New York State Assembly

 
•  Summary 
 
•  Actions 
 
•  Committee Votes 
 
•  Floor Votes 
 
•  Memo 
 
•  Text 
 
•  LFIN 
 
•  Chamber Video/Transcript 

A03276 Summary:

A03276 Actions:

A03276 Committee Votes:

Committee:HEALTH   Chair:Gottfried      
DATE:02/11/2019AYE/NAY:24/0  Action: Favorable refer to committee Codes        
Gottfried
Aye
Raia
Aye
Schimminger
Aye
McDonough
Aye
Galef
Aye
Ra
Aye
Dinowitz
Aye
Garbarino
Aye
Cahill
Aye
Byrne
Aye
Paulin
Aye
Byrnes
Aye
Cymbrowitz
Aye
Ashby
Aye
Gunther
Aye
Rosenthal
Aye
Hevesi
Aye
Jaffee
Aye
Steck
Aye
Abinanti
Aye
Braunstein
Excused
Kim
Excused
Solages
Aye
Bichotte
Aye
Barron
Aye
Sayegh
Aye

Committee:WAYS AND MEANS   Chair:Weinstein      
DATE:02/11/2019AYE/NAY:31/0  Action: Favorable         
Weinstein
Aye
Barclay
Aye
Lentol
Aye
Crouch
Aye
Schimminger
Aye
Fitzpatrick
Aye
Gantt
Excused
Hawley
Aye
Glick
Aye
Malliotakis
Aye
Nolan
Excused
Montesano
Aye
Pretlow
Aye
Ra
Aye
Perry
Aye
Blankenbush
Aye
Colton
Aye
Palmesano
Aye
Cook
Aye
Norris
Aye
Cahill
Aye
Aubry
Aye
Thiele
Aye
Cusick
Aye
Ortiz
Aye
Benedetto
Aye
Weprin
Aye
Rodriguez
Excused
Ramos
Aye
Braunstein
Aye
McDonald
Aye
Rozic
Aye
Simotas
Aye
Dinowitz
Aye
Miller
Excused

Committee:CODES   Chair:Lentol      
DATE:02/11/2019AYE/NAY:22/0  Action: Favorable refer to committee Ways and Means        
Lentol
Aye
Ra
Aye
Schimminger
Aye
Giglio
Aye
Pretlow
Aye
Montesano
Aye
Cook
Aye
Morinello
Aye
Cymbrowitz
Aye
Palumbo
Aye
O'Donnell
Aye
Garbarino
Aye
Lavine
Aye
Perry
Aye
Zebrowski
Aye
Abinanti
Aye
Weprin
Aye
Mosley
Aye
Hevesi
Aye
Fahy
Aye
Seawright
Aye
Rosenthal
Aye

A03276 Floor Votes:

A03276 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A3276            REVISED MEMO 03/19/2019
 
SPONSOR: Joyner

 
TITLE OF BILL:  An act to amend the public health law, in relation to
maternal mortality review boards and the maternal mortality and morbidi-
ty advisory council
 
 
PURPOSE OF BILL:
 
This legislation establishes the Maternal Mortality Review Board for the
purposes of reviewing maternal mortality and morbidity. The Board shall
assess the cause of death and factors leading, to death and preventabil-
ity for each maternal death reviewed, and to develop strategies for
reducing the risk of maternal mortality.
 
 
SUMMARY OF PROVISIONS:
 
The legislation adds a new Section 2509 to the Public Health Law which
establishes the Maternal Mortality Review Board for purposes of assess-
ing the cause of death and factors. leading to death and preventability
for each maternal death reviewed, and to develop strategies for.reducing
the risk of maternal mortality.
 
Section 2509, Subsection (b) authorizes the commissioner to enter into
an agreement with the City of New York providing that the functions of
the state board relating to maternal deaths and severe morbidity occur-
ring in the City shall be conducted by the city board, and requires the
city board to provide the state board with the results of its reviews,
relevant information in the possession of the city board, and the recom-
mendations of the city board. The department and the state board to
provide information and assistance to the city board for the performance
. of its functions.

Section 2509 Subsection 2 includes definitions of various terms.
 
