STATE OF NEW YORK ________________________________________________________________________ 6529 2019-2020 Regular Sessions IN SENATE June 14, 2019 ___________ Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the public health law, in relation to the maternal mortality review board The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 2509 of the public health law, as added by a chap- 2 ter of the laws of 2019, amending the public health law relating to 3 maternal mortality review boards and the maternal mortality and morbidi- 4 ty advisory council, as proposed in legislative bills numbers A.3276 and 5 S.1819, is amended to read as follows: 6 § 2509. Maternal mortality review board. 1. (a) There is hereby estab- 7 lished in the department the maternal mortality review board for the 8 purpose of reviewing maternal deaths and maternal morbidity and develop- 9 ing and disseminating findings, recommendations, and best practices to 10 contribute to the prevention of maternal mortality and morbidity. The 11 board shall assess the cause of death, factors leading to death and 12 preventability for each maternal death reviewed and, in the discretion 13 of the board, cases of severe maternal morbidity, and shall develop and 14 disseminate strategies for reducing the risk of maternal mortality and 15 morbidity, including risk resulting from racial, economic, or other 16 disparities. The commissioner may delegate the authority to conduct 17 maternal mortality reviews. 18 (b) The commissioner may enter into an agreement with the city of New 19 York providing: 20 (i) that the functions of the state board relating to maternal deaths 21 and severe maternal morbidity occurring within the city of New York 22 shall be conducted by the city board; 23 (ii) the city board shall provide to the state board the results of 24 its reviews, relevant information in the possession of the city board, 25 and the recommendations of the city board; and EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00490-03-9

S. 6529 2 1 (iii) the department and the state board shall provide information and 2 assistance to the city board for the performance of its functions. 3 (c) Nothing in this section shall prevent the city of New York from 4 establishing, without an agreement with the commissioner, a board relat- 5 ing to maternal deaths and severe maternal morbidity occurring within 6 the city of New York. 7 2. As used in this section, unless the context requires otherwise: 8 (a) "Advisory council" and "council" mean the advisory council on 9 maternal mortality and morbidity, established under this section. 10 (b) "Board" means a maternal mortality review board established by 11 this section, referred to in this section as the "state board", or a 12 board operating under this section established by the city of New York, 13 with or without an agreement with the commissioner, referred to in this 14 section as the "city board". 15 (c) "Maternal death" means the death of a woman during pregnancy or 16 within a year from the end of pregnancy. 17 (d) "Severe maternal morbidity" or "morbidity" means unexpected 18 outcomes of pregnancy, labor, or delivery that result in significant 19 short- or long-term consequences to a woman's health. 20 (e) "City commissioner" means the commissioner of the New York city 21 department of health and mental hygiene. 22 3. (a) The members of the state board shall be comprised of multidis- 23 ciplinary experts in the field of maternal mortality, women's health and 24 public health, and shall include health care professionals or other 25 experts who serve and are representative of the racial, ethnic, and 26 socioeconomic diversity of the women and mothers [in] of the state and, 27 to the extent possible, the medically underserved areas of the state or 28 areas of the state with disproportionately high occurrences of maternal 29 mortality or morbidity. 30 (b) The state board shall be composed of at least fifteen members, all 31 of whom shall be appointed by the commissioner. 32 (c) The terms of the state board members shall be three years. The 33 commissioner may choose to reappoint state board members to additional 34 three year terms. 35 (d) A majority of the appointed membership of the state board, no less 36 than three, shall constitute a quorum. 37 (e) When any member of the state board fails to attend three consec- 38 utive regular meetings, unless such absence is for good cause, that 39 membership may be deemed vacant for purposes of the appointment of a 40 successor. 41 (f) Meetings of the state board shall be held at least twice a year 42 but may be held more frequently as deemed necessary, subject to request 43 of the department. 44 (g) Members of the state and city boards shall be indemnified under 45 section seventeen of the public officers law or section fifty-k of the 46 general municipal law, as the case may be. 47 (h) Members of the state board shall not be compensated for their 48 participation on the board but shall receive reimbursement for their 49 ordinary and necessary expenses of participation. 50 (i) Membership on a board shall not disqualify any person from holding 51 any public office or employment. 52 4. (a) The commissioner [~~and the city commissioner, as the case may~~ 53 ~~be,~~] may request and shall receive upon request from any department, 54 division, board, bureau, commission, local health departments or other 55 agency of the state or political subdivision thereof or any public 56 authority, such information, including but not limited to death records,

