S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8338
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 14, 2019
                                ___________
 
 Introduced by M. of A. JOYNER -- read once and referred to the Committee
   on Ways and Means
 
 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:

   Section  1. Section 2509 of the public health law, as added by a chap-
 ter of the laws of 2019, amending the  public  health  law  relating  to
 maternal mortality review boards and the maternal mortality and morbidi-
 ty advisory council, as proposed in legislative bills numbers A.3276 and
 S.1819, is amended to read as follows:
   § 2509. Maternal mortality review board. 1. (a) There is hereby estab-
 lished  in  the  department  the maternal mortality review board for the
 purpose of reviewing maternal deaths and maternal morbidity and develop-
 ing and disseminating findings, recommendations, and best  practices  to
 contribute  to  the prevention of maternal mortality and morbidity.  The
 board shall assess the cause of death,  factors  leading  to  death  and
 preventability  for  each maternal death reviewed and, in the discretion
 of the board, cases of severe maternal morbidity, and shall develop  and
 disseminate  strategies  for reducing the risk of maternal mortality and
 morbidity, including risk resulting  from  racial,  economic,  or  other
 disparities.    The  commissioner  may delegate the authority to conduct
 maternal mortality reviews.
   (b) The commissioner may enter into an agreement with the city of  New
 York providing:
   (i)  that the functions of the state board relating to maternal deaths
 and severe maternal morbidity occurring within  the  city  of  New  York
 shall be conducted by the city board;
   (ii)  the  city  board shall provide to the state board the results of
 its reviews, relevant information in the possession of the  city  board,
 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

 A. 8338                             2
 
   (iii) the department and the state board shall provide information and
 assistance to the city board for the performance of its functions.
   (c)  Nothing  in  this section shall prevent the city of New York from
 establishing, without an agreement with the commissioner, a board relat-
 ing to maternal deaths and severe maternal  morbidity  occurring  within
 the city of New York.
   2. As used in this section, unless the context requires otherwise:
   (a)  "Advisory  council"  and  "council"  mean the advisory council on
 maternal mortality and morbidity, established under this section.
   (b) "Board" means a maternal mortality  review  board  established  by
 this  section,  referred  to  in this section as the "state board", or a
 board operating under this section established by the city of New  York,
 with  or without an agreement with the commissioner, referred to in this
 section as the "city board".
   (c) "Maternal death" means the death of a woman  during  pregnancy  or
 within a year from the end of pregnancy.
   (d)  "Severe  maternal  morbidity"  OR  "MORBIDITY"  means  unexpected
 outcomes of pregnancy, labor, or delivery  that  result  in  significant
 short- or long-term consequences to a woman's health.
   (e)  "City  commissioner"  means the commissioner of the New York city
 department of health and mental hygiene.
   3. (a) The members of the state board shall be comprised of  multidis-
 ciplinary experts in the field of maternal mortality, women's health and
 public  health,  and  shall  include  health care professionals or other
 experts who serve and are representative  of  the  RACIAL,  ETHNIC,  AND
 SOCIOECONOMIC  diversity of the women and mothers [in] OF THE STATE AND,
 TO THE EXTENT POSSIBLE, THE medically underserved areas of the state  or
 areas  of the state with disproportionately high occurrences of maternal
 mortality or morbidity.
   (b) The state board shall be composed of at least fifteen members, all
 of whom shall be appointed by the commissioner.
   (c) The terms of the state board members shall  be  three  years.  The
 commissioner  may  choose to reappoint state board members to additional
 three year terms.
   (d) A majority of the appointed membership of the state board, no less
 than three, shall constitute a quorum.
   (e) When any member of the state board fails to attend  three  consec-
 utive  regular  meetings,  unless  such  absence is for good cause, that
 membership may be deemed vacant for purposes of  the  appointment  of  a
 successor.
   (f)  Meetings  of  the state board shall be held at least twice a year
 but may be held more frequently as deemed necessary, subject to  request
 of the department.
   (g)  Members  of  the state and city boards shall be indemnified under
 section seventeen of the public officers law or section fifty-k  of  the
 general municipal law, as the case may be.
   (h)  Members  of  the  state  board shall not be compensated for their
 participation on the board but shall  receive  reimbursement  for  their
 ordinary and necessary expenses of participation.
   (i) Membership on a board shall not disqualify any person from holding
 any public office or employment.
   4.  (a)  The  commissioner [and the city commissioner, as the case may
 be,] may request and shall receive upon  request  from  any  department,
 division,  board,  bureau, commission, local health departments or other
 agency of the state or  political  subdivision  thereof  or  any  public
 authority, SUCH INFORMATION, INCLUDING BUT NOT LIMITED TO DEATH RECORDS,