Section 2509 Subsection 3 establishes the number of members comprising
the board, the terms office for the board members, the requirements for
a quorum of the board, and establishes a diversity requirement for the
members of the board. Among the requirements; the board shall include
health care professionals or other experts who serve and are represen-
tative of the diversity of the women and mothers in medically under-
served areas of the state or areas of the state with disproportionately
high occurrences of maternal mortality or morbidity Meetings of the
state board will be held at least twice a year, but may be held more
frequently as deemed necessary, subject to the request of the depart-
ment. Members of the state and city boards shall be indemnified and
membership on a board shall not disqualify any person from holding
public office or employment.

Section 2509 Subsection 4 authorizes the commissioner and the city
commissioner, as the case may be, to receive such information that will
help the department to properly carry out its functions, powers, and
duties. This information may include voluntary information, including
oral or written statements, relating to a maternal death and case of
severe maternal morbidity, from any family member or other interested
party (including the patient in the case of in a case of severe maternal
morbidity) relating to any case that may come before the board. Before
transmitting any information to the board, the commissioner or city
commissioner shall remove all personal identifying information of the
woman, health care practitioner or practitioners or anyone else individ-
ually 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, practitioner or
facility.

Section 2509 Subsection 5 each board shall make and report findings to
the commissioner and city commissioner, as the case may be, regarding
the causa of death, factors leading to death, and preventability of each
maternal death case, and each case of severe matern- al morbidity
reviewed by the board, and shall provide such findings and recommenda-
tions, including best practices and strategies for reducing the risk of
maternal mortality to the advisory council. Each board shall develop
recommendations to the state or city commissioner, as the case may be,
for areas of focus, including issues of severe maternal morbidity and
issues of racial, economic or other disparities in maternal outcomes.
 
Section 2509 Subsection 6 provides that 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 information 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, practitioner or facility, and shall use the informa-
tion provided or received under this section solely for the purposes of
improvement of the quality of health care of women and to prevent mater-
nal 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 information and records received, meetings conducted, reports 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 state or
city commissioner. Such information shall not be discoverable or admis-
sible as evidence in any action in any court or before any other tribu-
nal, board, agency or person.
 
Section 2509 Subsection 7 provides that 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.
 
Section 2509 Subsection 8 establishes an Advisory Council that may
review the findings of the boards, develop recommendations on policies,
best practices, and strategies to prevent maternal mortality and morbid-
ity, hold public hearings on those matters, make findings and issue
reports, including an annual report, on such matters, and request and
shall receive the assistance of the commissioner, the city commissioner,
and the boards in carrying out its functions. The advisory council shall
consist of at least 20 members, to be determined by the commissioner.
The commissioner and the city commissioner shall each appoint half of
the members of the council. The commissioner shall appoint the chair of
the council. The members of the council shall be comprised of multidis-
ciplinary experts and lay persons knowledgeable in the field of maternal
mortality, women's health and public health and shall include members
who serve and are representative of the diversity of the women and moth-
ers in medically underserved areas of the state or areas of the state
with disproportionately high occurrences of maternal mortality or
morbidity.
 
This bill does not restrict the otherwise lawful use or transmission by
the commissioner or city commissioner of information that is provided to
or required to be provided to the commissioner or city commissioner
other than by this bill.
 
 
JUSTIFICATION:

New York currently ranks 30th out of 50 states in its maternal death
rate. The issue is compounded by significant racial and ethnic dispari-
ties with black women nearly four times more likely to die during preg-
nancy and childbirth compared to white women. Moreover, severe maternal
morbidity, serious life-threatening complications of delivery, is even
more pervasive. The state must invest in mothers through creation of a
maternal mortality review board to create new strategies for the
prevention of maternal mortality and morbidity.
 
Development of the maternal mortality review board will provide a deeper
understanding of the causes and circumstances surrounding each maternal
death. Through convening of a multidisciplinary, diverse group of clin-
ical experts, the maternal mortality review board will facilitate a
comprehensive, confidential review of maternal deaths and develop
actionable recommendations for the prevention of future deaths.
 
 
PRIOR LEGISLATIVE HISTORY:
 
06/15/18 Amend and recommit to Codes,
06/05/18 Reported referred to Codes,
05/30/18 Amend and recommit to Health,
04/16/18 Referred to Health
 
 
FISCAL IMPLICATIONS:
 
None
 
 
EFFECTIVE DATE:
Immediately.

