S T A T E   O F   N E W   Y O R K
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                                  7438

                            I N  S E N A T E

                             April 29, 2016
                               ___________

Introduced  by  Sen.  COMRIE -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public  health  law,  in  relation  to  establishing
  protocols for stillbirths and establishing a stillbirth research data-
  base

  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 30 to read as follows:
  30. (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;
  (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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD13549-01-6

S. 7438                             2

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.
  S 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-
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-

S. 7438                             3

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.
  S 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.  Such  commissioner shall also adopt rules and regu-
lations as he or she determines necessary to effectuate the purposes  of
this act.