S T A T E O F N E W Y O R K
________________________________________________________________________
4018
2025-2026 Regular Sessions
I N A S S E M B L Y
January 30, 2025
___________
Introduced by M. of A. FORREST, LEVENBERG, LUNSFORD, MAMDANI, GIBBS,
SHRESTHA, GONZALEZ-ROJAS, BICHOTTE HERMELYN, GALLAGHER -- read once
and referred to the Committee on Health
AN ACT to amend the public health law, in relation to requiring hospi-
tals and other facilities that provide perinatal care to implement an
evidence-based implicit bias program, to providing birthing parents
with written information regarding certain patient rights, and to
including information related to pregnancy on death certificates
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Article 25 of the public health law is amended by adding a
new title 9 to read as follows:
TITLE IX
NEW YORK DIGNITY IN PREGNANCY AND CHILDBIRTH ACT
SECTION 2599-E. SHORT TITLE.
2599-F. LEGISLATIVE FINDINGS.
2599-G. DEFINITIONS.
2599-H. IMPLICIT BIAS PROGRAM.
2599-I. DATA COLLECTION.
§ 2599-E. SHORT TITLE. THIS TITLE SHALL BE KNOWN AND MAY BE CITED AS
THE "NEW YORK DIGNITY IN PREGNANCY AND CHILDBIRTH ACT".
§ 2599-F. LEGISLATIVE FINDINGS. 1. EVERY PERSON SHOULD BE ENTITLED TO
DIGNITY AND RESPECT DURING AND AFTER PREGNANCY AND CHILDBIRTH. PATIENTS
SHOULD RECEIVE THE BEST CARE POSSIBLE REGARDLESS OF THEIR RACE, GENDER,
AGE, CLASS, SEXUAL ORIENTATION, GENDER IDENTITY, DISABILITY, LANGUAGE
PROFICIENCY, NATIONALITY, IMMIGRATION STATUS, GENDER EXPRESSION, OR
RELIGION.
2. WHILE MATERNAL HEALTH CONTINUES TO MAKE GREAT STRIDES GLOBALLY,
THE UNITED STATES IS ONE OF THE ONLY NATIONS IN THE WORLD THAT HAS SEEN
AN INCREASE IN MATERNAL MORTALITY OVER THE PAST SEVERAL DECADES. TODAY,
THE UNITED STATES HAS THE HIGHEST MATERNAL MORTALITY RATE IN THE DEVEL-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07167-01-5
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OPED WORLD. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND
PREVENTION, MORE THAN ONE THOUSAND TWO HUNDRED BIRTHING PARENTS DIE OF
MATERNAL CASES EACH YEAR, AND ANOTHER FIFTY THOUSAND SUFFER FROM SEVERE
COMPLICATIONS. NATIONALLY IT IS ESTIMATED THAT SIXTY PERCENT (I.E., THE
MAJORITY) OF PREGNANCY-RELATED DEATHS ARE PREVENTABLE.
3. FOR INDIVIDUALS OF COLOR, PARTICULARLY BLACK INDIVIDUALS, THE
MATERNAL MORTALITY RATE REMAINS THREE TO FOUR TIMES HIGHER THAN CAUCA-
SIAN INDIVIDUALS. IN NEW YORK, THE MORTALITY RATE FOR BLACK INDIVIDUALS
PER ONE HUNDRED THOUSAND BIRTHS IS 51.6, WHEREAS FOR CAUCASIAN INDIVID-
UALS IT IS 15.9. NEW YORK HAS A RESPONSIBILITY TO DECREASE THE NUMBER OF
PREVENTABLE PREGNANCY- AND CHILDBIRTH-RELATED DEATHS.
4. ACCESS TO PRENATAL CARE, SOCIOECONOMIC STATUS, AND GENERAL PHYSICAL
HEALTH DO NOT FULLY EXPLAIN THE RACIAL DISPARITY SEEN IN MATERNAL
MORTALITY AND MORBIDITY RATES. THERE IS A GROWING BODY OF EVIDENCE THAT
BLACK BIRTHING PARENTS ARE OFTEN TREATED UNFAIRLY AND UNEQUALLY IN THE
HEALTH CARE SYSTEM.