A03276 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          3276
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 29, 2019
                                       ___________
 
        Introduced  by  M.  of  A. JOYNER, GOTTFRIED, JEAN-PIERRE, L. ROSENTHAL,
          THIELE, OTIS, BRONSON, HUNTER, ABINANTI,  HEVESI,  FAHY,  ENGLEBRIGHT,
          SIMON,   BICHOTTE,   SEAWRIGHT,   BARRON,   TAYLOR,   ARROYO,   GALEF,
          PEOPLES-STOKES,  RA,  FERNANDEZ,  RIVERA,  WRIGHT,  DICKENS,   D'URSO,
          JAFFEE,  LAVINE,  SOLAGES,  BARRETT,  EPSTEIN,  DAVILA,  LIFTON, NIOU,
          ROZIC, MONTESANO, COOK, GLICK, MOSLEY, ORTIZ, STERN -- read  once  and
          referred to the Committee on Health
 
        AN ACT to amend the public health law, in relation to maternal mortality
          review  boards and the maternal mortality and morbidity advisory coun-
          cil
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section 1. Legislative findings and intent. The legislature finds that
     2  maternal  mortality and morbidity is a serious public health concern and
     3  has a serious family and societal impact. New York state has  among  the
     4  highest  maternal  mortality rates in the country and racial disparities
     5  remain significant. The U.S. Centers for Disease Control and  Prevention
     6  has  determined that a regular process for professional, multi-discipli-
     7  nary, confidential review of all maternal deaths can help  identify  the
     8  causes  of  maternal  mortality, and those findings can lead to clinical
     9  and social change that can help prevent maternal mortality. The same  is
    10  true  for  severe  maternal  morbidity.  Confidentiality is important to
    11  ensure that full information is made available in the review process  to
    12  maximize protection of maternal health.
    13    Section  3  of  article  17  of  the  state  constitution states: "The
    14  protection and promotion of the health of the inhabitants of  the  state
    15  are  matters  of  public concern and provision therefor shall be made by
    16  the state and by such of its subdivisions and in  such  manner,  and  by
    17  such  means  as  the legislature shall from time to time determine." The
    18  legislature finds that the creation of a state maternal mortality review
    19  board, and recognition and protection of a city  of  New  York  maternal
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00490-02-9
        A. 3276                             2
 
     1  mortality  review  board, are a matter of state concern and an important
     2  exercise of the legislature's  constitutional  mandate  to  protect  the
     3  public health.
     4    §  2. The public health law is amended by adding a new section 2509 to
     5  read as follows:
     6    § 2509. Maternal mortality review board. 1. (a) There is hereby estab-
     7  lished in the department the maternal mortality  review  board  for  the
     8  purpose of reviewing maternal deaths and maternal morbidity and develop-
     9  ing  and  disseminating findings, recommendations, and best practices to
    10  contribute to the prevention of maternal mortality and morbidity.    The
    11  board  shall  assess  the  cause  of death, factors leading to death and
    12  preventability for each maternal death reviewed and, in  the  discretion
    13  of  the board, cases of severe maternal morbidity, and shall develop and
    14  disseminate strategies for reducing the risk of maternal  mortality  and
    15  morbidity,  including  risk  resulting  from  racial, economic, or other
    16  disparities.  The commissioner may delegate  the  authority  to  conduct
    17  maternal mortality reviews.
    18    (b)  The commissioner may enter into an agreement with the city of New
    19  York providing:
    20    (i) that the functions of the state board relating to maternal  deaths
    21  and  severe  maternal  morbidity  occurring  within the city of New York
    22  shall be conducted by the city board;
    23    (ii) the city board shall provide to the state board  the  results  of
    24  its  reviews,  relevant information in the possession of the city board,
    25  and the recommendations of the city board; and
    26    (iii) the department and the state board shall provide information and
    27  assistance to the city board for the performance of its functions.
    28    (c) Nothing in this section shall prevent the city of  New  York  from
    29  establishing, without an agreement with the commissioner, a board relat-
    30  ing  to  maternal  deaths and severe maternal morbidity occurring within
    31  the city of New York.
    32    2. As used in this section, unless the context requires otherwise:
    33    (a) "Advisory council" and "council"  mean  the  advisory  council  on
    34  maternal mortality and morbidity, established under this section.
    35    (b)  "Board"  means  a  maternal mortality review board established by
    36  this section, referred to in this section as the  "state  board",  or  a
    37  board  operating under this section established by the city of New York,
    38  with or without an agreement with the commissioner, referred to in  this
    39  section as the "city board".
    40    (c)  "Maternal  death"  means the death of a woman during pregnancy or
    41  within a year from the end of pregnancy.
    42    (d) "Severe maternal morbidity" means unexpected outcomes of  pregnan-
    43  cy,  labor,  or  delivery that result in significant short- or long-term
    44  consequences to a woman's health.
    45    (e) "City commissioner" means the commissioner of the  New  York  city
    46  department of health and mental hygiene.
    47    3.  (a) The members of the state board shall be comprised of multidis-
    48  ciplinary experts in the field of maternal mortality, women's health and
    49  public health, and shall include  health  care  professionals  or  other
    50  experts  who  serve and are representative of the diversity of the women
    51  and mothers in medically underserved areas of the state or areas of  the
    52  state  with disproportionately high occurrences of maternal mortality or
    53  morbidity.
    54    (b) The state board shall be composed of at least fifteen members, all
    55  of whom shall be appointed by the commissioner.
        A. 3276                             3
 
