S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3375
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 29, 2019
                                ___________
 
 Introduced  by  M.  of A. BICHOTTE, WALKER, JAFFEE, FINCH, RICHARDSON --
   Multi-Sponsored by -- M. of A. COOK -- read once and referred  to  the
   Committee on Health
 
 AN  ACT  to  amend  the  public  health law, in relation to establishing
   protocols for the handling of stillbirths by healthcare facilities and
   establishing a stillbirth research database
 
   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;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00372-01-9
              

 A. 3375                             2
 
   (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
 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-

 A. 3375                             3
 
 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-
 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. Effective immediately the addition, amendment  and/or
 repeal  of  any  rule  or regulation necessary for the implementation of
 this act on its effective date are authorized to be made  on  or  before
 such date.