MAINE STATE LEGISLATURE The following document is provided by the LAW AND LEGISLATIVE DIGITAL LIBRARY at the Maine State Law and Legislative Reference Library http://legislature.maine.gov/lawlib Reproduced from electronic and/or scanned originals ACTIVITY SHEET COMMITTEE: Health Human Services Committee LD 1599 TITLE An Act Regarding the Maternal and Infant Death Review Panel HEARING DATE: . 5719.75 WORK SESSION DATES: gr v/p COMMITTEE REPORT: 0-7 Hr REPORTED OUTDATE: . SECQNB REGULAR Legistative Document No. 1599 SP. 606 In Senate, December 18, 2009 An Act Regarding the Maternal and infant Death Review Panel (EMERGENCY) Approved for introduction?by a majority of the Legislative Council pursuant to Joint Rule 203. Received by the Secretary of the Senate on December 18, 2009. Referred to the Committee on Health and Human Services pursuant to Joint Rule 308.2 and ordered printed. JOY J. Secretary of the Senate Presented by Senator MARRACHE of Kennebec. Cosponsored by Representative SAVIELLO of Wilton, Representative CAMPBELL of New?eld and Representatives: STRANG BURGESS of Cumberland, STUCKEY of Portland. Primed on recycled paper Emergency preamble. Whereas, acts and resolves of the Legislature do not become effective until 90 days after adjournment unless enacted as emergencies; and Whereas, the statute establishing the maternal and infant death review panel includes a repeal date of January 1, 201 1; and Whereas, unless action is taken in the 124th Legislature to prevent the repeal, the panel's work, which furthers the public health and welfare, will cease; and Whereas, in the judgment of the Legislature, these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety; now, therefore, Be it enacted by the People of the State of Maine as follows: Sec. 1. 22 MRSA ?261, sub??6?A is enacted to read: 6-A. Duty to report; noti?cai A physician, physician assistant or nurse who was the primary care provider for a .voman who died during pregnancy or within 42 days of giving birth or a child who died within 1 year of birth shall within 30 days after the death of that person report the death to the panel in the manner speci?ed by rule adopted by the panel. A person who reports a death to the panel under this subsection shall, at the time of death or of making the report, provide notice to the parent or parents or other authorized representative of the deceased person of the report to the panel. Sec. 2. 22 MRSA ?261, sub-?ll, as enacted by PL 2005, c. 467, is repealed. Emergency clause. In view of the emergency cited in the preamble, this legislation takes effect when approved. SUMMARY This bill requires health care providers to report to the maternal and infant death review panel all deaths of infants under one year of age and women during pregnancy and within 42 days of giving birth and to provide notice of the report, at the time of death or at the time of making the report, to the parent or parents or authorized representative of the deceased person. The bill repeais the ending date of January 1, 201 1 of the maternal and infant death review panel. Page 1 A STATE OF MAINE 124TH LEGISLATURE LEGISLATIVE NOTICES JOINT STANDING COMMITTEE ON HEALTH AND HUMAN SERVICES Sen. Joseph C. Brannigan, Senate Chair Rep. Anne C. Perry, House Chair PUBLIC HEARINGIV (LB. 1592) (LB. 1599) (L.D. 1616) CONTACT PERSON: Wednesday, February 03, 2010, 1:00 PM, Room 209 Cross Building Bill ?An Act To Update the Laws Affecting the Maine Center for Disease Control and Prevention" (HP1130) (Presented by Representative of Eagle Lake) Submitted ?by the Department of Health and Human Services pursuant to Joint Rule 204. BiiI "An Act Regarding the Maternal and infant Death Review Panel? (SP0606) (EMERGENCY) (Presented by Senator MARRACHE of Kenneoec) (Cosponsored by Representative CAMPBELL, SR. of Newfield, Representative of Wilton, Representative STRANG BURGESS of Cumberland, Representative STUCKEY of Portland) Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 203. Bill "An Act To Enhance Newborn Blood Spot Screening To Conform to Federal Newborn Screening Standards" (HP1144) (Presented by Representative JONES of Mount Vernon) Submitted by the Department of Health and Human Services pursuant to Joint Rule 204. Jan Clark 100 State House Station Augusta, ME 04333?0100 2874 317' . .. - (Lo. 1599) (L.o._16_16) PERSON: WORKSESSION AGENDA - - 3-HEALTH AND . I -- 1:00 PM Room-209 Cross Building Bill "An Act To Update the Laws Affecting the Maine Center for-Disease Control and . i . -'-'PreventEon" (HP1130) (Presented by Representative MARTIN of Eagle Lake) Submitted -- bytheDepartment of Health Rule Bill "An Act Regarding the Maternal and, Infant DeathRevlew Panel" (SPOSOS) . - . (EMERGENCY) (Presented by Senator MARRACHE of Kennebec) (Cosponsored by i. Representative CAMPBELL, SR. of Newtield, Representative SAVEELLO of Wilton, 4 "Representative STRANG BURGESS ofCumberland, Representative STUCKEY of 3 Portland) Approved for introduction by a majority of the Legislative Council pursuant to. - _'JointRule_2_O3. . Bill "An Act To Enhance Newborn Blood Spot Screening To Conform to Federal Newborn Screening Standards" (HP1144) (Presented by Representative JONES of Mount Vernon) Submittedby the Department of__Health and Human Services pUrsuant TitoJointRuiezoA - -. Jan Clark - . - . . 