 A. 8338                             3
 
 MEDICAL RECORDS, AUTOPSY REPORTS, TOXICOLOGY REPORTS, HOSPITAL DISCHARGE
 RECORDS,  BIRTH  RECORDS  AND  ANY  OTHER INFORMATION THAT WILL HELP THE
 DEPARTMENT UNDER THIS SECTION  TO  PROPERLY  CARRY  OUT  ITS  FUNCTIONS,
 POWERS  AND  DUTIES.  THE COMMISSIONER, OR THE CITY COMMISSIONER FOR THE
 MATERNAL DEATHS OR MATERNAL MORBIDITY OCCURRING WITHIN THE VITAL STATIS-
 TICS REGISTRATION DISTRICT OF THE CITY OF NEW YORK MAY REQUEST AND SHALL
 RECEIVE UPON REQUEST FROM ANY DEPARTMENT, DIVISION, BOARD, COMMISSION OR
 OTHER AGENCY UNDER THE AUTHORITY OF THE CITY OF  NEW  YORK  as  well  as
 hospitals  established pursuant to article twenty-eight of this chapter,
 birthing facilities, medical examiners, coroners and coroner  physicians
 and  any  other  facility  providing  services  associated with maternal
 mortality OR MATERNAL MORBIDITY, such information,  including,  but  not
 limited  to, death records, medical records, autopsy reports, toxicology
 reports, hospital discharge records, birth records and any other  infor-
 mation  that  will  help  the  department under this section to properly
 carry out its functions, powers and duties.
   (b) The commissioner and the city commissioner shall receive  and  may
 solicit  voluntary  information,  including  oral or written statements,
 relating to any maternal death and case of  severe  maternal  morbidity,
 from  any family member or other interested party (including the patient
 in a case of severe maternal morbidity) relating to any  case  that  may
 come  before  the  board.  Oral statements received under this paragraph
 shall be transcribed or summarized in writing. The commissioner and  the
 city commissioner shall transmit that information to the board consider-
 ing the case.
   (c) Before transmitting any information to the board, the commissioner
 or  the city commissioner shall remove all personal identifying informa-
 tion of the woman, health care practitioner or practitioners  or  anyone
 else  individually named in such information, as well as the hospital or
 facility that treated the woman,  and  any  other  information  such  as
 geographic  location  that may inadvertently identify the woman, practi-
 tioner or facility.  This paragraph shall not preclude the  transmitting
 of  information  to the board that is reasonably necessary to enable the
 board to perform an appropriate review under this section.
   5. Each board:
   (a) shall make and report findings and recommendations to the  commis-
 sioner  [or  city  commissioner, as the case may be], AND IN THE CASE OF
 THE CITY BOARD TO THE COMMISSIONER AND THE CITY  COMMISSIONER  regarding
 the cause of death, factors leading to death, and preventability of each
 maternal death case, and each case of severe maternal morbidity reviewed
 by  the  board,  by  reviewing relevant information for each case in the
 state or the city of New York, as the case may be, and  consulting  with
 experts  as needed to evaluate the information for each death; and shall
 provide such findings and recommendations, including best practices  and
 strategies for reducing the risk of maternal mortality and morbidity, to
 the  advisory  council;  provided that material provided to the advisory
 council shall not include any information  that  would  be  confidential
 under this section;
   (b) shall develop recommendations to the commissioner [or city commis-
 sioner,  as  the  case may be], AND IN THE CASE OF THE CITY BOARD TO THE
 COMMISSIONER AND THE CITY COMMISSIONER for  areas  of  focus,  including
 issues  of  severe  maternal morbidity and issues of racial, economic or
 other disparities in maternal outcomes;
   (c) may, in addition to the findings and  recommendations  made  under
 this  subdivision,  and  consistent  with all applicable confidentiality
 protections, bring any particular matter to the attention of the commis-

