S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    505
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              January 9, 2017
                                ___________
 
 Introduced by M. of A. BICHOTTE -- read once and referred to the Commit-
   tee 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 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;
   (IV)  PROVISION  OF  ONE-ON-ONE  NURSING  CARE FOR THE DURATION OF THE
 MOTHER'S STAY AT THE FACILITY;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00493-02-7

 A. 505                              2
 
   (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-
 MALITIES; EXAMINATION OF THE PLACENTA AND UMBILICAL CORD; AND GROSS  AND
 MICROSCOPIC EXAMINATION OF MEMBRANES AND UMBILICAL CORD; OR

 A. 505                              3
 
   (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.  Such  commissioner shall also adopt rules and regu-
 lations as he or she determines necessary to effectuate the purposes  of
 this act.