(a) Each midwife who attends the birth of a child is responsible for collecting blood specimens for newborn screening tests to the extent required by the Health and Safety Code, Chapters 33 and 34, and 25 TAC §§37.51 - 37.65, or making a referral in accordance with this subsection. A midwife must not collect blood specimens for the tests without appropriate training. Each midwife must have one of the following documents on file with the department to maintain licensure.      
        (1) Midwife Training Certification Form for Newborn Screening Specimen Collection. A midwife who chooses to collect blood specimens for the newborn screening tests must first obtain training to collect blood specimens from an appropriate health care facility. Instruction must be based upon the procedure for newborn screening developed by the Department of State Health Service's Newborn Screening Program under authority of the Health and Safety Code, Chapter 33, as implemented in 25 TAC, Chapter 37, Subchapter D. At the completion of the instruction for newborn screening blood collection, the midwife must request that the form Midwife Training Certification Form for Newborn Screening Specimen Collection be signed by the designated representative of the health care facility, attesting to the fact that the midwife has complied with this requirement. This training, as part of the licensure requirements, is only necessary once unless there is a change in screening procedures. A midwife who submits to the department a completed form in compliance with this paragraph is considered approved by the department to collect blood specimens for the newborn screening tests.       
        (2) Newborn Screening Agreement for Newborn Babies of Midwife Clients. The midwife could also choose to refer the family to have the infant's screening done at an appropriate health care facility. In this case, the midwife must use the form Newborn Screening Agreement for Newborn Babies of Midwife Clients to attest to her responsibility for seeing that the screening is done and to designate a facility for such screening. The form must include a section where the facility representative signs, agreeing that the facility will do the screening.       
      (b) As long as the midwife has been approved by the department to perform the newborn screening test, the act of collecting this specimen will not constitute "practicing medicine" as defined by the Medical Practice Act.     
      (c) The physician, or other appropriately trained healthcare provider who instructs a midwife in the approved techniques for newborn screening on the orders of a physician, is immune from liability arising out of the failure or refusal of a midwife to:      
        (1) collect and submit the blood specimen in an approved manner; or       
        (2) send the samples to the laboratories designated by the Department of State Health Services in a timely manner.       
      (d) Newborn Screening Test Objection Form. A midwife must obtain a completed and signed Newborn Screening Test Objection form from any parent who refuses to allow a midwife to perform the newborn screening tests.     
     Source Note:        The provisions of this §115.120 adopted to be effective October 1, 2016, 41 TexReg 4477; amended to be effective September 1, 2023, 48 TexReg 4660