5. IMPLICIT BIAS IS A DRIVER OF HEALTH DISPARITIES IN COMMUNITIES OF
COLOR. AT PRESENT, HEALTH CARE PROVIDERS IN NEW YORK ARE NOT REQUIRED TO
UNDERGO ANY IMPLICIT BIAS TESTING OR TRAINING. NOR DOES THERE EXIST ANY
SYSTEM TO TRACK THE NUMBER OF INCIDENTS WHERE IMPLICIT PREJUDICE AND
IMPLICIT STEREOTYPES HAVE LED TO NEGATIVE BIRTH AND MATERNAL HEALTH
OUTCOMES.
6. IT IS THE INTENT OF THE LEGISLATURE TO REDUCE THE EFFECTS OF
IMPLICIT BIAS IN PREGNANCY, CHILDBIRTH, AND POSTNATAL CARE SO THAT ALL
PEOPLE ARE TREATED WITH DIGNITY AND RESPECT BY THEIR HEALTH CARE PROVID-
ERS.
§ 2599-G. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE, THE FOLLOWING
TERMS SHALL HAVE THE FOLLOWING MEANINGS:
1. "PREGNANCY-RELATED DEATH" MEANS THE DEATH OF A PERSON WHILE PREG-
NANT OR WITHIN THREE HUNDRED SIXTY-FIVE DAYS OF THE END OF A PREGNANCY,
IRRESPECTIVE OF THE DURATION OR SITE OF THE PREGNANCY, FROM ANY CAUSE
RELATED TO, OR AGGRAVATED BY, THE PREGNANCY OR ITS MANAGEMENT, BUT NOT
FROM ACCIDENTAL OR INCIDENTAL CAUSES.
2. "IMPLICIT BIAS" MEANS A BIAS IN JUDGMENT OR BEHAVIOR THAT RESULTS
FROM SUBTLE COGNITIVE PROCESSES, INCLUDING IMPLICIT PREJUDICE AND
IMPLICIT STEREOTYPES THAT OFTEN OPERATE AT A LEVEL BELOW CONSCIOUS
AWARENESS AND WITHOUT INTENTIONAL CONTROL.
3. "IMPLICIT PREJUDICE" MEANS PREJUDICIAL NEGATIVE FEELINGS OR BELIEFS
ABOUT A GROUP THAT A PERSON HOLDS WITHOUT BEING AWARE OF THEM.
4. "IMPLICIT STEREOTYPES" MEAN THE UNCONSCIOUS ATTRIBUTIONS OF PARTIC-
ULAR QUALITIES TO A MEMBER OF A CERTAIN SOCIAL GROUP. IMPLICIT STERE-
OTYPES ARE INFLUENCED BY EXPERIENCE AND ARE BASED ON LEARNED ASSOCI-
ATIONS BETWEEN VARIOUS QUALITIES AND SOCIAL CATEGORIES, INCLUDING RACE
OR GENDER.
5. "PERINATAL CARE" MEANS THE PROVISION OF CARE DURING PREGNANCY,
LABOR, DELIVERY, AND POSTPARTUM AND NEONATAL PERIODS.
§ 2599-H. IMPLICIT BIAS PROGRAM. 1. A HOSPITAL OR OTHER FACILITY THAT
PROVIDES PERINATAL CARE SHALL IMPLEMENT AN EVIDENCE-BASED IMPLICIT BIAS
PROGRAM FOR ALL HEALTH CARE PROVIDERS INVOLVED IN THE PERINATAL CARE OF
PATIENTS WITHIN THOSE FACILITIES.
