S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1819
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             January 16, 2019
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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 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:
 
   Section 1. Legislative findings and intent. The legislature finds that
 maternal mortality and morbidity is a serious public health concern  and
 has  a  serious family and societal impact. New York state has among the
 highest maternal mortality rates in the country and  racial  disparities
 remain  significant. The U.S. Centers for Disease Control and Prevention
 has determined that a regular process for professional,  multi-discipli-
 nary,  confidential  review of all maternal deaths can help identify the
 causes of maternal mortality, and those findings can  lead  to  clinical
 and  social change that can help prevent maternal mortality. The same is
 true for severe maternal  morbidity.  Confidentiality  is  important  to
 ensure  that full information is made available in the review process to
 maximize protection of maternal health.
   Section 3 of  article  17  of  the  state  constitution  states:  "The
 protection  and  promotion of the health of the inhabitants of the state
 are matters of public concern and provision therefor shall  be  made  by
 the  state  and  by  such of its subdivisions and in such manner, and by
 such means as the legislature shall from time to  time  determine."  The
 legislature finds that the creation of a state maternal mortality review
 board,  and  recognition  and  protection of a city of New York maternal
 mortality review board, are a matter of state concern and  an  important
 exercise  of  the  legislature's  constitutional  mandate to protect the
 public health.
   § 2. The public health law is amended by adding a new section 2509  to
 read as follows:

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

                                                            LBD00490-02-9

 S. 1819                             2
 
   § 2509. MATERNAL MORTALITY REVIEW BOARD. 1. (A) THERE IS HEREBY ESTAB-
 LISHED  IN  THE  DEPARTMENT  THE MATERNAL MORTALITY REVIEW BOARD FOR THE
 PURPOSE OF REVIEWING MATERNAL DEATHS AND MATERNAL MORBIDITY AND DEVELOP-
 ING AND DISSEMINATING FINDINGS, RECOMMENDATIONS, AND BEST  PRACTICES  TO
 CONTRIBUTE  TO  THE PREVENTION OF MATERNAL MORTALITY AND MORBIDITY.  THE
 BOARD SHALL ASSESS THE CAUSE OF DEATH,  FACTORS  LEADING  TO  DEATH  AND
 PREVENTABILITY  FOR  EACH MATERNAL DEATH REVIEWED AND, IN THE DISCRETION
 OF THE BOARD, CASES OF SEVERE MATERNAL MORBIDITY, AND SHALL DEVELOP  AND
 DISSEMINATE  STRATEGIES  FOR REDUCING THE RISK OF MATERNAL MORTALITY AND
 MORBIDITY, INCLUDING RISK RESULTING  FROM  RACIAL,  ECONOMIC,  OR  OTHER
 DISPARITIES.    THE  COMMISSIONER  MAY DELEGATE THE AUTHORITY TO CONDUCT
 MATERNAL MORTALITY REVIEWS.
   (B) THE COMMISSIONER MAY ENTER INTO AN AGREEMENT WITH THE CITY OF  NEW
 YORK PROVIDING:
   (I)  THAT THE FUNCTIONS OF THE STATE BOARD RELATING TO MATERNAL DEATHS
 AND SEVERE MATERNAL MORBIDITY OCCURRING WITHIN  THE  CITY  OF  NEW  YORK
 SHALL BE CONDUCTED BY THE CITY BOARD;
   (II)  THE  CITY  BOARD SHALL PROVIDE TO THE STATE BOARD THE RESULTS OF
 ITS REVIEWS, RELEVANT INFORMATION IN THE POSSESSION OF THE  CITY  BOARD,
 AND THE RECOMMENDATIONS OF THE CITY BOARD; AND
   (III) THE DEPARTMENT AND THE STATE BOARD SHALL PROVIDE INFORMATION AND
 ASSISTANCE TO THE CITY BOARD FOR THE PERFORMANCE OF ITS FUNCTIONS.
   (C)  NOTHING  IN  THIS SECTION SHALL PREVENT THE CITY OF NEW YORK FROM
 ESTABLISHING, WITHOUT AN AGREEMENT WITH THE COMMISSIONER, A BOARD RELAT-
 ING TO MATERNAL DEATHS AND SEVERE MATERNAL  MORBIDITY  OCCURRING  WITHIN
 THE CITY OF NEW YORK.
   2. AS USED IN THIS SECTION, UNLESS THE CONTEXT REQUIRES OTHERWISE:
   (A)  "ADVISORY  COUNCIL"  AND  "COUNCIL"  MEAN THE ADVISORY COUNCIL ON
 MATERNAL MORTALITY AND MORBIDITY, ESTABLISHED UNDER THIS SECTION.
   (B) "BOARD" MEANS A MATERNAL MORTALITY  REVIEW  BOARD  ESTABLISHED  BY
 THIS  SECTION,  REFERRED  TO  IN THIS SECTION AS THE "STATE BOARD", OR A
 BOARD OPERATING UNDER THIS SECTION ESTABLISHED BY THE CITY OF NEW  YORK,
 WITH  OR WITHOUT AN AGREEMENT WITH THE COMMISSIONER, REFERRED TO IN THIS
 SECTION AS THE "CITY BOARD".
   (C) "MATERNAL DEATH" MEANS THE DEATH OF A WOMAN  DURING  PREGNANCY  OR
 WITHIN A YEAR FROM THE END OF PREGNANCY.
   (D)  "SEVERE MATERNAL MORBIDITY" MEANS UNEXPECTED OUTCOMES OF PREGNAN-
 CY, LABOR, OR DELIVERY THAT RESULT IN SIGNIFICANT  SHORT-  OR  LONG-TERM
 CONSEQUENCES TO A WOMAN'S HEALTH.
   (E)  "CITY  COMMISSIONER"  MEANS THE COMMISSIONER OF THE NEW YORK CITY
 DEPARTMENT OF HEALTH AND MENTAL HYGIENE.
   3. (A) THE MEMBERS OF THE STATE BOARD SHALL BE COMPRISED OF  MULTIDIS-
 CIPLINARY EXPERTS IN THE FIELD OF MATERNAL MORTALITY, WOMEN'S HEALTH AND
 PUBLIC  HEALTH,  AND  SHALL  INCLUDE  HEALTH CARE PROFESSIONALS OR OTHER
 EXPERTS WHO SERVE AND ARE REPRESENTATIVE OF THE DIVERSITY OF  THE  WOMEN
 AND  MOTHERS IN MEDICALLY UNDERSERVED AREAS OF THE STATE OR AREAS OF THE
 STATE WITH DISPROPORTIONATELY HIGH OCCURRENCES OF MATERNAL MORTALITY  OR
 MORBIDITY.
   (B) THE STATE BOARD SHALL BE COMPOSED OF AT LEAST FIFTEEN MEMBERS, ALL
 OF WHOM SHALL BE APPOINTED BY THE COMMISSIONER.
   (C)  THE  TERMS  OF  THE STATE BOARD MEMBERS SHALL BE THREE YEARS. THE
 COMMISSIONER MAY CHOOSE TO REAPPOINT STATE BOARD MEMBERS  TO  ADDITIONAL
 THREE YEAR TERMS.
   (D) A MAJORITY OF THE APPOINTED MEMBERSHIP OF THE STATE BOARD, NO LESS
 THAN THREE, SHALL CONSTITUTE A QUORUM.

