S T A T E O F N E W Y O R K
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3375
2019-2020 Regular Sessions
I N A S S E M B L Y
January 29, 2019
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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:
Section 1. Section 206 of the public health law is amended by adding a
new subdivision 31 to read as follows:
31. (A) THE COMMISSIONER, IN CONSULTATION WITH THE STATE BOARD OF
MEDICAL EXAMINERS, THE NEW YORK BOARD OF NURSING, THE STATE BOARD FOR
PSYCHOLOGY, AND THE STATE BOARD FOR SOCIAL WORK, SHALL DEVELOP AND
PRESCRIBE BY REGULATION COMPREHENSIVE POLICIES AND PROCEDURES TO BE
FOLLOWED BY HEALTH CARE FACILITIES THAT PROVIDE BIRTHING AND NEWBORN
CARE SERVICES IN THE STATE WHEN A STILLBIRTH OCCURS.
(B) THE COMMISSIONER SHALL REQUIRE AS A CONDITION OF LICENSURE THAT
EACH HEALTH CARE FACILITY IN THE STATE THAT PROVIDES BIRTHING AND
NEWBORN CARE SERVICES ADHERE TO THE POLICIES AND PROCEDURES PRESCRIBED
IN THIS SUBDIVISION. THE POLICIES AND PROCEDURES SHALL INCLUDE, AT A
MINIMUM:
(I) PROTOCOLS FOR ASSIGNING PRIMARY RESPONSIBILITY TO ONE PHYSICIAN,
WHO SHALL COMMUNICATE THE CONDITION OF THE FETUS TO THE MOTHER AND FAMI-
LY, AND INFORM AND COORDINATE STAFF TO ASSIST WITH LABOR, DELIVERY, AND
POSTMORTEM PROCEDURES;
(II) GUIDELINES TO ASSESS A FAMILY'S LEVEL OF AWARENESS AND KNOWLEDGE
REGARDING THE STILLBIRTH;
(III) THE ESTABLISHMENT OF A BEREAVEMENT CHECKLIST, AND AN INFORMA-
TIONAL PAMPHLET TO BE GIVEN TO A FAMILY EXPERIENCING A STILLBIRTH THAT
INCLUDES INFORMATION ABOUT FUNERAL AND CREMATION OPTIONS;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00372-01-9
A. 3375 2
(IV) PROVISION OF ONE-ON-ONE NURSING CARE FOR THE DURATION OF THE
MOTHER'S STAY AT THE FACILITY;
(V) TRAINING OF PHYSICIANS, NURSES, PSYCHOLOGISTS, AND SOCIAL WORKERS
TO ENSURE THAT INFORMATION IS PROVIDED TO THE MOTHER AND FAMILY EXPERI-
ENCING A STILLBIRTH IN A SENSITIVE MANNER, INCLUDING INFORMATION ABOUT
WHAT TO EXPECT, THE AVAILABILITY OF GRIEF COUNSELING, THE OPPORTUNITY TO
DEVELOP A PLAN OF CARE THAT MEETS THE FAMILY'S SOCIAL, RELIGIOUS, AND
CULTURAL NEEDS, AND THE IMPORTANCE OF AN AUTOPSY AND THOROUGH EVALUATION
OF THE FETUS;
(VI) BEST PRACTICES TO PROVIDE PSYCHOLOGICAL AND EMOTIONAL SUPPORT TO
THE MOTHER AND FAMILY FOLLOWING A STILLBIRTH, INCLUDING REFERRING TO THE
FETUS BY NAME, AND OFFERING THE FAMILY THE OPPORTUNITY TO CUT THE UMBIL-
ICAL CORD, HOLD THE BABY WITH PRIVACY AND WITHOUT TIME RESTRICTIONS, AND
PREPARE A MEMORY BOX WITH KEEPSAKES, SUCH AS A HANDPRINT, FOOTPRINT,
BLANKET, BRACELET, LOCK OF HAIR, AND PHOTOGRAPHS, AND PROVISIONS FOR
RETAINING THE KEEPSAKES FOR ONE YEAR IF THE FAMILY CHOOSES NOT TO TAKE
THEM AT DISCHARGE;
(VII) PROTOCOLS TO ENSURE THAT THE PHYSICIAN ASSIGNED PRIMARY RESPON-
SIBILITY FOR COMMUNICATING WITH THE FAMILY DISCUSSES THE IMPORTANCE OF
AN AUTOPSY FOR THE FAMILY, INCLUDING THE SIGNIFICANCE OF AUTOPSY FIND-
INGS ON FUTURE PREGNANCIES AND THE SIGNIFICANCE THAT DATA FROM THE
AUTOPSY MAY HAVE FOR OTHER FAMILIES;
(VIII) PROTOCOLS TO ENSURE COORDINATED VISITS TO THE FAMILY BY A
HOSPITAL STAFF TRAINED TO ADDRESS THE PSYCHOSOCIAL NEEDS OF A FAMILY
EXPERIENCING A STILLBIRTH, PROVIDE GUIDANCE IN THE BEREAVEMENT PROCESS,
ASSIST WITH COMPLETING ANY FORMS REQUIRED IN CONNECTION WITH THE STILL-
BIRTH AND AUTOPSY, AND OFFER THE FAMILY THE OPPORTUNITY TO MEET WITH THE
HOSPITAL CHAPLAIN OR OTHER INDIVIDUAL FROM THE FAMILY'S RELIGIOUS COMMU-
NITY; AND
(IX) GUIDELINES FOR EDUCATING HEALTH CARE PROFESSIONALS AND HOSPITAL
STAFF ON CARING FOR FAMILIES AFTER STILLBIRTH.
