Budget Amendment ID: FY2023-S4-554
EHS 554
Maternal Mortality and Morbidity Review Committee
Ms. Comerford, Ms. Rausch, Ms. Gobi, Ms. Lovely, Mr. Tarr and Ms. Edwards moved that the proposed new text be amended by adding the following section:-
"SECTION XX. Chapter 111 of the General Laws is hereby amended by inserting after section 24N the following section:-
Section 24O. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:-
“Committee,” the herein established maternal mortality and morbidity review committee within the Massachusetts Department of Public Health.
“Commissioner,” the commissioner of public health.
“Department,” the department of public health.
“Pregnancy-related death” the death of a pregnant person during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiologic effects of pregnancy.
“Pregnancy-associated death” the death of a pregnant person during pregnancy or within one year of the end of pregnancy regardless of the cause.
(b) There is established a maternal mortality and morbidity review committee within the Massachusetts Department of Public Health to review maternal deaths and make recommendations to improve maternal outcomes and eliminate preventable maternal death. The committee shall: (i) conduct case reviews of the pregnancy-related and pregnancy-associated death in Massachusetts; (ii) make recommendations to improve the ability to provide high-quality, evidence-based health care to women and infants in Massachusetts; (iii) identify gaps in the provision of health care services including, but not limited to, consideration of quality of care, access to the most appropriate health care services, transportation and lack of financial resources by analyzing: (A) the race, ethnicity and age of persons who experience maternal mortality; (B) the geographic region of the residence persons who experience maternal mortality; (C) and the socioeconomic status of persons who experience maternal mortality review probable cause of death and identify contributing factors; (iv) determine whether the death was preventable, and if so what actions could have been taken to prevent the death; (v) make recommendations for changes in law, policy, and practice that will prevent maternal mortality, including specific recommendations for communities where significant race-based inequities exist; and (vi) request and obtain a copy of all records and reports pertaining to the pregnancy-related and pregnancy-associated maternal mortality or near-death case under review. Notwithstanding any general or special law to the contrary, upon request of the committee, any public or private health care provider, healthcare facility, social services agency, law enforcement agency, and medical examiner shall provide all requested records. All information collected or generated by the committee shall remain in the possession of department staff and no direct identifying information may be presented to the committee.
(c) The committee shall maintain all information, documents and records in possession of the committee as confidential and not subject to subpoena or discovery in any civil or criminal proceedings; provided however, information, documents and records otherwise available from other sources shall not be exempt from subpoena or discovery through those sources solely because such information, documents and records were presented to or reviewed by the committee. Members of the committee and persons attending a committee meeting must maintain confidentiality and may not disclose any confidential information relating to the committee’s business outside of the committee.
Committee meetings shall be closed to the public and shall not be subject to chapter 30A. Any minutes or notes of meeting, and any information and records acquired by the committee pursuant to this section shall be confidential. Such information or records shall not be considered a public record, shall be exempt from disclosure under section 10 of chapter 66, and may only be disclosed as necessary to carry out the committee’s duties and purposes.
An agency or individual providing access to medical records under this section shall not be held liable for civil damages or be subject to any criminal or disciplinary action for good faith efforts in providing such records.
Information, records, reports, statements, notes, memoranda or other data collected under this section shall not be admissible as evidence in any action of any kind in any court or before any other tribunal, board, agency or person. Such information, records, reports, statements, notes, memoranda or other data shall not be exhibited nor their contents disclosed in any way, in whole or in part, by any officer or representative of the department or any other person, except as may be necessary for the purpose of furthering the review of the committee of the case to which they relate. No person participating in such review shall disclose, in any manner, the information so obtained except in strict conformity with such review project.
All proceedings and activities of the committee under this section, opinions of members of the committee formed as a result of those proceedings and activities, and records obtained, created, or maintained under this section, including records of interviews, written reports and statements procured by the department or any other person, agency or organization acting jointly or under contract with the department in connection with the requirements of this section, shall be confidential.
Members of the committee shall not be questioned in any civil or criminal proceeding regarding the information presented in or opinions formed as a result of a meeting or communication of the committee; however, nothing in this section shall be construed to prevent a member of the committee from testifying to information obtained independently of the proceedings of the committee or which is public information.
Statistical compilations of data that do not contain any information that would permit the identification of any person may be disclosed to the public for the purposes in this section.
(d) The commissioner or the commissioner's designee shall chair the committee. Each member shall serve for a term of three years and until their successor is appointed. Nothing shall prohibit the commissioner from appointing a committee member to serve additional terms. Committee members shall be compensated for their participation on the committee and be reimbursed for ordinary and necessary expenses for the performance of their duties (mileage and tolls). The department shall convene the committee on a regular basis as deemed necessary by the department. In appointing members of the committee, the commissioner shall include members that work in and represent communities that are most impacted per the state maternal mortality ratio so that the composition of the committee reflects:
(1) the racial, ethnic and linguistic diversity of the state;
(2) the differing geographic regions within the state, including rural and urban areas; and
(3) communities that are most impacted by pregnancy-related deaths, severe maternal morbidity and a lack of access to relevant perinatal and intrapartum care services.
The committee shall not exceed twenty members and be appointed by the commissioner. The committee shall include: representatives of the department of public health; a representative of the Massachusetts Perinatal Neonatal Quality Improvement Network; the Chief Medical Examiner or a designee; the Chair of the Massachusetts chapter of the American College of Obstetrics and Gynecology or a designee; the Chair of the Massachusetts chapter of the American College of Nurse Midwives or a designee; the Chair of the Massachusetts chapter of the Association of Women's Health, Obstetric and Neonatal Nurses or a designee; a medical professional with obstetric and neonatal nursing training; a medical professional with training in cardiology; medical professional with training in pathology; a medical professional with expertise in substance use prevention and treatment; a psychology, social work or other mental health professional; a representative from academia; a medical professional with formal anesthesiology training; a medical professional with maternal fetal medicine or perinatology training; a medical professional with psychiatric training; a medical professional with family medicine training; a director of a federally funded-Healthy Start program or a designee; a minimum of two doulas; a minimum of two community or family members who have been directly affected by a maternal death and another person, selected by majority vote of the members of the committee, with relevant expertise or knowledge; a member of a community-based organization; a representative from the department of family and children; and a law enforcement officer.
(e) On or before December 31 of each even numbered year the committee will develop and submit to the Legislature and any other organization the committee determines as necessary to facilitate the objectives of the committee a report that includes, without limitation:
(1) A description of the incidents of maternal mortality and severe maternal morbidity reviewed during the immediately preceding 24 months, provided in a manner that does not allow for the identification of any person;
(2) A summary of the disparities identified and reviewed;
(3) Special topic reports and urgent messages issued by the committee to reduce maternal mortality and severe maternal morbidity in this State; and
(4) Recommendations for any legislation or other changes to policy to reduce maternal mortality and severe maternal morbidity or otherwise improve the delivery of health care in this Commonwealth.".