100 State House Station . - Aug?ustarME 04333?0100 '1 .287?1317 TESTIMONY SIGN IN SHEET Joint Standing Committee on Health and Human Services, LD: 42? Date: 2 ~3?j/J Name - Town/Affiliation Propoment Oppohent Neither TM .d?ggsg Zihgmc?g? - a Ski/94,0 ngwm/ made; WLWA . guy Ma?. Maine Early Childhood Comprehensive Systems Initiative DHHS, State House Station #11 2 Anthony Avenue AugLista, ME 04333-0011 Maine Children's Growth ?Council. First Lady Karen Baldacci Superintendent William P. Braun The, Vo'icefor Early Childhood Statement of the Maine Children?s Growth Council Before the Joint Standing Committee on Health and Human Services In support of LD 1599, An Act Regarding the Maternal and Infant Death Review Panel, sponsored by Senator Lisa Marrach? Public Hearing: February 3, 2010 Dear Senator Brannigan, Representative Perry and members of the Health and Human Services Committee, At our meeting on February 1, 2010, the Maine Children?s Growth Council voted unanimously to support LB 1599, "An Act Regarding the Maternal and infant Death Review Panel.? The Maine Maternal and Infant Mortality Review Panel was designed to assess the events, circumstances and services in place prior to, at the time of and following the death of an infant or mother. Constructed after national models of Maternal and infant Mortality Review Panels, this group of professionals, parents, physicians and clinicians are charged with determining what systemic gaps in policy or service might have prevented death or mitigated trauma. By repealing the sunset clause, this bill will allow the Maine Maternal and infant Mortality Review Panel to continue its powerful work to inform systems change locally and statewide. The Council strongly believes in the value of a sustainable infrastrUcture to support early childhood systems and we are convinced that it is imperative to adopt best and promising practices that optimize the opportunities for Maine?s young children to thrive. This is one of those practices. Maine?s future prosperity and quality of life are important to every Mainer. We strongly urge you to support the passage of this bill that helps our children now and our Communities in the future. Sincerely, The Children?s Growth Council Members Co-Chairs . Members of the Children?s C?ncil Alan Coho-?Lewis Becky Brown Brenda Harvey Dana Connors Debra Hannigan Eloise Viteili Heidi Hart Jan Clarkin Jane Weil Jim Clair Jonathan Leach Judy Reidt Parker Karen Heck First Lady Karen M. Baldacci Kathy Colfer Laurie LaChance Lori Fried Moses Patti Woolley Penni Theriault Peter Lindsay Rep. Meredith Strang Burgess Rep. Seth Berry Rosa Redonnet Sarah Forster Sen. Joseph Perry Sen. Peter Mills Stephen Meister Susan Gendron Todd Brackett William P. Braun University of Maine, Parent Parent Maine DHHS, Commissioner State Chamber of Commerce Maine DOE, Child Development Services Women, Work, Community Richardson, Whitman, Large Badger Maine Children?sTrust a Maine Association for infant Mental Health Goold Health Systems The Children?s Center Maine Children?s Alliance Bingham Program Governor?s Office KVCAP, Educare'Centrai Maine Maine Development Foundation Peaks Island Children?s WorkshOp, Every Child Matters Maine DHHS, State Head Start Collaboration Kids First. United Way of Midcoast Maine Legislature Legislature University of Maine, Chancellor?s Office Attorney General?s Office Legislature Legislature Maine DHHS, Maternal and Child Health Maine DOE, Commissioner Lincoln County Sheriff RSU 19 Superintendent Testimony of the Maine Center for Disease Control and Prevention Maine Department of Health and Human Services Before the Joint Standing Committee on Health and Human Services In Support of LB 1599? An Act Regarding the Maternal and Infant Death Review Panel . Sponsored by Senator Marrach? February 3, 2010. - Senator Brannigan, Representative Perry, and Members of the Joint Standing Committee on I Health and Human Services, my name is Valerie Ricker andll serve as the Director of the Family a Health Division Within the. Maine Center'for Disease and Prevention, Department of Health and Human Servicesl am testifying in support to LD 1599, An Act Regarding the Maternal and Infant PanelThe statuteestablishing the Maternal and Infant Panel includes a - I 7- sunset of the MIMR in 201' 1. Senator Marrache?s bill proposes the repeal of this part of the .. .MIMRstatuteg - - question you maybe aSking?yourse?lf is Why the should continue when there isjalready - a statutorily mandated Child Death and Serious Injury Review Panel. While the panels overlap in. cases that includedeaths of children after the first month of life but before 1 year such as - shaken baby and sudden unexpected infant death,'there is a signi?cant difference in The Child Death and Serious Injury Review (CDSIR) Panel is a similar but separate multidisciplinary'review panel that exists as a result of Child Welfare legislation. is composed of medical,child welfare and judicial, behavioral. health and law enforcement . professionals to review. serious injuries and child deaths that may have been preventable. This . . - .panel reviewscases of child abuse and neglect (shaken but is also concerned . A with injuries from scalding tap water, drowning, auto accidents, As stated in the Maternal and Infant Mortality Review (MIMR) Panel?s Procedures Manual and Guidelines the purpose of the MIMR is to: thorotlgh examinations of maternal and infant deaths