Bill Text: HI HB1898 | 2016 | Regular Session | Introduced

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Bill Title: Maternal Mortality Review Panel; Department of Health; Appropriation

Spectrum: Moderate Partisan Bill (Democrat 11-3)

Status: (Introduced - Dead) 2016-01-27 - Referred to HLT, FIN, referral sheet 2 [HB1898 Detail]

Download: Hawaii-2016-HB1898-Introduced.html

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HOUSE OF REPRESENTATIVES	H.B. NO.	1898
TWENTY-EIGHTH LEGISLATURE, 2016
STATE OF HAWAII

A BILL FOR AN ACT

 

 

relating to health.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that Hawaii is one of only thirteen states without a multi-disciplinary professional panel to review pregnancy-related deaths.  It is estimated that up to fifty per cent of all maternal deaths are preventable, thus maternal mortality review panels are integral to saving the lives of women who are pregnant or within one year of a pregnancy.  The legislature further finds that despite advances in medical care, the United States maternal mortality rate continues to rise.  According to the Center for Disease Control, the number of reported pregnancy-related deaths increased from 8.4 deaths per 100,000 live births in 1997 to a high of 17.8 deaths per 100,000 live births in 2011.  Findings from review panels guide the creation of treatment protocols, education campaigns, and standardization of pregnancy care leading to more lives saved.

     The purpose of this Act is to establish a maternal mortality panel to conduct comprehensive, multidisciplinary, confidential, and peer-review protected reviews of maternal deaths in the State to identify factors associated with the deaths and make recommendations for system changes to improve health care services for women in the State.

     SECTION 2.  Chapter 324, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  MATERNAL MORTALITY REVIEW PANEL

     §324-A  Definitions.  As used in this part, unless the context otherwise requires:

     "Department" means the department of health.

     "Director" means the director of health or the director's designee.

     "Family" means:

     (1)  Spouse;

     (2)  Each legal parent;

     (3)  The natural mother;

     (4)  The natural father;

     (5)  The adjudicated, presumed, or concerned natural father as described in section 578-2;

     (6)  Each parent's spouse or former spouses;

     (7)  Each sibling or person related by consanguinity or marriage;

     (8)  Each person residing in the same dwelling unit; and

     (9)  Any other person who, or legal entity that, is a child's legal or physical custodian or guardian, or who is otherwise responsible for the child's care, other than an authorized agency that assumes such a legal status or relationship with the child under chapter 587A.

     "Individually identifiable health information" means the same as in title 45 Code of Federal Regulations part 164, subpart E, as may be amended.

     "Maternal mortality", "maternal death", or "maternal mortality event" means any one of the following:

     (1)  Pregnancy-related death, which is the death of a woman while pregnant or within one year after a pregnancy, regardless of whether the pregnancy is normal or ectopic, from any cause related to or aggravated by the woman's pregnancy or its management, but not from accidental or incidental causes;

     (2)  Pregnancy-associated death, which is the death of a woman while pregnant or within one year after a pregnancy, irrespective of cause; or

     (3)  Pregnancy-associated, but not pregnancy-related death, which is the death of a woman while pregnant or within one year after a pregnancy due to a cause unrelated to pregnancy.

     "Maternal mortality review information" means information regarding the woman and woman's family, including but not limited to:

     (1)  Social, medical, and legal histories;

     (2)  Death and birth certificates;

     (3)  Law enforcement investigative data;

     (4)  Medical examiner or coroner investigative data;

     (5)  Parole and probation information and records;

     (6)  Information and records of social service agencies;

     (7)  Educational records; and

     (8)  Health care institution information and records.

     "Panel" means the Hawaii maternal mortality review panel, established pursuant to section 324-B.

     "Provider of medical care" means any health care practitioner who provides any medical evaluation or treatment, or any facility through which health care is provided, including dental and mental health evaluation or treatment.

