Regular Session 2017-2018 House Bill 1869 P.N. 2592

PRINTER'S NO. 2592

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1869

Session of

2017

INTRODUCED BY MACKENZIE, BERNSTINE, BOBACK, CHARLTON, COX,

DRISCOLL, GILLEN, KAUFER, MULLERY, O'BRIEN, READSHAW,

SCHLOSSBERG, STEPHENS, WARD AND WATSON, OCTOBER 17, 2017

REFERRED TO COMMITTEE ON HEALTH, OCTOBER 17, 2017

AN ACT

Establishing the Maternal Mortality Review Committee and

providing for its powers and duties; providing for duties of

the Department of Health; and imposing a penalty.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. Short title.

This act shall be known and may be cited as the Maternal

Mortality Review Act.

Section 2. Legislative findings.

The General Assembly finds and declares as follows:

(1) Maternal deaths are a serious public health concern

and have a tremendous family and societal impact. Maternal

deaths are significantly underestimated and inadequately

documented, preventing efforts to identify and reduce or

eliminate the causes of death.

(2) No processes exist in this Commonwealth for the

confidential identification, investigation or dissemination

of findings regarding maternal deaths.

(3) There is a need to establish a maternal mortality

review program to review maternal deaths and to develop

strategies for the prevention of maternal deaths.

(4) The Centers for Disease Control and Prevention

recommend that maternal deaths should be investigated through

a State-based maternal mortality review committee in order to

institute the systemic changes needed to decrease maternal

mortality.

(5) There is a need to establish a formal process for

the confidential identification and investigation of

individual cases followed by the dissemination of aggregated,

nonindividually identifiable findings regarding maternal

deaths in this Commonwealth.

(6) There is a need to adopt programs, policies,

recommendations and strategies based on collected data to

prevent maternal deaths.

(7) There is a need to provide public information and

education regarding the incidence and causes of maternal

deaths and the reduction of risks to health care providers

and facilities, key government agencies and the public.

Section 3. Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Committee." The Maternal Mortality Review Committee.

"Department." The Department of Health of the Commonwealth.

"Maternal death." The death of a woman during pregnancy or

within one year after the pregnancy has ended through

childbirth, stillbirth or other means. Maternal deaths may be

pregnancy-related or pregnancy-associated.

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"Pregnancy-associated death." The death of a woman while

pregnant or within one year of delivery or end of pregnancy from

any cause unrelated to the pregnancy.

"Pregnancy-related death." The death of a woman while

pregnant or within one year of delivery or end of pregnancy from

any cause related to or aggravated by the pregnancy or its

management.

"Secretary." The Secretary of Health of the Commonwealth.

Section 4. Maternal Mortality Review Committee.

(a) Establishment.--The Maternal Mortality Review Committee

is established within the department.

(b) Members.--The committee shall consist of the following

members:

(1) The secretary or a designee authorized to act on

behalf of the secretary.

(2) An obstetrician.

(3) A maternal fetal medicine specialist.

(4) A certified nurse-midwife.

(5) A registered nurse representing maternal health

care.

(6) A psychiatrist.

(7) An addiction medicine specialist.

(8) A social worker or social service provider.

(9) A medical examiner or coroner responsible for

recording deaths.

(10) An emergency medical services provider.

(11) A health statistician.

(12) A representative of the department's bureau of

family health programs.

(13) Three individuals specializing in emergency

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medicine, family medicine, pathology, anesthesiology,

cardiology, critical care or any other relevant medical

specialty.

(14) Additional personnel at the discretion of the

secretary.

relevant experts or stakeholders who may or may not represent

one of the areas of expertise set forth in subsection (b). In

consulting with individuals, a member of the committee or

employee of the department may not disclose any identifying

information of a patient or health care provider.

(d) Appointment of members and chairperson.--The secretary

shall appoint the members of the committee and a chairperson

within 60 days of the effective date of this section. Members

shall serve at the discretion of the secretary. In appointing

members to the committee, the secretary shall:

(1) Include members from various geographic regions in

this Commonwealth, including both rural and urban areas, and

from both academic and community-based hospitals and health

networks that are of varying size.

(2) Endeavor to include members who are working in and

representing communities that are most affected by maternal

deaths and by a lack of access to relevant perinatal and

intrapartum care services.

(3) Include members who represent several academic

disciplines and professional specializations essential to

reviewing cases of maternal deaths.