 S. 1819                             3
 
   (E)  WHEN  ANY MEMBER OF THE STATE BOARD FAILS TO ATTEND THREE CONSEC-
 UTIVE REGULAR MEETINGS, UNLESS SUCH ABSENCE  IS  FOR  GOOD  CAUSE,  THAT
 MEMBERSHIP  MAY  BE  DEEMED  VACANT FOR PURPOSES OF THE APPOINTMENT OF A
 SUCCESSOR.
   (F)  MEETINGS  OF  THE STATE BOARD SHALL BE HELD AT LEAST TWICE A YEAR
 BUT MAY BE HELD MORE FREQUENTLY AS DEEMED NECESSARY, SUBJECT TO  REQUEST
 OF THE DEPARTMENT.
   (G)  MEMBERS  OF  THE STATE AND CITY BOARDS SHALL BE INDEMNIFIED UNDER
 SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW OR SECTION FIFTY-K  OF  THE
 GENERAL MUNICIPAL LAW, AS THE CASE MAY BE.
   (H)  MEMBERS  OF  THE  STATE  BOARD SHALL NOT BE COMPENSATED FOR THEIR
 PARTICIPATION ON THE BOARD BUT SHALL  RECEIVE  REIMBURSEMENT  FOR  THEIR
 ORDINARY AND NECESSARY EXPENSES OF PARTICIPATION.
   (I) MEMBERSHIP ON A BOARD SHALL NOT DISQUALIFY ANY PERSON FROM HOLDING
 ANY PUBLIC OFFICE OR EMPLOYMENT.
   4. (A) THE COMMISSIONER AND THE CITY COMMISSIONER, AS THE CASE MAY BE,
 MAY  REQUEST  AND  SHALL RECEIVE UPON REQUEST FROM ANY DEPARTMENT, DIVI-
 SION, BOARD, BUREAU, COMMISSION, LOCAL HEALTH DEPARTMENTS OR OTHER AGEN-
 CY OF THE STATE OR POLITICAL SUBDIVISION THEREOF OR ANY PUBLIC  AUTHORI-
 TY, AS WELL AS HOSPITALS ESTABLISHED PURSUANT TO ARTICLE TWENTY-EIGHT OF
 THIS  CHAPTER,  BIRTHING  FACILITIES,  MEDICAL  EXAMINERS,  CORONERS AND
 CORONER PHYSICIANS AND ANY OTHER FACILITY PROVIDING SERVICES  ASSOCIATED
 WITH  MATERNAL  MORTALITY,  SUCH INFORMATION, INCLUDING, BUT NOT LIMITED
 TO, DEATH RECORDS, MEDICAL RECORDS, AUTOPSY REPORTS, TOXICOLOGY REPORTS,
 HOSPITAL DISCHARGE RECORDS, BIRTH RECORDS AND ANY OTHER INFORMATION THAT
 WILL HELP THE DEPARTMENT UNDER THIS SECTION TO PROPERLY  CARRY  OUT  ITS
 FUNCTIONS, POWERS AND DUTIES.
   (B)  THE  COMMISSIONER AND THE CITY COMMISSIONER SHALL RECEIVE AND MAY
 SOLICIT VOLUNTARY INFORMATION, INCLUDING  ORAL  OR  WRITTEN  STATEMENTS,
 RELATING  TO  ANY  MATERNAL DEATH AND CASE OF SEVERE MATERNAL MORBIDITY,
 FROM ANY FAMILY MEMBER OR OTHER INTERESTED PARTY (INCLUDING THE  PATIENT
 IN  A  CASE  OF SEVERE MATERNAL MORBIDITY) RELATING TO ANY CASE THAT MAY
 COME BEFORE THE BOARD. ORAL STATEMENTS  RECEIVED  UNDER  THIS  PARAGRAPH
 SHALL  BE TRANSCRIBED OR SUMMARIZED IN WRITING. THE COMMISSIONER AND THE
 CITY COMMISSIONER SHALL TRANSMIT THAT INFORMATION TO THE BOARD CONSIDER-
 ING THE CASE.
   (C) BEFORE TRANSMITTING ANY INFORMATION TO THE BOARD, THE COMMISSIONER
 OR THE CITY COMMISSIONER SHALL REMOVE ALL PERSONAL IDENTIFYING  INFORMA-
 TION  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,  PRACTI-
 TIONER  OR FACILITY.  THIS PARAGRAPH 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.
   5. EACH BOARD:
   (A)  SHALL MAKE AND REPORT FINDINGS AND RECOMMENDATIONS TO THE COMMIS-
 SIONER OR CITY COMMISSIONER, AS THE CASE MAY BE, REGARDING THE CAUSE  OF
 DEATH,  FACTORS  LEADING  TO  DEATH, AND PREVENTABILITY OF EACH MATERNAL
 DEATH CASE, AND EACH CASE OF SEVERE MATERNAL MORBIDITY REVIEWED  BY  THE
 BOARD,  BY  REVIEWING RELEVANT INFORMATION FOR EACH CASE IN THE STATE OR
 THE CITY OF NEW YORK, AS THE CASE MAY BE, AND CONSULTING WITH EXPERTS AS
 NEEDED TO EVALUATE THE INFORMATION FOR EACH  DEATH;  AND  SHALL  PROVIDE
 SUCH  FINDINGS AND RECOMMENDATIONS, INCLUDING BEST PRACTICES AND STRATE-
 GIES FOR REDUCING THE RISK OF MATERNAL MORTALITY AND MORBIDITY,  TO  THE
 ADVISORY  COUNCIL; PROVIDED THAT MATERIAL PROVIDED TO THE ADVISORY COUN-

