TMA Legislative Hotline: Governor Signs Tobacco 21 Bill
By Jennifer Perkins



Less than one week remains for the governor to sign or veto bills. Below is a list of several pieces of legislation important to medicine that have been signed into law since the end of the legislative session last month.

Sunday, June 16 is the deadline for Gov. Greg Abbott to sign or veto bills.

Tobacco and Cancer

Senate Bill 21 by Sen. Joan Huffman (R-Houston) will raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military. The Texas Medical Association and public health advocates have been pushing this legislation for several sessions.

Dallas-based public health physician John Carlo, MD, who chairs the Texas Public Health Coalition and also serves on the TMA Council on Legislation, described the need for SB 21 this way: “Something had to be done when 28,000 Texans die each year from tobacco use, and TMA and the Texas Public Health Coalition are thrilled that Sen. Joan Huffman and Rep. John Zerwas, MD, persisted and refused to give up on our state’s young people. Since almost all adult smokers got hooked before they were 21, we are grateful this law will save lives and prevent suffering.” 

SB 21 was signed by the governor June 7 and takes effect Sept. 1, 2019.

Preventing Opioid Use Disorder in Pregnant and Postpartum Women

Senate Bill 436 by Sen. Jane Nelson (R-Flower Mound) directs the Department of State Health Services (DSHS) to develop and implement initiatives to assist pregnant and postpartum women with opioid-use disorder and newborns with neonatal abstinence syndrome. This bill is specifically referring to the TexasAIM Opioid Bundle that evolved out of the Maternal Mortality and Morbidity Task Force

SB 436 authorizes DSHS to conduct a pilot program to implement TexasAIM Opioid Bundle initiatives at hospitals that have expertise in caring for newborns with neonatal abstinence syndrome or related conditions. 

The bill will help health care professionals refer women to appropriate treatment, increase access to medication-assisted treatment, and prevent opioid-use disorder by reducing amounts of opioids provided prenatally and postpartum. 

SB 436 was signed by the governor and took effect June 7.


House Bill 3041 by Rep. Chris Turner (D-Grand Prairie) will allow a prior authorization to be renewed if it expires before the patient receives the medical service or procedure. Typically, health plans require the review process to begin anew after a prior authorization expires, and approval is not guaranteed. HB 3041 will prevent patients from being caught in limbo between prior authorizations, potentially negatively affecting their health. Patients with chronic diseases in particular will be helped by HB 3041 with the elimination of lag time between prior authorizations. HB 3041 was signed by the governor June 7 and takes effect Sept. 1.

Mental Health

Senate Bill 11 by Sen. Larry Taylor (R-Friendswood) is the school safety bill, intended to reduce the likelihood of school violence, reduce security threats, secure educational facilities, and make mental health resources available to schools. Components of the bill include:

  • Ensuring that school building standards provide a secure and safe school environment;
  • Training teachers how to safely respond in an emergency; and
  • Establishing the Texas Child Psychiatry Access Network (CPAN), giving pediatricians and other primary care physicians ready access to a network of psychiatrists and other licensed behavioral health professionals. 

The majority of behavioral health issues in children first become apparent during primary care visits. CPAN will help pediatricians and other primary care physicians find trained health care professionals, including child and adolescent psychiatrists, to help meet the behavioral health needs of Texas’ youth. Children younger than 18 years must have parental consent to receive any mental health care services.

SB 11 was signed by the governor and took effect June 6.

Public Health/Long-Term Care

Senate Bill 384, by Senator Nelson, will require all health care facilities to report health care-affiliated infections. This will strengthen infection-control programs in both acute and long-term care facilities, helping to prevent the thousands of preventable deaths that occur annually. 

State inspections of Texas nursing homes found the No. 1 deficiency was infection and lack of disease control. Requiring health care facilities to report outbreaks to DSHS in a timely manner will significantly improve the odds of containing infections. 

SB 384 was signed by the governor June 7 and takes effect Sept. 1. 

Graduate Medical Education/Workforce

 House Bill 80 by Rep. Lina Ortega (D-El Paso) will direct the Texas Higher Education Coordinating Board (THECB) to conduct a study and develop an inventory of existing doctoral-level health science education programs. THECB, in collaboration with the Texas Health Professions Resource Center, the Texas Center for Nursing Workforce Studies, and the Texas Demographic Center, will issue a report to the legislature with recommendations for establishing new programs and for expanding existing ones. The study and recommendations are due Dec. 1, 2023.  

Texas ranks 47th in the number of practicing primary care physicians, and rural areas are particularly underserved. The HB 80 study will help identify the health care deserts and provide guidance on ameliorating the disparity across the state.

HB 80 was signed by the governor and took effect June 2.


Senate Bill 500 by Sen. Jane Nelson (R-Flower Mound) is the supplemental spending bill to backfill deficits in the 2018-19 biennial budget. The $9.3 billion bill includes $4.3 billion from the Economic Stabilization Fund (ESF), or Rainy Day Fund. SB 500 provides $2.1 billion to fill a gap in the state’s Medicaid program, which lawmakers intentionally underfunded in 2017. It also appropriates money to the Texas State Board of Pharmacy to integrate the prescription monitoring program into physicians electronic health records. 

If you have a question about a specific bill from this legislative session, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 


Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the interim session.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador.

Last Updated On

June 11, 2019

Originally Published On

June 11, 2019

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