(e) Meetings.--The committee shall meet when necessary, at

least once annually, to fulfill the duties and goals of the

committee. The initial meeting of the committee shall be held

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within 90 days of the effective date of this section.

(f) Reimbursement.--Committee members shall serve without

compensation.

(g) Confidentiality agreement.--Committee members and any

person appearing before the committee shall sign a

confidentiality agreement applicable to all proceedings and

reviews conducted by the committee.

(h) Committee support.--The department shall provide staff

necessary to administer and manage this act.

Section 5. Purpose and duties of committee.

(a) Purpose.--The purpose of the committee is to conduct a

multidisciplinary review of maternal deaths and develop

recommendations for the prevention of future maternal deaths.

(b) Duties.--The following apply:

(1) The committee shall review maternal death cases

identified by the department from sources, including, but not

limited to, the following:

(i) Pregnancy check boxes on a decedent's death

certificate.

(ii) Vital statistics linkage of birth, fetal death

and induced termination of pregnancy records with death

records.

(iii) Direct referrals from health care facilities

and health care providers.

(iv) Medical examiners and coroners.

(2) In conducting a review of a maternal death case, the

committee may review the following:

(i) Medical examiner and coroner's reports or

postmortem examination records.

(ii) Death certificates and birth certificates.

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(iii) Law enforcement records and interviews with

law enforcement officials as long as the release of the

records will not jeopardize an ongoing criminal

investigation or proceeding.

(iv) Medical records from hospitals and other health

care providers.

(v) Information made available by firefighters or

emergency services personnel.

(vi) Reports and records made available by the court

to the extent permitted by law or court rule.

(vii) Reports to animal control.

(viii) Emergency medical services records.

(ix) Traffic fatality reports.

(x) Department of Human Services records.

(xi) Any other records necessary to conduct the

review.

(3) Data under paragraph (2) is not limited to

summaries, annual reports, abstracts or other abbreviated

documents. There shall be a presumption that data requested

by the committee shall be relevant and shall be provided to

the committee. No data shall be withheld from the committee

absent a showing of good cause.

(4) The committee shall summarize causes of death and

findings and report recommendations regarding the prevention

of maternal deaths.

(5) The committee shall disseminate aggregated,

nonindividually identifiable findings and recommendations at

least every three years to the secretary, the chairperson of

the Health and Human Services Committee of the Senate, the

chairperson of the Health Committee of the House of

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Representatives, health care providers, health care

facilities and the general public.

Section 6. Authority to access data.

(a) Medical records.--Notwithstanding any other provision of

law and consistent with the Health Insurance Portability and

Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936),

health care facilities and health care providers shall provide

medical records of the deceased under review without the

authorization of a person in interest to the committee for

purposes of review under this act.

(b) Other records.--Other records pertaining to the deceased

under review for the purposes of this act shall be open to

inspection as permitted by law.

facilities and pharmacies shall provide reasonable access to the

committee for the purpose of reviewing medical records

associated with maternal death cases under review by the

committee.

Section 7. Confidentiality and protection of collected data,

proceedings and activities.

(a) Maintenance.--The committee shall maintain the

confidentiality of any identifying information obtained relating

to a maternal death, including the names of the deceased,

guardians, family members, caretakers and alleged or suspected

perpetrators of abuse, neglect or a criminal act.

(b) Agreement.--Each member of the committee and any person

appearing before the committee shall sign a confidentiality

agreement applicable to all proceedings and reviews conducted by

the committee.

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provides information or records to the department shall not be

subject to civil or criminal liability as a result of providing

the information or record.

(d) Discovery.--The proceedings, deliberations and records

of the committee are privileged and confidential and shall not

be subject to discovery, subpoena or introduction into evidence

in a civil or criminal action.

(e) Meetings.--Meetings of the committee at which a specific

maternal death is discussed shall be closed to the public and

shall not be subject to the provisions of 65 Pa.C.S. Ch. 7

(relating to open meetings).

(f) Attendance.--Nothing in this act shall prevent the

committee from allowing the attendance of a person, including a

parent, with information relevant to a review, at a committee

meeting.

(g) Penalty.--A person who violates the provisions of this

section commits a misdemeanor of the third degree.

(h) Information collection.--Information collected under

this act shall be summarized and reported in an aggregated,

nonindividually identifiable manner.

(i) Applicability of Right-to-Know Law.--Information

collected under this act shall be exempt from the act of

February 14, 2008 (P.L.6, No.3), known as the Right-to-Know Law.

Section 8. Effective date.

This act shall take effect in 90 days.

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