subject to assisted reproductive technological treatments or
procedures. Civil penalties were named. HB 2948 did not pass.
SB 128 by Senator Shapleigh prohibited human cloning, but
specifically stated that it would not restrict or prohibit
scientific research, including nuclear transplantation, to develop
regenerative or reparative medical therapies or treatments. This
bill did not pass.
Cloning/Stem Cell Bills TMA Opposed
HB 864 by Rep. Phil King defined "embryo," "fetus," "human
cloning," "oocyte," and "somatic cell." "Human cloning" was defined
to eliminate all forms of embryonic stem cell research. The bill
prohibited 1) attempting or performing human cloning; 2)
participating in an attempt; 3) shipping/transferring a human
embryo or fetus produced by human cloning and/or receiving such: 4)
shipping, transferring, receiving (wholly or partially) any oocyte,
embryo, fetus, or human somatic cell for the purpose of human
cloning; 5) and performing research on a human embryo or fetus
created by human cloning. Another concern: The description of what
was
not
restricted regarding scientific research was left open, which
could be problematic. HB 864 did not pass.
HB 2081 by Rep. Ken Paxton (R-McKinney) would have prohibited
the use of state money for embryonic stem cell research or for
supporting research involving the destruction of human embryos.
HB 2311 by Rep. Charlie Howard (R-Sugar Land) would have
prohibited transfer of an embryo except in an adoption proceeding.
The bill required the legal process of adoption for an embryo to be
transferred to anyone besides the persons contributing genetic
material for an embryo. SB 943 by Sen. Ken Armbrister (D-Victoria)
and several bipartisan cosponsors was very similar to HB 864. TMA
opposed the bill as it would have eliminated all human embryonic
stem cell research. None of these bills passed.
TMA Council on Cardiovascular Disease and Stroke
HB 2344 by Rep. Vilma Luna (D-Corpus Christi) and Sen. Royce
West (D-Dallas) will elevate the TMA Council on Cardiovascular
Disease and Stroke to the same standing and visibility of other
chronic disease councils, like those on diabetes and cancer. The
bill will expand the council's powers and duties so the council
will be much better equipped to fulfill its mission of education,
awareness, and action among Texans to reduce the human and
financial toll of cardiovascular disease and stroke (CVD).
The bill amended the appointment process and composition in two
ways: granting appointment powers to the governor, and
reconstituting the 11-member council to mandate specific
appointments, including licensed physicians specializing in
cardiology, neurology, and primary care. Furthermore, the bill
empowers the council to specifically address primary and secondary
prevention of CVD and stroke and women's heart health, in addition
to the establishment of two fiscal accounts. The Heart Disease and
Stroke Resource Fund, which will receive gifts, grants, and
legislative appropriations, and the Heart Disease and Stroke
"You're the Cure" Account, which will be maintained by the council
outside the state treasury and will receive gifts, grants, and
donations. The council will be required to make written
recommendations to the HHSC and the legislature for performing its
duties. The council also may advise the legislature on legislation
that is needed to further develop and maintain a statewide system
of quality education services for all persons with CVD or stroke,
as well as develop and submit legislation or comment on pending
legislation that affects persons with CVD and stroke.
Statewide Stroke System
SB 330 by Sen. Bob Deuell (R-Greenville) and Rep. Jim McReynolds
(D-Lufkin) establishes an emergency transport system for stroke
victims. The goal of SB 330, which was developed by the Texas
Chapter of the American Heart/Stroke Association, is to quickly
identify and transport patients to appropriate stroke treatment
facilities, including designated stroke facilities if indicated.
TMA supported the intent of the bill, but expressed numerous
concerns about it. Over the course of the session, TMA worked with
the bill sponsors to amend the bill to prevent statutory references
to specific clinical guidelines and protocols and to deemphasize
creation of designated stroke centers. Many physicians objected to
the state sanctioning specific stroke centers, raising concerns
about bypassing other equally qualified facilities, inadequacy of
physician workforce to meet the needs of designated centers, and
liability issues. Many physicians also raised clinical concerns
regarding the safety of some stroke treatments.
The bill directs the Governor's EMS and Trauma Council (GETAC)
to appoint a stroke committee no later than Jan. 1, 2006, and
to help develop a statewide stroke emergency transport plan by Jan.
1, 2007. The plan is to be submitted to the governor, lieutenant
governor, speaker of the house of representatives, and executive
commissioner of the Texas Health and Human Services Commission. The
bill sets forth requirements for composition of the stroke
committee, which must include licensed physicians specializing in
vascular neurology, interventional radiology, neurosurgery, and
emergency medicine; a member of the Texas Council on Cardiovascular
Disease and Stroke who has expertise in stroke care; a registered
nurse with stroke care expertise; and a representative of the
American Stroke Association, Texas Chapter.
SB 330 requires GETAC, with the assistance of the stroke
committee and in collaboration with the Texas Council on
Cardiovascular Disease and Stroke, to develop a statewide stroke
emergency transport plan, and to consult the criteria for stroke
facilities established by national medical organizations (such as
the Joint Commission on Accreditation of Healthcare Organizations)
when developing the stroke emergency transport plan. The stroke
emergency transport plan must include:
- Training requirements on stroke recognition and treatment,
including emergency screening procedures;
- A list of appropriate early treatments to stabilize
patients;
- Protocols for rapid transport to a stroke facility when rapid
transport is appropriate and it is safe to bypass another health
care facility; and
- Plans for coordination with statewide agencies or committees
on programs for stroke prevention and community education
regarding stroke and stroke emergency transport.
The bill defines "stroke facility" as a health care facility
that is capable of primary or comprehensive treatment of stroke
victims; is part of an emergency medical services and trauma care
system; has a health care professional available 24/7 who is
knowledgeable about stroke care and capable of carrying out acute
stroke therapy; and records patient treatment and outcomes.
Medical Science Near Miss
Medicinal Marijuana
HB 658 by Rep. Elliott Naishtat (D-Austin) would have provided an
affirmative defense to prosecution if a practitioner licensed to
practice medicine in this state recommended marijuana for the
amelioration of the symptoms or effects of a bona fide medical
condition.
Medical Science TMA Staff Contacts:
- Hilary Dennis, Legislative Affairs, (512) 370-1370
- Yvonne Barton, Legislative Affairs, (512) 370-1359
- Barbara James, RN, Science and Quality, (512) 370-1400
- C.J. Francisco, JD, Office of the General Counsel, (512)
370-1339
Overview
|
Tax Reform
|
Scope of Practice
|
Physician Ownership
|
Inadequate Health Plan Networks
(Balanced Billing)
|
Managed Care/Insurance Reform
|
Texas State Board of Medical
Examiners Sunset and Physician Licensure
|
Agency Sunset Review
|
Corporate Practice of Medicine
|
Health Care Funding
|
Medicaid and CHIP
|
Indigent Care and the
Uninsured
|
Workers' Compensation
|
Professional Liability Reform
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Medical Education/Workforce
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Child Health, Safety, and
Nutrition/Fitness
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Public Health
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Border Health
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Rural Health
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Mental Health
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Trauma/EMS
|
Prescription Drugs
|
Long-Term Care
|
Abortion
|
Transplantation/Organ Donation
|
Table of Contents