S. 6529 3 1 medical records, autopsy reports, toxicology reports, hospital discharge 2 records, birth records and any other information that will help the 3 department under this section to properly carry out its functions, 4 powers and duties. The commissioner, or the city commissioner for the 5 maternal deaths or maternal morbidity occurring within the vital statis- 6 tics registration district of the city of New York may request and shall 7 receive upon request from any department, division, board, commission or 8 other agency under the authority of the city of New York as well as 9 hospitals established pursuant to article twenty-eight of this chapter, 10 birthing facilities, medical examiners, coroners and coroner physicians 11 and any other facility providing services associated with maternal 12 mortality or maternal morbidity, such information, including, but not 13 limited to, death records, medical records, autopsy reports, toxicology 14 reports, hospital discharge records, birth records and any other infor- 15 mation that will help the department under this section to properly 16 carry out its functions, powers and duties. 17 (b) The commissioner and the city commissioner shall receive and may 18 solicit voluntary information, including oral or written statements, 19 relating to any maternal death and case of severe maternal morbidity, 20 from any family member or other interested party (including the patient 21 in a case of severe maternal morbidity) relating to any case that may 22 come before the board. Oral statements received under this paragraph 23 shall be transcribed or summarized in writing. The commissioner and the 24 city commissioner shall transmit that information to the board consider- 25 ing the case. 26 (c) Before transmitting any information to the board, the commissioner 27 or the city commissioner shall remove all personal identifying informa- 28 tion of the woman, health care practitioner or practitioners or anyone 29 else individually named in such information, as well as the hospital or 30 facility that treated the woman, and any other information such as 31 geographic location that may inadvertently identify the woman, practi- 32 tioner or facility. This paragraph shall not preclude the transmitting 33 of information to the board that is reasonably necessary to enable the 34 board to perform an appropriate review under this section. 35 5. Each board: 36 (a) shall make and report findings and recommendations to the commis- 37 sioner [~~or city commissioner, as the case may be~~], and in the case of 38 the city board to the commissioner and the city commissioner regarding 39 the cause of death, factors leading to death, and preventability of each 40 maternal death case, and each case of severe maternal morbidity reviewed 41 by the board, by reviewing relevant information for each case in the 42 state or the city of New York, as the case may be, and consulting with 43 experts as needed to evaluate the information for each death; and shall 44 provide such findings and recommendations, including best practices and 45 strategies for reducing the risk of maternal mortality and morbidity, to 46 the advisory council; provided that material provided to the advisory 47 council shall not include any information that would be confidential 48 under this section; 49 (b) shall develop recommendations to the commissioner [~~or city commis-~~ 50 ~~sioner, as the case may be~~], and in the case of the city board to the 51 commissioner and the city commissioner for areas of focus, including 52 issues of severe maternal morbidity and issues of racial, economic or 53 other disparities in maternal outcomes; 54 (c) may, in addition to the findings and recommendations made under 55 this subdivision, and consistent with all applicable confidentiality 56 protections, bring any particular matter to the attention of the commis-