in Maine. By understanding the factors associated with infant and maternal deaths, we will expand our capacity as a state to direct prevention efforts to the most effective and humane strategies possible and be ableto take actions to promote healthy mothers and infants. The overall purpose of the program, using a public health approach, is to strengthen community resources and enhance state and local systems and policies affectng women, infants and families, in order to improve health outcomes in this population and prevent maternal and infant mortality and morbidity.?1 . The MIMR is composed of neonatologists, obstetricians, family practitioners, nurse practitioners, registered nurses, social service providers, representatives of families that have eXperienced a maternal or infant death and other community stakeholders interested in ensuring that?pregnant women and their infants receive the best care and have the best outcomes possible. The reason - states look at maternal and infant deaths is because those mortality rates are sensitive public" health indicators of social health and well-being, and of the extent to which a society invests in women of reproductive age and children as its most precious natural resource. Initially the MIMR found it dif?th to identify cases for review as the establishing legislation for the MIMR prohibited the MIMR Panel from contacting families to offer a review prior to 4 a months after the death of the mother or child: The. result was in a majority of cases the Contact information was incorrect or changed since the ?ling cf the death certi?cate and thus many potential cases were lost. .A review of available death certi?cates revealed less than 10% had reliable contact information at the time of this review. The Of?ce of Data Research and Vital. Statistics is establishing an electronic death certi?cate system that conforms to a national standard that will assure that the information needed by MIMR will better identify a maternal? death that might be pregnancy related is included in'the Recently several ?families,that have experienced the loss of an infant, have contacted the Panel - COOrdin'ator requesting information about the work of the Panel and asking to participate in the review proCess. The modi?cations to the death. certi?Cate as?well as families approaching the . A MIMRabout participating in a review demonstrate the potential to signi?Cantly increase-the number of cases ayailable- for review by the MIMROverthecourseof the last 2 years the initially focused upon-?nalizing their . - policiesand procedures as well as educating? members about theroles and responsibilities related - to MIMR membership. The Panel conducted a mock review of an infant and a maternal death which-enabled the Panel 'to reviewits procedures; .While'the referral of cases to the MIMR has -- been slow, the Panel has gathered data and information to inform panel members about speci?c risk factors fer infant mortality that have emerged as growing concerns in Maine. The following issues were identi?ed as needingfin?depth investigationz?t' - Assurance that highest risk infants g, very low birth Weight babies) are b0rn at. hospitals with appropriate facilities and professionals to provide the best chance of survival for the infant e. Level facilities). Substance abuse around the time of pregnancy as a factor contributing to prematurity, low birth weight, and birth defects, the leading causes of neonatal infant mortality. - I Shaken baby (Abusive Head Trauma) as a cause of neonatal and infant mortality. a Unsafe sleep practices as causes of infant death. 1 Maine Department of Health and Human Services. (2008). Maternal and Infant Mortality Review Panel Procedures Manual and Guidelines. Augusta, ME: Maine Department of Heal th and Hum an Services, p. I. Maternal mental illness. as potential cause of maternal suicide, child abuse and neglect, and poor pregnancy care which could result in poor birth outcomes.- One case reviewed by the Panel raised concerns related to neonatal transportation such as possible delays, type of transport, etc. and resulted in the MIMR Panel reVi?ewing the maternal . and neonatal transport system from community hospitals to centers of care withspecialize'd services (Neonatal ICU). This led to a recommendation that 'in reviewing future 'cases? the MIMR Panel should monitor transportation issues which maynegatively impact medical conditions and outcomes. In addition to the work above, over the last year, the MIMR wrote reports reviewing outcomes for infants exposed to drugs in utero, late preterm birth and all causes of preterm birth in Maine . (the second leading cause of infant mortality and a leading cauSe of developmental delay in children), and sudden unexpected infant death (the third leading cause Of infant mortality). 