     1    (c) The terms of the state board members shall  be  three  years.  The
     2  commissioner  may  choose to reappoint state board members to additional
     3  three year terms.
     4    (d) A majority of the appointed membership of the state board, no less
     5  than three, shall constitute a quorum.
     6    (e)  When  any member of the state board fails to attend three consec-
     7  utive regular meetings, unless such absence  is  for  good  cause,  that
     8  membership  may  be  deemed  vacant for purposes of the appointment of a
     9  successor.
    10    (f) Meetings of the state board shall be held at least  twice  a  year
    11  but  may be held more frequently as deemed necessary, subject to request
    12  of the department.
    13    (g) Members of the state and city boards shall  be  indemnified  under
    14  section  seventeen  of the public officers law or section fifty-k of the
    15  general municipal law, as the case may be.
    16    (h) Members of the state board shall  not  be  compensated  for  their
    17  participation  on  the  board  but shall receive reimbursement for their
    18  ordinary and necessary expenses of participation.
    19    (i) Membership on a board shall not disqualify any person from holding
    20  any public office or employment.
    21    4. (a) The commissioner and the city commissioner, as the case may be,
    22  may request and shall receive upon request from  any  department,  divi-
    23  sion, board, bureau, commission, local health departments or other agen-
    24  cy  of the state or political subdivision thereof or any public authori-
    25  ty, as well as hospitals established pursuant to article twenty-eight of
    26  this chapter,  birthing  facilities,  medical  examiners,  coroners  and
    27  coroner  physicians and any other facility providing services associated
    28  with maternal mortality, such information, including,  but  not  limited
    29  to, death records, medical records, autopsy reports, toxicology reports,
    30  hospital discharge records, birth records and any other information that
    31  will  help  the  department under this section to properly carry out its
    32  functions, powers and duties.
    33    (b) The commissioner and the city commissioner shall receive  and  may
    34  solicit  voluntary  information,  including  oral or written statements,
    35  relating to any maternal death and case of  severe  maternal  morbidity,
    36  from  any family member or other interested party (including the patient
    37  in a case of severe maternal morbidity) relating to any  case  that  may
    38  come  before  the  board.  Oral statements received under this paragraph
    39  shall be transcribed or summarized in writing. The commissioner and  the
    40  city commissioner shall transmit that information to the board consider-
    41  ing the case.
    42    (c) Before transmitting any information to the board, the commissioner
    43  or  the city commissioner shall remove all personal identifying informa-
    44  tion of the woman, health care practitioner or practitioners  or  anyone
    45  else  individually named in such information, as well as the hospital or
    46  facility that treated the woman,  and  any  other  information  such  as
    47  geographic  location  that may inadvertently identify the woman, practi-
    48  tioner or facility.  This paragraph shall not preclude the  transmitting
    49  of  information  to the board that is reasonably necessary to enable the
    50  board to perform an appropriate review under this section.
    51    5. Each board:
    52    (a) shall make and report findings and recommendations to the  commis-
    53  sioner  or city commissioner, as the case may be, regarding the cause of
    54  death, factors leading to death, and  preventability  of  each  maternal
    55  death  case,  and each case of severe maternal morbidity reviewed by the
    56  board, by reviewing relevant information for each case in the  state  or
        A. 3276                             4
 