 A. 8338                             4
 
 sioner or the city commissioner, AND IN THE CASE OF THE  CITY  BOARD  TO
 THE COMMISSIONER AND THE CITY COMMISSIONER;
   (d) shall issue a report on its findings and recommendations every two
 years,  and may also issue reports more frequently. The reports shall be
 public documents; and
   (e) may request and shall receive the assistance of  the  commissioner
 IN  THE  INSTANCE  OF  THE  STATE BOARD and the city commissioner IN THE
 INSTANCE OF THE CITY BOARD in carrying out its functions.
   6. The commissioner and the city commissioner and the state  and  city
 boards  shall  each  keep  confidential  any  information  collected  or
 received under this section that includes personal identifying  informa-
 tion  of  the woman, health care practitioner or practitioners or anyone
 else individually named in such information, as well as the hospital  or
 facility  that  treated  the  woman,  and  any other information such as
 geographic location that may inadvertently identify the  woman,  practi-
 tioner  or  facility, and shall use the information provided or received
 under this section solely for the purposes of improvement of the quality
 of health care of women and to prevent maternal mortality and morbidity.
 This subdivision shall not preclude the transmitting of  information  to
 the board that is reasonably necessary to enable the board to perform an
 appropriate  review  under this section.  All records received, meetings
 conducted, reports, EXCEPT THOSE REPORTS REQUIRED TO BE  ISSUED  BY  THE
 BOARD BY THIS SECTION, and records made and maintained and all books and
 papers obtained by the board shall be confidential and shall not be made
 open  or  available,  including under article six of the public officers
 law, and shall be limited to board members as well as  those  authorized
 by the commissioner or city commissioner.  Such information shall not be
 discoverable  or  admissible  as  evidence in any action in any court or
 before any other tribunal, board, agency or person.
   7. The commissioner and the city commissioner, within their respective
 legal authority, may use the recommendations and findings of the  boards
 to  develop  guidance  and other actions relating to best practices, and
 shall disseminate  information  relating  to  that  guidance  and  other
 actions to appropriate health care providers.
   8. (a) There is hereby established in the department an advisory coun-
 cil on maternal mortality and morbidity.
   (b) The advisory council:
   (i) may review the findings of the boards;
   (ii)  may  develop  recommendations  on  policies, best practices, and
 strategies to prevent maternal mortality and morbidity;
   (iii) may hold public hearings on those matters;
   (iv) may make findings and issue reports, including an annual  report,
 on such matters; and
   (v)  may request and shall receive the assistance of the commissioner,
 the city commissioner, and the boards in carrying out its functions.
   (c) The advisory council shall consist of at least  twenty  members[,]
 to  be  determined  by  the commissioner. The commissioner [and the city
 commissioner] shall [each] appoint [half of] the members of the council,
 AT LEAST TEN OF WHOM SHALL BE ON THE RECOMMENDATION OF THE CITY  COMMIS-
 SIONER.  The commissioner shall appoint the chair of the council.
   (d) The members of the council shall be comprised of multidisciplinary
 experts  and  lay persons knowledgeable in the field of maternal mortal-
 ity, women's health and public health  and  shall  include  members  who
 serve  and  are  representative of the RACIAL, ETHNIC, AND SOCIOECONOMIC
 diversity of the women and mothers [in] OF THE STATE, AND TO THE  EXTENT
 POSSIBLE,  THE  medically underserved areas of the state or areas of the

 A. 8338                             5
 
 state with disproportionately high occurrences of maternal mortality  or
 morbidity.
   (e)  The  terms  of  the  council  members  shall  be three years. The
 [appointing official]  COMMISSIONER  may  choose  to  reappoint  council
 members  to  additional three-year terms. Vacancies on the council shall
 be filled by appointment  by  the  [appointing  official]  COMMISSIONER,
 CONSISTENT  WITH  PARAGRAPH  (C) OF THIS SUBDIVISION.  A majority of the
 appointed membership of the council shall constitute a quorum. When  any
 member  of  the  council fails to attend three consecutive regular meet-
 ings, unless such absence is for good  cause,  that  membership  may  be
 deemed vacant for purposes of the appointment of a successor.
   (f) Meetings of the council shall be held at least twice a year.
   (g)  Members  of the council shall be indemnified under section seven-
 teen of the public officers law. Members of the  council  shall  not  be
 compensated  for  their  participation  on the council but shall receive
 reimbursement for their  ordinary  and  necessary  expenses  of  partic-
 ipation.  Membership on the council shall not disqualify any person from
 holding any public office or employment.
   § 2. This act shall take effect of the  same  date  and  in  the  same
 manner  as a chapter of the laws of 2019, amending the public health law
 relating to maternal mortality review boards and the maternal  mortality
 and morbidity advisory council, as proposed in legislative bills numbers
 A.3276 and S.1819, takes effect.