1 This bill'would repeal the end date of January 2011? and allOw the Panel to continue its wOrk. Panel is essential to provide public health oversight and quality improvement to ensure the safety of our maternal and infant care system.? - . .In sUmrhary, We support this bill because we believe the MMR Panel is an effective tool in? identifying and-intervening to improve the birth outcomes for "Maine families. We thank the sponsor for raising this important issue, and I am happy to answer any questions now or ?at the 'worksession. i Testimony 'of Sheryl Peavey Before the Joint Standing Committee on Health and Human Services In Support of LB 1599, An Act Regarding the Maternal and Infant Death ReviewPanel Sponsored by Senator Lisa Marrach? Public Hearing: February3, 2010 Senator Brannigan, Representative Perry, and Members of the Joint Standing Committee on Health'and Human Services Committee, - . I am Sheryl Peavey, resident of - Weeks Mills, mother of three boys and a stepdaughter. am here to testify in support of LD 15 99, An Act Regarding the Maternal and Infant Mortality Review Panel as a parent and member of this panel. The Maternal and Infant Mortality Review Panel was created in Maine to help us better understand how well functioning are our systems designed to support healthy birth outcomes. Based on national models and standards of quality for review panels, this diverse group thoughtfully reviews the events and activities prior to, during and after the death of a young child or mother. It does not conduct criminal investigations, nordoes it point ?ngers when things go Wrong. I am a member of this panel to help provide the parent perspective as we review these dif?cult events. I would like to share with you some of my personal story in Colorado (before I returned home to Maine) to give you a picture of what this Panel can do to make a difference for families. My ?rst son Dylan was born in August 1997. He was a healthy, inquisitive child and barring the normal parenting scares of raging fevers with ear infections and the occasional consumption cf rocks and bugs, his ?rst two years were hill of shared learnings. On a Saturday, the week before his second birthday, he suddenly became ill ?om what we believe was a virus. He died in my arms as I was dialing 911 early Sunday morning. What happened in the next hours and days would be the sort of information that a panel could sift through and realize that some simple changes could have mitigated the trauma. When the ?rst county sheriff arrived while I was still on the phone with 911, he stood there helpless?~the only mask he had for CPR was adult sized. When the ambulance arrived, we were told that a helicopter was on the way ?om Denver and it would meet us'at Children?s Hospital. An hour later, we arrived?in Denver only to spend several minutes asking hospital personnel how to ?nd our son. We ?nally were told that the helicopter never left our mountain town. The head nurse suggested we go back home. - So, there I was, two times zones from my parents, with the immediate realization that I would never again feel my son?s arms around me or hear his laughter or his tears. I don?t remember the drive back up the mountain. I don?t remember who we called ?rst. What I do recall is the accusatory tone of the death scene investigator who made me ,{feel as though my inability to recall speci?c details less than three hours after my son?s death indicated maltreatment on my part. A mask, communication during emergencies, compassionate queStioning. Three things, that with better preparation, could have made a difference in my experience. But our MIMR panel would also take a look at what was helpful for grieving families. The coroner?s office, who stayed in regular contact with me for three months, calling to check in even when there were no updates about the results of the tissue sample sent to the CDC in' Atlanta. The pediatrician who told me that Dylan most likely would have died in the hospital had I brought him in anyway, The small town community who not only tracked dov'Vn my father and sister at a conference in New York, but connected with people here in Liberty to get my mother to Portland and on a plane. My employer, who gave permission for the company employees to volunteer at Dylan?s child care center so the staff there could attend his servicemand?what ,atribute to Dylan to know that for at least one day, the 249 other children at that center had plenty of p0sitive attention and presence ?'orn caring adults. Compassionate communication, informal community supports, ?exible employer. Three things, that when shared with ?rst responders, community agencies, or employers, could make a difference for another family when a child dies. I respectfully ask that you remove the sunset clause from its legislation and allow the panel to continue its work to build on the of our Maine communities. Helping to make even little procedural changes can lessen the grief for parents. Thank you for this opportunity to testify. I am willing to answer any questions and will be available to attend the work session. Testimony of Jay A. Naliboff, MD In Favor of ID 1599 Senator Brannigan, Representative Perry, members of the Health and Human Services Committee, my name is Jay Naliboff and I am a practicing obstetrician gynecologist at Franklin Memorial Hospital in Farmington. I am also the Chair of the Maine Section of the American College of Obstetricians and Gynecologists and a member of the Maine Maternal and Infant Mortality Review Committee. I would like to thank Representative Saviello for sponsoring LD 1599 and I would like to thank Speaker Pingree, Senator Mitchell and the members of the Legislative Council for allowing this bill to be considered on an emergency basis. Review of maternal and infant mortality in Maine is still a work in progress. After passage of the enabling legislation, rule-making occupied most