2. AN IMPLICIT BIAS PROGRAM IMPLEMENTED PURSUANT TO SUBDIVISION ONE OF
THIS SECTION SHALL INCLUDE ALL OF THE FOLLOWING:
(A) IDENTIFICATION OF PREVIOUS OR CURRENT UNCONSCIOUS BIASES AND
MISINFORMATION;
(B) IDENTIFICATION OF PERSONAL, INTERPERSONAL, INSTITUTIONAL, STRUC-
TURAL, AND CULTURAL BARRIERS TO INCLUSION;
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(C) CORRECTIVE MEASURES TO DECREASE IMPLICIT BIAS AT INTERPERSONAL AND
INSTITUTIONAL LEVELS, INCLUDING ONGOING POLICIES AND PRACTICES FOR THAT
PURPOSE;
(D) INFORMATION ON THE EFFECTS, INCLUDING, BUT NOT LIMITED TO, ONGOING
PERSONAL EFFECTS, OF HISTORICAL AND CONTEMPORARY EXCLUSION AND
OPPRESSION OF MINORITY COMMUNITIES;
(E) INFORMATION ABOUT CULTURAL IDENTITY ACROSS RACIAL OR ETHNIC
GROUPS;
(F) INFORMATION ABOUT COMMUNICATING MORE EFFECTIVELY ACROSS IDENTI-
TIES, INCLUDING RACIAL, ETHNIC, RELIGIOUS, AND GENDER IDENTITIES;
(G) DISCUSSION ON POWER DYNAMICS AND ORGANIZATIONAL DECISION MAKING;
(H) DISCUSSION ON HEALTH INEQUITIES WITHIN THE PERINATAL CARE FIELD,
INCLUDING INFORMATION ON HOW IMPLICIT BIAS IMPACTS MATERNAL AND INFANT
HEALTH OUTCOMES;
(I) PERSPECTIVES OF DIVERSE, LOCAL CONSTITUENCY GROUPS AND EXPERTS ON
PARTICULAR RACIAL, IDENTITY, CULTURAL, AND PROVIDER-COMMUNITY RELATIONS
ISSUES IN THE COMMUNITY; AND
(J) INFORMATION ON REPRODUCTIVE JUSTICE.
3. A HEALTH CARE PROVIDER INVOLVED IN THE PERINATAL CARE OF PATIENTS
IN A HOSPITAL OR OTHER FACILITY THAT PROVIDES PERINATAL CARE SHALL
COMPLETE INITIAL TRAINING THROUGH THE IMPLICIT BIAS PROGRAM AS IMPLE-
MENTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION. UPON COMPLETION OF
THE INITIAL TRAINING, A HEALTH CARE PROVIDER SHALL COMPLETE ADDITIONAL
TRAINING THROUGH THE IMPLICIT BIAS PROGRAM EVERY TWO YEARS THEREAFTER,
OR ON A MORE FREQUENT BASIS IF DEEMED NECESSARY BY THE HOSPITAL OR
FACILITY, IN ORDER TO KEEP CURRENT WITH CHANGING RACIAL, IDENTITY, AND
CULTURAL TRENDS AND BEST PRACTICES IN DECREASING INTERPERSONAL AND
INSTITUTIONAL IMPLICIT BIAS.
4. A HOSPITAL OR OTHER FACILITY THAT PROVIDES PERINATAL CARE SHALL
PROVIDE A CERTIFICATE OF TRAINING COMPLETION BY A HEALTH CARE PROVIDER
INVOLVED IN THE PERINATAL CARE OF PATIENTS TO ANOTHER FACILITY OR THE
PROVIDER WHO ATTENDED THE TRAINING UPON REQUEST. A HOSPITAL OR FACILITY
MAY ACCEPT A CERTIFICATE OF TRAINING COMPLETION FROM ANOTHER HOSPITAL OR
OTHER FACILITY THAT PROVIDES PERINATAL CARE TO SATISFY THE TRAINING
REQUIRED OF HEALTH CARE PROVIDERS INVOLVED IN THE PERINATAL CARE OF
PATIENTS PURSUANT TO SUBDIVISION THREE OF THIS SECTION FROM A HEALTH
CARE PROVIDER WHO WORKS IN MORE THAN ONE FACILITY.