     §324-B  Hawaii maternal mortality review panel; established.  (a)  There is established the Hawaii maternal mortality review panel, which shall be placed within the department for administrative purposes only.  The purpose of the panel is to conduct comprehensive, multidisciplinary, confidential, and peer-review protected reviews of maternal deaths in the State to identify factors associated with the deaths and make recommendations for system changes to improve health care services for women in the State.  The members of the panel shall be appointed by the director, in collaboration with the organizations listed below, and shall consist of:

     (1)  Three members from the Hawaii section of the American Congress of Obstetricians and Gynecologists, and of the three members, there shall be at least one generalist and at least one maternal fetal medicine specialist;

     (2)  One member from the Hawaii chapter of the American Academy of Pediatrics specializing in neonatology;

     (3)  One member from the Hawaii Medical Association;

     (4)  One member from the Hawaii chapter of the American College of Nurse-Midwives;

     (5)  One member from the Hawaii section of the Association of Women's Health, Obstetric and Neonatal Nurses;

     (6)  The head of the department's maternal and child health branch, or a designee;

     (7)  An epidemiologist from the department with experience analyzing perinatal data, or a designee;

     (8)  The chief medical examiner, pathologist, or designee;

     (9)  A representative of community mental health centers in the State; and

    (10)  A representative from the University of Hawaii;

provided that the chair of the panel may invite nonvoting expert consultants to its meetings.

     (b)  The terms of the members shall be three years; provided that the initial members' terms shall be staggered in a manner to be determined by the director.  The director shall appoint the initial chair of the panel, who shall call the first meeting of the panel and serve as chair for six months, after which time the panel shall elect its chair.  Members of the panel shall serve without compensation but shall be reimbursed for actual and necessary expenses, including travel, board, and lodging, incurred in the performance of panel activities.

     (c)  The director shall delegate to the panel the functions of collecting, analyzing, and disseminating maternal mortality review information; organizing and convening meetings of the panel; and performing other substantive and administrative tasks as may be incident to these activities.  The activities of the panel and its employees or agents shall be subject to the same confidentiality provisions as apply to members of the panel.

     §324-C  Panel duties.  (a)  The panel, in collaboration with the director, shall conduct comprehensive and multidisciplinary reviews of maternal mortality in Hawaii.  The panel shall not be subject to part I of chapter 92.

     (b)  The panel may invite consultants to attend reviews of maternal mortality events.  Each consultant shall be subject to the same confidentiality provisions that apply to panel members.

     (c)  The panel shall be responsible for disseminating the panel's recommendations to the institutions and professional organizations represented by members on the panel, as applicable.  The panel's recommendations shall not contain any information that would permit identification of a person and shall be disseminated through the institution's or organization's quality assurance program to protect the confidentiality of all persons involved in any maternal mortality event.

     (d)  The panel shall not have the power to:

     (1)  Call witnesses or take testimony from any individual involved in the investigation of a maternal death; or

     (2)  Enforce any public health standard or criminal law, or otherwise participate in any legal proceeding, except to the extent that a member of the panel is involved in the investigation of a maternal death or resulting prosecution and participates in the legal proceeding in the course of performing a member's duties outside of the panel.

     (e)  The director, in collaboration with the panel, shall submit an annual written report to the legislature no later than twenty days prior to the convening of each regular session on the panel's activities and incidents of maternal deaths in the State.  The report shall include statistics setting forth the number of maternal deaths in the State, identifiable trends in maternal deaths, including possible causes, and recommendations for system changes, including any proposed legislation.

     §324-D  Access to information.  (a)  All providers of medical care and state and county agencies shall report all maternal mortality events to the director.

     (b)  Upon written request of the director, all providers of medical care and state and county agencies shall disclose to the department, and those individuals appointed by the director to the panel, maternal mortality review information regarding the circumstances of a maternal death so that the department may conduct a multidisciplinary review of maternal mortality pursuant to section 321-31 and this part.

     (c)  To the extent that this section conflicts with other state confidentiality laws, this section shall prevail.

     §324-E  Use of maternal mortality review information and records.  (a)  Except as otherwise provided in this part, all maternal mortality review information acquired by the department during its review of maternal deaths pursuant to this part, is confidential and may only be disclosed as necessary to carry out the purposes of this part.