of a year. Next changes in leadership and un?lled positions at Maine CDC slowed us down further. There is now in place a stable core group of health care professionals, Maine CDC staff, epidemiologists, DHS professionals and concerned lay members who are ready to begin reviewing maternal and infant mortality in Maine. We have had requests by family members who have suffered a loss and who wish others to learn from their experience. We have rules, in place. We have staff able to extract the necessary information and conduct family interviews. The new state Death Certi?cates will make case ?nding -ea31er. Although maternal and infant mortality is commendably low in Maine each case has lessons to teach about access to care, delivery of care, and family resilience in the face of tragedy. I urge you therefore to report out LD 1599 as ?ought to pass?. Respectfully submitted, Jay A. Naliboff, MD March of Dimes Urges the Maine Legislature to pass LD 1599 which would repeal the ending date of January 1, 2011 of the maternal and infant death review panel and require health care providers to report all maternal and infant deaths within a time frame to the review panel . The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. The March of Dimes supports ID 1599 and repealing the ending date for the Maternal and Infant Death Review Panel and require health care providers to report to the review panel all deaths of infants under one year of age and women during pregnancy and within 4-2 days of giving birth and to provide notice of the report, at the time of death or at the time of making the report to the parent or parents or designated person. There are over 200 plus similar prongS in large cities and counties across the nation. Maine is one of a few review panels to cover the entire state. Programs such as this help ed identify the information that led to the Back to Sleep Campaign, educating families that placing a baby on its back for sleeping would help reduce the instance of SIDS (sudden infant death Panel members never see speci?c patient name and/ or address. All records reviews and information gathering is done by the MIMR coordinator, who removes any and all identifying information. The March of Dimes urges passage of LD 1599, which repeals the ending date for the review panel and requires health care providers to report maternal and infant deaths within a time Ewe to the panel. The overall purpose of the program, using a public health approach, is to strengthen resources and enhance state and local systems and policies affecting women, infants and families, in order to improve health outcomes for mothers and babies. March of Dimes supports LD 1599 to which will repeal the ending date of January 1, 2011 of the maternal and infant death review panel and require health care providers to report all maternal and infant deaths within a time frame to the review panel. March of Dimes Maine Chapter 60 Gray Road, Unit #8 Falmouth lVfE'. 04105?2024- Phone: (207) 878?1199 m.marchofdimes.com For more information, please contact Jeff Gale, Director of Program Services at (401) 454-4911 or igale@marchofdimes.com The March Ly?Dimer a national, whining; health organization whore mz'm'on to improoe the health of hahz'er promote/rig, hz'n?h dainty and in?znt mon?alzy. Founded in 7938, the Foundation iJ' of m'entz'rtr, e/z'nz'donr, porentr, memherr ofthe hmz'nen and other oolnnz?eer: and ho: a track record odoanoerforAmeriea and children. .. h1f311ti.M01?alitY.ReVieW Panel) Was repeal date. 'of 21111131? 1 - -- - panel cool'dinator is required to reinW-th? deaths of _a11_W011iei1_ during," - . . zij?arof ??gs?T I . LEGALANALYSIS I. if - I I I Death -. .ThefMatemal and. hifant Death Review-Panel; i?efe?ed teas-?the MHVIR (Magma-lad .- - - I 42 days Ofgivillg bilTh a11_d__tl1e majoritypf daathSOf infants i :1 his b? iofftliejdcathandnotify offhe deceasa?d - .: - 32; Adds to the panel duties notice feqil.irem611ts cases in 5 i Which?lafetus'doeslmt SuiYiV? until bil?iivhai?lc pliggllanCywas'expecte'd?tci I513 I .I .. . I .duties and powers - I . . I. dea?iCerti?cateinfo?na?o? obtaincd?'oin the-new" I - 4. '-Repeals therep?aldataofthepanelE1. {Aquestion was raised about refer to Ii__1_1e3_c_aiscs_involving the failure of the. I ,IV'fctus: to until b11111, An amendment is to address - .- INFORMATION NEEDEDBY-COMMJITTEE: 3N0 infonnation available trans 't 22' T1tle22 Ch?R?port?; in'or. before'January 15th each year; thei'departlnent shall report to' the" i Legislature'on thB'Pi'esl-fi-iptiQhprogramOrkforce Rules; The__department Shall adopt rules to implement this section; .Rnles adopted- .- g. . hoards, pursuant 'tothis' section are routine technical" sales} as de?ned "in Title chapter 375," -2 . as health When bene?ts-are not available under this section, the-comrnis'sioner'inay . te policy provide bene?ts under pharmaceutical benefits programs'thatWere in e?ect on May 26, 2001. - ent shall 3001, c. 293, 5, eff. May 25,? 2001; 2001; c; 467, 13?1, eaJune 28, 2001; 0.2-. . - aintained._w.. - -- - - - Historical and statutory Notes." . :2005Legislationf . .- .. . - - - La'ws- 2005, c. 401', in subsec'. 1, par; la- 3. - . - for ?Section 254". - - Lllserveas. - to health Ill use the to develop authorized 261.? Maternal-andinfant death'review panel . Text Matilda-imain 1, 2011. I i- .. The department shall establish the. maternal and infant death review panel accordance withthis Sections; . I- - -- . mgr?? Definitions? As. used-in this contextrotherwise indicates, the gagging following terms have the following I .