5. NOTWITHSTANDING SUBDIVISIONS ONE, TWO, THREE AND FOUR OF THIS
SECTION, IF A HEALTH CARE PROVIDER INVOLVED IN THE PERINATAL CARE OF
PATIENTS IS NOT DIRECTLY EMPLOYED BY A HOSPITAL OR FACILITY THAT
PROVIDES PERINATAL CARE, THE HOSPITAL OR FACILITY WHERE THE HEALTH CARE
PROVIDER PROVIDES SUCH CARE SHALL OFFER IMPLICIT BIAS TRAINING PURSUANT
TO THIS SECTION TO SUCH HEALTH CARE PROVIDER.
6. THE COMMISSIONER SHALL MONITOR IMPLEMENTATION OF THIS SECTION BY
FACILITIES THAT PROVIDE PERINATAL CARE AND MAY INSPECT RECORDS FROM
IMPLICIT BIAS TRAINING PROGRAMS OR REQUIRE SUCH HOSPITALS OR FACILITIES
TO REPORT TO THE COMMISSIONER ON THE IMPLICIT BIAS TRAINING PROGRAM,
INCLUDING CONTINUING EDUCATION CURRICULA USED AND COURSES OFFERED PURSU-
ANT TO THIS SECTION. INITIAL TRAINING PROVIDED PURSUANT TO THIS SECTION
SHALL BE MADE AVAILABLE TO HEALTH CARE PROVIDERS INVOLVED IN THE PERINA-
TAL CARE WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS TITLE.
§ 2599-I. DATA COLLECTION. 1. THE DEPARTMENT SHALL TRACK DATA ON
SEVERE MATERNAL MORBIDITY, INCLUDING, BUT NOT LIMITED TO, ALL OF THE
FOLLOWING HEALTH CONDITIONS:
(A) OBSTETRIC HEMORRHAGE;
(B) HYPERTENSION;
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(C) PREECLAMPSIA AND ECLAMPSIA;
(D) VENOUS THROMBOEMBOLISM;
(E) SEPSIS;
(F) CEREBROVASCULAR ACCIDENT; AND
(G) AMNIOTIC FLUID EMBOLISM.
2. THE DATA ON SEVERE MATERNAL MORBIDITY COLLECTED PURSUANT TO SUBDI-
VISION ONE OF THIS SECTION SHALL BE PUBLISHED AT LEAST ONCE EVERY TWO
YEARS AFTER BOTH OF THE FOLLOWING HAVE OCCURRED:
(A) THE DATA HAS BEEN AGGREGATED BY STATE REGIONS, AS DEFINED BY THE
DEPARTMENT, TO ENSURE DATA REFLECTS HOW REGIONALIZED CARE SYSTEMS ARE OR
SHOULD BE COLLABORATING TO IMPROVE MATERNAL HEALTH OUTCOMES, OR OTHER
SMALLER REGIONAL SORTING BASED ON STANDARD STATISTICAL METHODS FOR ACCU-
RATE DISSEMINATION OF PUBLIC HEALTH DATA WITHOUT RISKING A CONFIDENTIAL-
ITY OR OTHER DISCLOSURE BREACH; AND
(B) THE DATA HAS BEEN DISAGGREGATED BY RACIAL AND ETHNIC IDENTITY.
3. THE DEPARTMENT SHALL TRACK DATA ON PREGNANCY-RELATED DEATHS,
INCLUDING, BUT NOT LIMITED TO, ALL OF THE CONDITIONS LISTED IN SUBDIVI-
SION ONE OF THIS SECTION, INDIRECT OBSTETRIC DEATHS, AND OTHER MATERNAL
DISORDERS PREDOMINANTLY RELATED TO PREGNANCY AND COMPLICATIONS PREDOMI-
NANTLY RELATED TO THE PUERPERIUM.