     1  the city of New York, as the case may be, and consulting with experts as
     2  needed  to  evaluate  the  information for each death; and shall provide
     3  such findings and recommendations, including best practices and  strate-
     4  gies  for  reducing the risk of maternal mortality and morbidity, to the
     5  advisory council; provided that material provided to the advisory  coun-
     6  cil  shall  not include any information that would be confidential under
     7  this section;
     8    (b) shall develop recommendations to the commissioner or city  commis-
     9  sioner,  as  the  case  may  be, for areas of focus, including issues of
    10  severe maternal morbidity  and  issues  of  racial,  economic  or  other
    11  disparities in maternal outcomes;
    12    (c)  may,  in  addition to the findings and recommendations made under
    13  this subdivision, and consistent  with  all  applicable  confidentiality
    14  protections, bring any particular matter to the attention of the commis-
    15  sioner or the city commissioner;
    16    (d) shall issue a report on its findings and recommendations every two
    17  years,  and may also issue reports more frequently. The reports shall be
    18  public documents; and
    19    (e) may request and shall receive the assistance of  the  commissioner
    20  and the city commissioner in carrying out its functions.
    21    6.  The  commissioner and the city commissioner and the state and city
    22  boards  shall  each  keep  confidential  any  information  collected  or
    23  received  under this section that includes personal identifying informa-
    24  tion of the woman, health care practitioner or practitioners  or  anyone
    25  else  individually named in such information, as well as the hospital or
    26  facility that treated the woman,  and  any  other  information  such  as
    27  geographic  location  that may inadvertently identify the woman, practi-
    28  tioner or facility, and shall use the information provided  or  received
    29  under this section solely for the purposes of improvement of the quality
    30  of health care of women and to prevent maternal mortality and morbidity.
    31  This  subdivision  shall not preclude the transmitting of information to
    32  the board that is reasonably necessary to enable the board to perform an
    33  appropriate review under this section.  All records  received,  meetings
    34  conducted,  reports  and  records  made and maintained and all books and
    35  papers obtained by the board shall be confidential and shall not be made
    36  open or available, including under article six of  the  public  officers
    37  law,  and  shall be limited to board members as well as those authorized
    38  by the commissioner or city commissioner.  Such information shall not be
    39  discoverable or admissible as evidence in any action  in  any  court  or
    40  before any other tribunal, board, agency or person.
    41    7. The commissioner and the city commissioner, within their respective
    42  legal  authority, may use the recommendations and findings of the boards
    43  to develop guidance and other actions relating to  best  practices,  and
    44  shall  disseminate  information  relating  to  that  guidance  and other
    45  actions to appropriate health care providers.
    46    8. (a) There is hereby established in the department an advisory coun-
    47  cil on maternal mortality and morbidity.
    48    (b) The advisory council:
    49    (i) may review the findings of the boards;
    50    (ii) may develop recommendations  on  policies,  best  practices,  and
    51  strategies to prevent maternal mortality and morbidity;
    52    (iii) may hold public hearings on those matters;
    53    (iv)  may make findings and issue reports, including an annual report,
    54  on such matters; and
    55    (v) may request and shall receive the assistance of the  commissioner,
    56  the city commissioner, and the boards in carrying out its functions.
        A. 3276                             5
 
     1    (c)  The advisory council shall consist of at least twenty members, to
     2  be determined by the commissioner. The commissioner and the city commis-
     3  sioner shall each appoint half  of  the  members  of  the  council.  The
     4  commissioner shall appoint the chair of the council.
     5    (d) The members of the council shall be comprised of multidisciplinary
     6  experts  and  lay persons knowledgeable in the field of maternal mortal-
     7  ity, women's health and public health  and  shall  include  members  who
     8  serve  and  are representative of the diversity of the women and mothers
     9  in medically underserved areas of the state or areas of the  state  with
    10  disproportionately high occurrences of maternal mortality or morbidity.
    11    (e)  The  terms  of  the  council  members  shall  be three years. The
    12  appointing official may choose to reappoint  council  members  to  addi-
    13  tional  three-year  terms.  Vacancies  on the council shall be filled by
    14  appointment by the appointing official.   A majority  of  the  appointed
    15  membership  of the council shall constitute a quorum. When any member of
    16  the council fails to attend three consecutive regular  meetings,  unless
    17  such absence is for good cause, that membership may be deemed vacant for
    18  purposes of the appointment of a successor.
    19    (f) Meetings of the council shall be held at least twice a year.
    20    (g)  Members  of the council shall be indemnified under section seven-
    21  teen of the public officers law. Members of the  council  shall  not  be
    22  compensated  for  their  participation  on the council but shall receive
    23  reimbursement for their  ordinary  and  necessary  expenses  of  partic-
    24  ipation.  Membership on the council shall not disqualify any person from
    25  holding any public office or employment.
    26    § 3. This act shall take effect immediately.