- . 1 3g ?health I ?Center? ?n'ieans 'the'MaineCenter forDisease Control and Prevention$63335 . ?Deceased person? means a woman who died during pregnancy or within 42' days of ?its annual l'giving or a child who-died 1 Brear of birth._ I .I 7. deleted ?of I - - C. ?Director? means the director of the center; . . . .S ?Panel? means the maternal and Infant death rev1ew panel established under . - E. means an employee "Of the center: Who is appointed by ic'ates, the i director or.a person: designated by the panel coordinatOr. ., The panel Coordinator must be I . j- "a licensed-physician- or registered nurse other health 'care'professional? licenSed or registeredinth'is State.Zzi' -2. Membership; -- The panel3_consi'sts of health. care and social Service providers, public. at the maternal'and infant health and mortality." The director 'shall' appoint the members of the: - panel, who serve at the pleasure of the director.? The director shall appoint an employee of 3 - $115335 :1119 the centerto serve'as panel coordinatorContact with authorized representatives; The ?rst contact pursuant to this section with a parent'or parents or". other authorized representative'of? a deceased person'may not. - occur-prior. to emonths after the death and must; - . . description . . .. . . 'er on letterhead'oi' thecenter; and . 3 Be by. letter from the State Health ore I - . B. - Includea'_ separateinvitation to participate: in a review of the deathof the deceased"_ - person-fromsa 'stateWide organization? dedicated to improving the health of babies by- {e prescripa 31" - . preventing bil?tthl?Cth premature bnth?and mfant mortality.- I I 4. Duties and The panel coordinator'has' the following 131403131111. duties and powers. . . ., The-panel, coordinator shall review the deaths 'of women-during pregnancy or I dual Who 13'. . -;Witl1jn 42 days of giVing birthand the majority of deaths of 1 year of age, .- i the bene?t with selection. of cases of ?i1_ ant death based on the need to review particular causes of - i death- or obtaining Prior to accessing medical records", the panel coordinator shall obtain permission'in' 'the Elderly) all"_ cases for; access to those records fromthe' parent or} parentsi'or-other: authorized. .- I'representative ofthe deceaSedpersonhealth Of?cials, law' enforcement of?cers and other persons with professional eotperti'se 'on? . WELFARE CERTIF I . Prior-to 'conducting a_ voluntary interview, thelpane1__coordinatorshall obtain permis? . . sion in all. Cases for the. interview from :the parent or parents :or other authorized 7- Hero-1.1m, -- 1D. The panel coordinator may Conduct volmitary interviews with the-parent 'or parents 2005, mass of .a deceased child or other relevant family members of a deceased person. ThepurpoSe - [15 ?of the voluntary interview is limited?to gathering information or. data for the purposes of 5 . azthe panel in summary 01? _abStract form witlioutllfamillea'IDes or patient identi?ers. -.A . . "person who conducts intervieWs _under this paragraph must meet the quali?cations _'-for A . _le 7 4 panel. coordinator and also have professional experience 'ortraining _in bereavement 3' services. .AperSOn conducting an interview under this. paragraph may make a referral . for bereavementcounseling; . _"The -pane1_t:oordinator shall prepare asummaiy'orabstract of releVantjinformation 1: - iVol . .-regarding the deceased p?ers0n', .asdetermined to be useful to the pane1,'but withOut the availabilit - name or identifierlofxthe deceased'person, and _shall present the summaryor abstract to: With Child I 5. Duties and powers ofpanel. Thepanelhas the following duties and powers. l' f] .i A. shall conduct reviews of the panel .- - I-?The panel shall present an annual repert to the department and to__thejOint standing . - 1 committeeof the Legislature having jurisdiction _over health and human Services matters; ,1 .E -. "The report must identify factors contributing to maternal andinfant death in the State, '1 I determine the and weaknesses 'of the current maternal and infant health care .- - delivery system and-make _recoimnendations to_the department-to decrease Ztherate of .- - II. - maternal andinfant - . 7 Theupanel the annual report to _thei'parentfor parents 'or other I . I authorized representative :of. the deCeased person that granted permission to the _"panel . - c_oerdinator;_for subsection 4, paragraphC. 3 3' '2007, 0.583 C, "The panelshall share the results of its datareviewsand recommendationswith the 3- 'Child; death and serious injury review panel established pursuant. to section . .V'_'subsectionv paragraph The maternal and infant death review panel may request. - and, review data'ifrOm the child death and serious _injLuy review panel, regardless of any i- .. . _priorworlc bythe child'deathand Seriousinjury._rev_iewpanel; 231:. I . . --Limitations._ The panel coordinator may not preceed "with reviews bf medical records?: .35;th .D . - -"or-voluntaryinterviews Without the permission of-the parent "or-parents .or otherauthorized 329 . representative-of the cleceasedperson, pane1_coordinat01_'_may not photocopy or retain__- 330' JE: . copiesiof medical records. performing worklunder this section, the panel coordinator 2 332: -5 .Su shall the burden '_imp0sed .on'health? care practitioners, hospitals and facilities. 