Bill Text: NY A03375 | 2019-2020 | General Assembly | Introduced

Bill Title: Relates to establishing protocols for stillbirths and establishing a stillbirth research database.

Spectrum: Moderate Partisan Bill (Democrat 6-1)

Status: (Introduced) 2019-01-29 - referred to health [A03375 Detail]

Download: New_York-2019-A03375-Introduced.html

                STATE OF NEW YORK
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                    January 29, 2019
        Introduced  by  M.  of A. BICHOTTE, WALKER, JAFFEE, FINCH, RICHARDSON --
          Multi-Sponsored by -- M. of A. COOK -- read once and referred  to  the
          Committee on Health
        AN  ACT  to  amend  the  public  health law, in relation to establishing
          protocols for the handling of stillbirths by healthcare facilities and
          establishing a stillbirth research database
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section 1. Section 206 of the public health law is amended by adding a
     2  new subdivision 31 to read as follows:
     3    31.  (a)  The  commissioner,  in  consultation with the state board of
     4  medical examiners, the New York board of nursing, the  state  board  for
     5  psychology,  and  the  state  board  for  social work, shall develop and
     6  prescribe by regulation comprehensive  policies  and  procedures  to  be
     7  followed  by  health  care  facilities that provide birthing and newborn
     8  care services in the state when a stillbirth occurs.
     9    (b) The commissioner shall require as a condition  of  licensure  that
    10  each  health  care  facility  in  the  state  that provides birthing and
    11  newborn care services adhere to the policies and  procedures  prescribed
    12  in  this  subdivision.  The  policies and procedures shall include, at a
    13  minimum:
    14    (i) protocols for assigning primary responsibility to  one  physician,
    15  who shall communicate the condition of the fetus to the mother and fami-
    16  ly,  and inform and coordinate staff to assist with labor, delivery, and
    17  postmortem procedures;
    18    (ii) guidelines to assess a family's level of awareness and  knowledge
    19  regarding the stillbirth;
    20    (iii)  the  establishment  of a bereavement checklist, and an informa-
    21  tional pamphlet to be given to a family experiencing a  stillbirth  that
    22  includes information about funeral and cremation options;
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        A. 3375                             2
     1    (iv)  provision  of  one-on-one  nursing  care for the duration of the
     2  mother's stay at the facility;
     3    (v)  training of physicians, nurses, psychologists, and social workers
     4  to ensure that information is provided to the mother and family  experi-
     5  encing  a  stillbirth in a sensitive manner, including information about
     6  what to expect, the availability of grief counseling, the opportunity to
     7  develop a plan of care that meets the family's  social,  religious,  and
     8  cultural needs, and the importance of an autopsy and thorough evaluation
     9  of the fetus;
    10    (vi)  best practices to provide psychological and emotional support to
    11  the mother and family following a stillbirth, including referring to the
    12  fetus by name, and offering the family the opportunity to cut the umbil-
    13  ical cord, hold the baby with privacy and without time restrictions, and
    14  prepare a memory box with keepsakes, such  as  a  handprint,  footprint,
    15  blanket,  bracelet,  lock  of  hair, and photographs, and provisions for
    16  retaining the keepsakes for one year if the family chooses not  to  take
    17  them at discharge;
    18    (vii)  protocols to ensure that the physician assigned primary respon-
    19  sibility for communicating with the family discusses the  importance  of
    20  an  autopsy  for the family, including the significance of autopsy find-
    21  ings on future pregnancies and  the  significance  that  data  from  the
    22  autopsy may have for other families;
    23    (viii)  protocols  to  ensure  coordinated  visits  to the family by a
    24  hospital staff trained to address the psychosocial  needs  of  a  family
    25  experiencing  a stillbirth, provide guidance in the bereavement process,
    26  assist with completing any forms required in connection with the  still-
    27  birth and autopsy, and offer the family the opportunity to meet with the
    28  hospital chaplain or other individual from the family's religious commu-
    29  nity; and
    30    (ix)  guidelines  for educating health care professionals and hospital
    31  staff on caring for families after stillbirth.
    32    § 2. Subdivision 1 of section 201 of the public health law is  amended
    33  by adding three new paragraphs (w), (x) and (y) to read as follows:
    34    (w)  establish  a  fetal  death  evaluation protocol, which a hospital
    35  licensed shall follow in collecting data relevant  to  each  stillbirth.
    36  The  information  required  to  be  collected  shall include, but not be
    37  limited to:
    38    (i) the race, age of the mother, maternal and paternal family history,
    39  comorbidities, prenatal care history, antepartum  findings,  history  of
    40  past  obstetric  complications,  exposure  to viral infections, smoking,
    41  drug and alcohol use, fetal  growth  restriction,  placental  abruption,
    42  chromosomal  and  genetic abnormalities obtained pre-delivery, infection
    43  in premature fetus, cord accident, including evidence of obstruction  or
    44  circulatory  compromise,  history  of  thromboembolism,  and whether the
    45  mother gave birth before; and
    46    (ii) documentation of the evaluation of a stillborn  fetus,  placenta,
    47  and  cytologic specimen that conform to the standards established by the
    48  American College of Obstetricians and Gynecologists and meet  any  other
    49  requirements deemed by the commissioner as necessary, including, but not
    50  limited to, the following components:
    51    (A)  if  the  parents consent to a complete autopsy: the weight of the
    52  fetus and placenta, head circumference, length of fetus, foot length  if
    53  stillbirth occurred before twenty-three weeks of gestation, and notation
    54  of  any  dysmorphic  feature;  photograph of the whole body, frontal and
    55  profile of face, extremities and palms, close-up of any specific  abnor-

        A. 3375                             3
     1  malities;  examination of the placenta and umbilical cord; and gross and
     2  microscopic examination of membranes and umbilical cord; or
     3    (B) if the parents do not consent to a complete autopsy, an evaluation
     4  of  a  fetus as set forth in clause (A) of this subparagraph, and appro-
     5  priate alternatives to a complete autopsy, including a  placental  exam-
     6  ination,  external  examination,  selected  biopsies,  X-rays,  MRI, and
     7  ultrasound.
     8    (x) shall establish and maintain a database that contains a  confiden-
     9  tial  record  of  all  data  obtained  pursuant to paragraph (w) of this
    10  subdivision. The data shall be made available to the public through  the
    11  department  website,  except  that  no data shall identify any person to
    12  whom the data relate.
    13    (y) shall evaluate the data obtained pursuant to paragraph (w) of this
    14  subdivision for purposes of identifying  the  causes  of,  and  ways  to
    15  prevent,  stillbirths,  and  may contract with a third party, including,
    16  but not limited to, a public institution  of  higher  education  in  the
    17  state or a foundation, to undertake the evaluation.
    18    §  3. This act shall take effect sixty days after it shall have become
    19  a law; provided, however, that no later than five years after the effec-
    20  tive date of this act, the commissioner of health shall  report  to  the
    21  governor,  and  to  the  legislature,  on the findings of the evaluation
    22  required pursuant to section two of this act, and shall include  in  the
    23  report  any recommendations for legislative action that the commissioner
    24  deems appropriate. Effective immediately the addition, amendment  and/or
    25  repeal  of  any  rule  or regulation necessary for the implementation of
    26  this act on its effective date are authorized to be made  on  or  before
    27  such date.