§ 2. Subdivision 1 of section 201 of the public health law is amended
by adding three new paragraphs (w), (x) and (y) to read as follows:
(W) ESTABLISH A FETAL DEATH EVALUATION PROTOCOL, WHICH A HOSPITAL
LICENSED SHALL FOLLOW IN COLLECTING DATA RELEVANT TO EACH STILLBIRTH.
THE INFORMATION REQUIRED TO BE COLLECTED SHALL INCLUDE, BUT NOT BE
LIMITED TO:
(I) THE RACE, AGE OF THE MOTHER, MATERNAL AND PATERNAL FAMILY HISTORY,
COMORBIDITIES, PRENATAL CARE HISTORY, ANTEPARTUM FINDINGS, HISTORY OF
PAST OBSTETRIC COMPLICATIONS, EXPOSURE TO VIRAL INFECTIONS, SMOKING,
DRUG AND ALCOHOL USE, FETAL GROWTH RESTRICTION, PLACENTAL ABRUPTION,
CHROMOSOMAL AND GENETIC ABNORMALITIES OBTAINED PRE-DELIVERY, INFECTION
IN PREMATURE FETUS, CORD ACCIDENT, INCLUDING EVIDENCE OF OBSTRUCTION OR
CIRCULATORY COMPROMISE, HISTORY OF THROMBOEMBOLISM, AND WHETHER THE
MOTHER GAVE BIRTH BEFORE; AND
(II) DOCUMENTATION OF THE EVALUATION OF A STILLBORN FETUS, PLACENTA,
AND CYTOLOGIC SPECIMEN THAT CONFORM TO THE STANDARDS ESTABLISHED BY THE
AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS AND MEET ANY OTHER
REQUIREMENTS DEEMED BY THE COMMISSIONER AS NECESSARY, INCLUDING, BUT NOT
LIMITED TO, THE FOLLOWING COMPONENTS:
(A) IF THE PARENTS CONSENT TO A COMPLETE AUTOPSY: THE WEIGHT OF THE
FETUS AND PLACENTA, HEAD CIRCUMFERENCE, LENGTH OF FETUS, FOOT LENGTH IF
STILLBIRTH OCCURRED BEFORE TWENTY-THREE WEEKS OF GESTATION, AND NOTATION
OF ANY DYSMORPHIC FEATURE; PHOTOGRAPH OF THE WHOLE BODY, FRONTAL AND
PROFILE OF FACE, EXTREMITIES AND PALMS, CLOSE-UP OF ANY SPECIFIC ABNOR-
A. 3375 3
MALITIES; EXAMINATION OF THE PLACENTA AND UMBILICAL CORD; AND GROSS AND
MICROSCOPIC EXAMINATION OF MEMBRANES AND UMBILICAL CORD; OR
(B) IF THE PARENTS DO NOT CONSENT TO A COMPLETE AUTOPSY, AN EVALUATION
OF A FETUS AS SET FORTH IN CLAUSE (A) OF THIS SUBPARAGRAPH, AND APPRO-
PRIATE ALTERNATIVES TO A COMPLETE AUTOPSY, INCLUDING A PLACENTAL EXAM-
INATION, EXTERNAL EXAMINATION, SELECTED BIOPSIES, X-RAYS, MRI, AND
ULTRASOUND.
(X) SHALL ESTABLISH AND MAINTAIN A DATABASE THAT CONTAINS A CONFIDEN-
TIAL RECORD OF ALL DATA OBTAINED PURSUANT TO PARAGRAPH (W) OF THIS
SUBDIVISION. THE DATA SHALL BE MADE AVAILABLE TO THE PUBLIC THROUGH THE
DEPARTMENT WEBSITE, EXCEPT THAT NO DATA SHALL IDENTIFY ANY PERSON TO
WHOM THE DATA RELATE.
(Y) SHALL EVALUATE THE DATA OBTAINED PURSUANT TO PARAGRAPH (W) OF THIS
SUBDIVISION FOR PURPOSES OF IDENTIFYING THE CAUSES OF, AND WAYS TO
PREVENT, STILLBIRTHS, AND MAY CONTRACT WITH A THIRD PARTY, INCLUDING,
BUT NOT LIMITED TO, A PUBLIC INSTITUTION OF HIGHER EDUCATION IN THE
STATE OR A FOUNDATION, TO UNDERTAKE THE EVALUATION.
§ 3. This act shall take effect sixty days after it shall have become
a law; provided, however, that no later than five years after the effec-
tive date of this act, the commissioner of health shall report to the
governor, and to the legislature, on the findings of the evaluation
required pursuant to section two of this act, and shall include in the
report any recommendations for legislative action that the commissioner
deems appropriate. Effective immediately the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made on or before
such date.