333; PI. . In; "Cen?dentiality. All recei'ds created orimaintained, pursuant to .this seetion,_other than. 33.3: reports provided-under subsection B, are protected. as provided this . 'subsection?The records are confidentialunder sectioni42, subsection-5. The records are not 334. Re - "open -to"public_ inspection, are _not public records for the purposes of Title .1, :chapter :13, - .. Subchapter land are *ndtisubject tosubpoena or. civil process _nor admissible in evidence connection with any or otherproceedingpractitioner, hospital or health care facility nor the employee l. . _z or agent of that person or entity-is notfsubject to Lcivil or criminal liabilityarising from the: AS. {med . disclosure'orfan'nishing _of-records _or information to the panel pursuant to__.this sectiondepartment may accept any public or private funds to? carry out the purposes ofth?is sectionm?e?fenea. -. . . Rulemaking._ :The department shall adopt rules to implement this section, - I - ?rules _on'collecting information and data, selectingmembers _of the panel, collecting and using somtega . - . identi?ablehealth information and conducting reviews underthis section; The; - -- -_IuleS-1nust ensure that access to _inclividuallyidentifiable health informatiOn is restricted as - "finuchas possible While enabling the panel to accomplish its work. The rules must 'eStablish a 12f 3' - h05P3__'. protocol confidentiality, specify the 3_manner. in (Which-family {and .1?epresentatives will?be [contacted for permission and. maintain public. con?dence 111., Title 22 . g. I Y. i sin perms; "proteetien of individually identi?able Rules adopted 'p'ureuem to this subsection. . aullhorizetl are as de?ned in ?I?itle 5, chapter 375,? schhapterB??A. - -. tor'par'entsn 3; .. -- . Fhe Purpose} 1'5 . -- .- -- [mam-OHS" forf- This section is remitted by its own terms, a?cctiv? Janitan 2011 I . i . a wereavement I i .. .. {ea1?efer1?al ?2,262. I Home Visitl ??formatidn. voluntary univers home visiting program. "The department-a" pemnitted the." abstract to with children frOm the .pren? 31' 'stage of development through 5 year of age, regardless of .I .. family income level. The hon visiting program'must incorporate following principles: .- Brg?. I . a A. IHealthy and strong par nt?child attachment; I - - - Physical and behavibral 'alth of the family; I Reduced incidence?lofChild and neglect; I Positive and creative learnin environrneiits for the 111d; -. I I Effective'and positiv'e'parentil I i I Pali'ental?competent?es and self? Reducing family isolation throug (communi- . .- School readiness; and I eats or 0111191?. se1f~suf?ciencyl itothepanelits. presented oint standing 5} vices matters. in" the State; - at health care se the rateof 3' are .e .0 Pd. Ltions With the 1 . 5 section-4004, . . - ?i gerdlessofeny CERT learn '0 .1 De?nitions. . -- a -- Scigguor retain 329.. Certi?cate of need required. Exceptions. 332. s' Subsequent review; and faculties. 333. Procedures after volunta 3 . tv reductions. 1 . - . Llon? other thal 333?111. Procedures for allo ursing facihty projects. .k . proval; record. - - . -- li?ed review and approval process. nurSing'facilieg 1339. . Revie process; public hearin'g.'. - . 1aireallocatio'n'ef? 34s. Withhol ingeffun'ds.) (?Mde'd m- - I nm?smgfacmw'cap City; - 350._ a Penalty. lemds are-no 334-?- 4 Repealed. .. i -. .- . 350WA. Repealed. .1,_chapter 13,? . .. I. emp oyee- - rising from the-E. A5 listed in tins tothig-Sectionfouowgmgamh .thaw-5115151195 Access ?3 dare? means the 'ab?i'ty'itofobtain .a'timeiy manner - .- i. I. .l .I .. needed person __he_alth Services toiachieve the. best possible health outcom balanced by the limitation, travel, diet'ance,3waiti11g tune, available resource availability of let?ng and usmga Somme of care and the health'status of the population served. -. - - JS sectlon. - ThereStrieted as thhu?dence 'in. tlieWh?.ther in indi?duas 01? group Pra?ticeL . . 3268 1: Without the . availability of funds, shall 0 er a'volunt?aiy universal heme visiting pro" for new families - pter, coi1:teirt'othei'vlrise hidicatesithe'fo terrn'shave 5 health syste' resourcelimitations;?Accessto caremay be in?uenced many factors: 2. :A'm?ulatory surgical facility. ?Ambulatory surgical facility? fneansj_'a faci 'ty,=notpart 3 of a. hospital,- that provides surgical treatment to patients" not requiring hospitalizatibn. - I II II I 10,2010 gmposea Cohimitt?? II acts do not become effec?fve - I -'ui_1__tIi1 9.0 days after I the Statute establishing the and infant death panel .Ii1I1c1ILI1IdesaI1'epeal - I . I oIfJaJIlILtat'yIl,2011actionis taken intheI lI24th Legislature Ito preventthe repeal, the panel?sII I 3.. ?l?ch and :Iwclfal?e, win 08.336; and II W11 areas; in the judgment of the Legislature, these. facts create an emergency Within the meaning Of the C011Stit11tion of Maineand 1'eqni1?e the following necessafy -fcI)1? the I. I- I .Ig-pijesertI/atioin oIfthIeIpublicIIpeace, health and safety; now; therefore, .- .- the 0f_IMai1I1I?__aIsIfolles.22MRSA ?2j51 is amended. {55-1 . I 37.; depaltinent stIhallIestahli-SIh ti?eVieiw panel in aIcCordance with - I I - As nsedinthis the cdlitIextIothelwIise indicates, the following I I II means the Maine Centerfo?rDiseaseI Control - . 