4. THE DATA ON PREGNANCY-RELATED DEATHS COLLECTED PURSUANT TO SUBDIVI-
SIONS ONE AND THREE OF THIS SECTION SHALL BE PUBLISHED AT LEAST ONCE
EVERY THREE YEARS AFTER BOTH OF THE FOLLOWING HAVE OCCURRED:
(A) THE DATA HAS BEEN AGGREGATED BY STATE REGIONS, AS DEFINED BY THE
DEPARTMENT, TO ENSURE DATA REFLECTS HOW REGIONALIZED CARE SYSTEMS ARE OR
SHOULD BE COLLABORATING TO IMPROVE MATERNAL HEALTH OUTCOMES, OR OTHER
SMALLER REGIONAL SORTING BASED ON STANDARD STATISTICAL METHODS FOR ACCU-
RATE DISSEMINATION OF PUBLIC HEALTH DATA WITHOUT RISKING A CONFIDENTIAL-
ITY OR OTHER DISCLOSURE BREACH; AND
(B) THE DATA HAS BEEN DISAGGREGATED BY RACIAL AND ETHNIC IDENTITY.
§ 2. Section 2803-n of the public health law is amended by adding two
new subdivisions 5 and 6 to read as follows:
5. EACH HOSPITAL SHALL PROVIDE EACH EXPECTANT BIRTHING PARENT, UPON
ADMISSION OR AS SOON THEREAFTER AS REASONABLY PRACTICABLE, WRITTEN
INFORMATION REGARDING THE PATIENT'S RIGHT TO THE FOLLOWING:
(A) TO BE INFORMED OF CONTINUING HEALTH CARE REQUIREMENTS FOLLOWING
DISCHARGE FROM THE HOSPITAL;
(B) TO AUTHORIZE THAT A FRIEND OR FAMILY MEMBER MAY BE PROVIDED INFOR-
MATION ABOUT THE PATIENT'S CONTINUING HEALTH CARE REQUIREMENTS FOLLOWING
DISCHARGE FROM THE HOSPITAL;
(C) TO PARTICIPATE ACTIVELY IN DECISIONS REGARDING MEDICAL CARE. TO
THE EXTENT PERMITTED BY LAW, PARTICIPATION SHALL INCLUDE THE RIGHT TO
REFUSE TREATMENT;
(D) APPROPRIATE PAIN ASSESSMENT AND TREATMENT;
(E) TO BE FREE FROM DISCRIMINATION ON THE BASIS OF RACE, COLOR, RELI-
GION, ANCESTRY, NATIONAL ORIGIN, DISABILITY, MEDICAL CONDITION, GENETIC
INFORMATION, MARITAL STATUS, SEX, GENDER, GENDER IDENTITY, GENDER
EXPRESSION, SEXUAL ORIENTATION, CITIZENSHIP, PRIMARY LANGUAGE, OR IMMI-
GRATION STATUS; AND
(F) TO FILE A COMPLAINT WITH THE DEPARTMENT OF HEALTH AND THE MEDICAL
BOARD OF NEW YORK AND INFORMATION ON HOW TO FILE THE COMPLAINT.
6. EACH HOSPITAL SHALL PROVIDE EACH EXPECTANT BIRTHING PARENT, UPON
ADMISSION OR AS SOON THEREAFTER AS REASONABLY PRACTICABLE, WRITTEN
INFORMATION REGARDING THE HOSPITAL'S POLICIES AND PROCEDURES FOR
CONTACTING NEXT OF KIN REGARDING PREGNANCY-RELATED DEATHS, AND HOW TO
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SEEK LEGAL COUNSEL IN THE EVENT OF ANY PREGNANCY-RELATED DEATHS OR INJU-
RIES.
§ 3. Subdivision 4 of section 4141 of the public health law is amended
by adding a new paragraph (e) to read as follows:
(E) THE MEDICAL CERTIFICATE SHALL INCLUDE INFORMATION INDICATING
WHETHER THE DECEDENT WAS PREGNANT AT THE TIME OF DEATH, OR WITHIN A YEAR
PRIOR TO THE DEATH, IF KNOWN, AS DETERMINED BY OBSERVATION, AUTOPSY, OR
REVIEW OF THE MEDICAL RECORD. THIS PARAGRAPH SHALL NOT BE INTERPRETED TO
REQUIRE THE PERFORMANCE OF A PREGNANCY TEST ON A DECEDENT, OR TO REQUIRE
A REVIEW OF MEDICAL RECORDS IN ORDER TO DETERMINE PREGNANCY.
§ 4. This act shall take effect immediately.