S. 6529 4 1 sioner or the city commissioner, and in the case of the city board to 2 the commissioner and the city commissioner; 3 (d) shall issue a report on its findings and recommendations every two 4 years, and may also issue reports more frequently. The reports shall be 5 public documents; and 6 (e) may request and shall receive the assistance of the commissioner 7 in the instance of the state board and the city commissioner in the 8 instance of the city board in carrying out its functions. 9 6. The commissioner and the city commissioner and the state and city 10 boards shall each keep confidential any information collected or 11 received under this section that includes personal identifying informa- 12 tion of the woman, health care practitioner or practitioners or anyone 13 else individually named in such information, as well as the hospital or 14 facility that treated the woman, and any other information such as 15 geographic location that may inadvertently identify the woman, practi- 16 tioner or facility, and shall use the information provided or received 17 under this section solely for the purposes of improvement of the quality 18 of health care of women and to prevent maternal mortality and morbidity. 19 This subdivision shall not preclude the transmitting of information to 20 the board that is reasonably necessary to enable the board to perform an 21 appropriate review under this section. All records received, meetings 22 conducted, reports, except those reports required to be issued by the 23 board by this section, and records made and maintained and all books and 24 papers obtained by the board shall be confidential and shall not be made 25 open or available, including under article six of the public officers 26 law, and shall be limited to board members as well as those authorized 27 by the commissioner or city commissioner. Such information shall not be 28 discoverable or admissible as evidence in any action in any court or 29 before any other tribunal, board, agency or person. 30 7. The commissioner and the city commissioner, within their respective 31 legal authority, may use the recommendations and findings of the boards 32 to develop guidance and other actions relating to best practices, and 33 shall disseminate information relating to that guidance and other 34 actions to appropriate health care providers. 35 8. (a) There is hereby established in the department an advisory coun- 36 cil on maternal mortality and morbidity. 37 (b) The advisory council: 38 (i) may review the findings of the boards; 39 (ii) may develop recommendations on policies, best practices, and 40 strategies to prevent maternal mortality and morbidity; 41 (iii) may hold public hearings on those matters; 42 (iv) may make findings and issue reports, including an annual report, 43 on such matters; and 44 (v) may request and shall receive the assistance of the commissioner, 45 the city commissioner, and the boards in carrying out its functions. 46 (c) The advisory council shall consist of at least twenty members[,] 47 to be determined by the commissioner. The commissioner [~~and the city~~ 48 ~~commissioner~~] shall [~~each~~] appoint [~~half of~~] the members of the council, 49 at least ten of whom shall be on the recommendation of the city commis- 50 sioner. The commissioner shall appoint the chair of the council. 51 (d) The members of the council shall be comprised of multidisciplinary 52 experts and lay persons knowledgeable in the field of maternal mortal- 53 ity, women's health and public health and shall include members who 54 serve and are representative of the racial, ethnic, and socioeconomic 55 diversity of the women and mothers [in] of the state, and to the extent 56 possible, the medically underserved areas of the state or areas of the

S. 6529 5 1 state with disproportionately high occurrences of maternal mortality or 2 morbidity. 3 (e) The terms of the council members shall be three years. The 4 [~~appointing official~~] commissioner may choose to reappoint council 5 members to additional three-year terms. Vacancies on the council shall 6 be filled by appointment by the [~~appointing official~~] commissioner, 7 consistent with paragraph (c) of this subdivision. A majority of the 8 appointed membership of the council shall constitute a quorum. When any 9 member of the council fails to attend three consecutive regular meet- 10 ings, unless such absence is for good cause, that membership may be 11 deemed vacant for purposes of the appointment of a successor. 12 (f) Meetings of the council shall be held at least twice a year. 13 (g) Members of the council shall be indemnified under section seven- 14 teen of the public officers law. Members of the council shall not be 15 compensated for their participation on the council but shall receive 16 reimbursement for their ordinary and necessary expenses of partic- 17 ipation. Membership on the council shall not disqualify any person from 18 holding any public office or employment. 19 § 2. This act shall take effect of the same date and in the same 20 manner as a chapter of the laws of 2019, amending the public health law 21 relating to maternal mortality review boards and the maternal mortality 22 and morbidity advisory council, as proposed in legislative bills numbers 23 A.3276 and S.1819, takes effect.

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