 S. 1819                             4
 
 CIL SHALL NOT INCLUDE ANY INFORMATION THAT WOULD BE  CONFIDENTIAL  UNDER
 THIS SECTION;
   (B)  SHALL DEVELOP RECOMMENDATIONS TO THE COMMISSIONER OR CITY COMMIS-
 SIONER, 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;
   (C) MAY, IN ADDITION TO THE FINDINGS AND  RECOMMENDATIONS  MADE  UNDER
 THIS  SUBDIVISION,  AND  CONSISTENT  WITH ALL APPLICABLE CONFIDENTIALITY
 PROTECTIONS, BRING ANY PARTICULAR MATTER TO THE ATTENTION OF THE COMMIS-
 SIONER OR THE CITY COMMISSIONER;
   (D) SHALL ISSUE A REPORT ON ITS FINDINGS AND RECOMMENDATIONS EVERY TWO
 YEARS, AND MAY ALSO ISSUE REPORTS MORE FREQUENTLY. THE REPORTS SHALL  BE
 PUBLIC DOCUMENTS; AND
   (E)  MAY  REQUEST AND SHALL RECEIVE THE ASSISTANCE OF THE COMMISSIONER
 AND THE CITY COMMISSIONER IN CARRYING OUT ITS FUNCTIONS.
   6. 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  INFORMA-
 TION  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,  PRACTI-
 TIONER  OR  FACILITY, AND SHALL USE THE INFORMATION PROVIDED OR RECEIVED
 UNDER THIS SECTION SOLELY FOR THE PURPOSES OF IMPROVEMENT OF THE QUALITY
 OF HEALTH CARE OF WOMEN AND TO PREVENT MATERNAL 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 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 COMMISSIONER OR CITY COMMISSIONER.  SUCH INFORMATION SHALL NOT BE
 DISCOVERABLE  OR  ADMISSIBLE  AS  EVIDENCE IN ANY ACTION IN ANY COURT OR
 BEFORE ANY OTHER TRIBUNAL, BOARD, AGENCY OR PERSON.
   7. 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.
   8. (A) THERE IS HEREBY ESTABLISHED IN THE DEPARTMENT AN ADVISORY COUN-
 CIL ON MATERNAL MORTALITY AND MORBIDITY.
   (B) THE ADVISORY COUNCIL:
   (I) MAY REVIEW THE FINDINGS OF THE BOARDS;
   (II)  MAY  DEVELOP  RECOMMENDATIONS  ON  POLICIES, BEST PRACTICES, AND
 STRATEGIES TO PREVENT MATERNAL MORTALITY AND MORBIDITY;
   (III) MAY HOLD PUBLIC HEARINGS ON THOSE MATTERS;
   (IV) MAY MAKE FINDINGS AND ISSUE REPORTS, INCLUDING AN ANNUAL  REPORT,
 ON SUCH MATTERS; AND
   (V)  MAY REQUEST AND SHALL RECEIVE THE ASSISTANCE OF THE COMMISSIONER,
 THE CITY COMMISSIONER, AND THE BOARDS IN CARRYING OUT ITS FUNCTIONS.
   (C) THE ADVISORY COUNCIL SHALL CONSIST OF AT LEAST TWENTY MEMBERS,  TO
 BE DETERMINED BY THE COMMISSIONER. THE COMMISSIONER AND THE CITY COMMIS-
 SIONER  SHALL  EACH  APPOINT  HALF  OF  THE  MEMBERS OF THE COUNCIL. THE
 COMMISSIONER SHALL APPOINT THE CHAIR OF THE COUNCIL.