     (b)  The department shall redact any individually identifiable information prior to sharing maternal mortality review information with panel members.

     (c)  General maternal mortality review information and statistical compilations of data that do not contain any individually identifiable information shall be public records.

     (d)  The panel and every panel member shall maintain the confidentiality of the maternal mortality review information and all information obtained as part of the panel proceedings.  Neither the panel nor any panel member shall release or re-disclose information obtained as part of the panel proceedings.

     (e)  No individual participating in the panel's review of a maternal death shall be questioned in any civil or criminal proceeding regarding information presented in or opinions formed as a result of a panel meeting.  Nothing in this subsection shall be construed to prevent a person from testifying to information obtained independently of the department's request for maternal mortality review information or the panel's review of the maternal death, or which is public information, or where disclosure is required by a court of law.

     (f)  Maternal mortality review information held by the department as a result of maternal mortality reviews conducted under this part shall not be subject to subpoena, discovery, or introduction into evidence in any civil or criminal proceeding, except that maternal mortality review information otherwise available from other sources shall not be immune from subpoena, discovery, or introduction into evidence through those sources solely because they were provided to the department as required by this part.

     (g)  The director shall have access to individually identifiable information relating to each maternal mortality event on a case-by-case basis where public health is at risk.

     (h)  The director may retain identifiable information regarding facilities where a maternal mortality event occurred and geographic information on each maternal mortality event solely for the purposes of trending and analysis of maternal mortality events over time.

     §324-F  Immunity from liability.  The panel, the panel members, any provider of medical care, state or county agency, or individual participating in, or cooperating in, the review of a maternal death pursuant to this part shall not be held civilly or criminally liable for providing the information required under this part.

     §324-G  Rules.  The director, with the advice and recommendation of a majority of the members of the panel, shall adopt rules pursuant to chapter 91 related to the following:

     (1)  The system for identifying and reporting maternal mortality events to the director;

     (2)  The form and manner through which the director and the members of the panel may acquire information pursuant to this part;

     (3)  The protocol to be used in contacting a family member of the deceased woman for a discussion of the maternal mortality event, including allowing family members to delay or refuse such a discussion; and

     (4)  The confidentiality provisions of this part."

     SECTION 3.  Section 324-1, Hawaii Revised Statutes, is amended to read as follows:

     "§324-1  Sources of information protected.  Any person, hospital, sanitorium, nursing or rest home, or other similar medical facility may provide information, interviews, reports, statements, memoranda, or other data or material relating to the condition and treatment of any person to [the maternal and perinatal mortality study committee of] the Hawaii Medical Association, the maternal mortality review panel, any in-hospital staff committee, or the department of health, to be used in the course of any study for the purpose of reducing morbidity or mortality.

     No liability of any kind or character for damages or other relief shall arise or be enforced against any person or organization by reason of having provided the information or material, or by reason of having released or published the findings, conclusions, and summaries of the research or study committees to advance medical research and medical education."

     SECTION 4.  Section 324-2, Hawaii Revised Statutes, is amended to read as follows:

     "§324-2  Identification of persons studied; restriction.  The [maternal and perinatal mortality study committee of the] Hawaii Medical Association, the department of health, the maternal mortality review panel, or any in-hospital staff committee shall use or publish this material only for the purpose of advancing medical research, medical education, or education of the public in the interest of reducing morbidity or mortality.  In all events, the identity, or any group of facts which tends to lead to the identity[,] of any person whose condition or treatment has been studied shall be confidential and shall not be revealed under any circumstances."

     SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $10,000 or so much thereof as may be necessary for fiscal year 2016-2017 for the implementation and operation of the maternal mortality review panel.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 6.  In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

     SECTION 7.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 8.  This Act shall take effect on July 1, 2016.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Maternal Mortality Review Panel; Department of Health; Appropriation

 

Description:

Establishes the Hawaii maternal mortality review panel within the department of health to conduct a comprehensive review of maternal deaths that have occurred in the State.  Makes an appropriation.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.