 S. 1819                             5
 
   (D) THE MEMBERS OF THE COUNCIL SHALL BE COMPRISED OF MULTIDISCIPLINARY
 EXPERTS AND LAY PERSONS KNOWLEDGEABLE IN THE FIELD OF  MATERNAL  MORTAL-
 ITY,  WOMEN'S  HEALTH  AND  PUBLIC  HEALTH AND SHALL INCLUDE MEMBERS WHO
 SERVE AND ARE REPRESENTATIVE OF THE DIVERSITY OF THE WOMEN  AND  MOTHERS
 IN  MEDICALLY  UNDERSERVED AREAS OF THE STATE OR AREAS OF THE STATE WITH
 DISPROPORTIONATELY HIGH OCCURRENCES OF MATERNAL MORTALITY OR MORBIDITY.
   (E) THE TERMS OF  THE  COUNCIL  MEMBERS  SHALL  BE  THREE  YEARS.  THE
 APPOINTING  OFFICIAL  MAY  CHOOSE  TO REAPPOINT COUNCIL MEMBERS TO ADDI-
 TIONAL THREE-YEAR TERMS. VACANCIES ON THE COUNCIL  SHALL  BE  FILLED  BY
 APPOINTMENT  BY  THE  APPOINTING OFFICIAL.   A MAJORITY OF THE APPOINTED
 MEMBERSHIP OF THE COUNCIL SHALL CONSTITUTE A QUORUM. WHEN ANY MEMBER  OF
 THE  COUNCIL  FAILS TO ATTEND THREE CONSECUTIVE REGULAR MEETINGS, UNLESS
 SUCH ABSENCE IS FOR GOOD CAUSE, THAT MEMBERSHIP MAY BE DEEMED VACANT FOR
 PURPOSES OF THE APPOINTMENT OF A SUCCESSOR.
   (F) MEETINGS OF THE COUNCIL SHALL BE HELD AT LEAST TWICE A YEAR.
   (G) MEMBERS OF THE COUNCIL SHALL BE INDEMNIFIED UNDER  SECTION  SEVEN-
 TEEN  OF  THE  PUBLIC  OFFICERS LAW. MEMBERS OF THE COUNCIL SHALL NOT BE
 COMPENSATED FOR THEIR PARTICIPATION ON THE  COUNCIL  BUT  SHALL  RECEIVE
 REIMBURSEMENT  FOR  THEIR  ORDINARY  AND  NECESSARY  EXPENSES OF PARTIC-
 IPATION. MEMBERSHIP ON THE COUNCIL SHALL NOT DISQUALIFY ANY PERSON  FROM
 HOLDING ANY PUBLIC OFFICE OR EMPLOYMENT.
   § 3. This act shall take effect immediately.