3.: I II I B.I 1nIeansI-a'WQmIaanl10 died during pregnancy or within .42 days Of givin .bhth or: {child Who diedWithinIl =Iyea1'IIof bn?ch.? - - - I II authorized tebreSentatiye olfa'deCeased person?Panel? means the inatenial andinfant IdeathIrevieW pancl established underI this - means an employee of the center appointed byIthedIi1'ectoI1? 01? I - designated coordinator} The panel coordinator mustbea liCensed '5 - I -. ?Family? means a woman who has experienced a fetal death 01? the parent Or parents 01orIi?egistefed nurse 01?Iothe13I health care professionallicensed or registered Iin-this; State; I panel consiIStsI'oIf health care a11cIl_IIs_oci_al sewice I II I I gof? ciats,_ law enforcement of?cers and with professional.expertise On maternal and I I I I I .1I infant health and mentality; directorshall IappOint the 111Ie1nb61?s of the panel, who sen/cat the i- - II .thleasIuIrIe oIfthe 'appOint an. :e_1_anlonee of the _cIenter_._toI_se1v_e as_Ipanel -II II . . II [Coordinator :LD.1599I-2.dcc - I . With alithorihed representatives: The with-an?thefamil maynot'occur priort'o 4'_111011t11s afterthe 5 Be Iletter the letterhead of tlie'center; '5 I. inVitation to 'paitiCipate in'a revievv of the death of the deceased I. I I 'person or thetfetal death fromastateivide'organization dedicated to improving the health cf -. babies by'pi':eVenting'birth birth and infant mommypowers? orpanacqamin'atqr.fgThe pa??ifmdi-di?ator raga?1e ramming duties - I 3 'i I t' I Iii. i coordinators11'all review-the'deaths all Women during-pregnancy or'vvithin 42, r. - .- days'of giving birth the'maiorit'v'of cases in' Which a fetal'death Colours after 28'Weeks of a 3-. . I I ge'st'ation'and-_ the: niaj ority of deaths- of infants under 1 year ofagerwith selection of cases of . 5 infant death based on the need to review particular causes of death Crobtaininga representative . -. The panellcoo?rdiriator'shall haVe access to the death certi?cates of de'Ceased and- - I *3 tolfetal' death certi?cates offet'alldeaths'28 weeks and greater gestation". I 9 -- - accesSingmedical'records; the iniall for access t'othose records from the I: family ?3 .i Pi?i'O?to oondiic?'ng a vo'lu'ntaryinteiview, penniSSioh in. I . allcas'es for theinterview from the - - - a - not" voluntary interVieWs with thefamilyparent?ei?paients? -: 1 I - 'i "(The plirpose'ofthe'" - voluntary inteivi'ew- is'li'mite'd to gathering'infonnation or data for the pinposes or the-panel in 7 . . "3 shininary or abstr'a'Ct' fonii'withoiit family names _or patient identi?ers. A perSOn' whoconductg a? .. interviews under-{this paragraph'iri'ust meet the quali?cations for panel coordinator and also.?3 :1 have professional "experience" or training in bereavement 'serVice'sL: A pierSOIn Conduct:ng air-13 I I 2 int'erView under this paragraph may'inake a: referral for bereavement c'ouIiSeling. I -- I The panel co'o'rdin'atorinay cond E. The panel coordinator shall prepare a or abstract relevantIinformation?regarding . the deceased peISOn Or fetus, as determined to be Useful to the panel, but WithOutWDersonal identifVing"infOrInation, andshallpresent'the . I 'i a i'silininarys'or to the panel, I I I Drivers o'f'ptin?lf; The :p'anerhas theallowing-duties land-powers; shallConduct"Comprehensive the} The panel. shall present an aimual'repOrt to the depaitinentaiid to the" joint H's-tandingf . 5 of the LegiSIature having jurisdiction overliealth__and-human Services'niatters.? The i . identify factors contributing? toniatemal and infant death in the the 5- the current'm'ateinalgiand infant'health care delivery System and f? - I I I I make? recommendations tothe department to' decrease the rate of maternal- andirifaiit death;- I 1 i - :Theip'anel sliall _offe_r ?aco'py-ofthe annual repo'i'tlto the - . .I .I faniilynienibei?that granted -- .- . .. .. . I Thepanel shall 0f its data'i'eviews'and -1'ec_ominendations_with the child . :gdeath and serious injury reviewpanel establishedpursuant to seetioii paragiiaph E. ItTlie'Inatenialand infant death _'ieyiew panel niayi'equest and reviewdata?'orn the i death andserious injtuy-i'eview panel, regardless Of any Ipl'iorgw'oi'ktby. the: child deatli'and . "ifs-serious injuryreview-panel-.- ?peiinissiontothe panel: 1' The panel c'ooi'dinato'rmay not proceed 'witht?ey'ieWsof medical recordsoiT - V'OIuntary"inteWiews Without thepennissionld the 'i'Th? 1391161-C501?di?af01?may liidt'lPhOtoCoPS/IOiiretain: 3 . - copies of niediCal recoi?dsto?r ?1'eVieW' cases 0f abortion. tlii_s"_s_ectioii_, the I I -_'p_anel coordinator Shall burden imposed on "g I records puifsuant to this-section, other than 1: provided ?nder Subsec?'tion. Pai?asl?aph B, ai?e'pifot?cted as .pI?OVidsd. ili The 7 il-g section 42, subsection 5. The are not open to public - - -- 'inspectioiigaife?not public 1_e?or_ds__ for the puiposes of Title and are not Ii I - executive, legislative Oifiotheifproceeding] -- _.subject tosubpoenaor civil process' not admissible in eVidence inconnection With any judicial, 2 I health eai'efacility-or the'eniployee goif; i. 2* agent of that person or-entityis not subject tociVil '3 -- - -- accept any public or private funds foamy out the puijaosesll': If 5 - __of;tliis I I on collecting infonnation and of the panel, Collecting and using infounation and conducting this Sectio_i_1._. "The iules -- - access'to individually.identi?able health information is restricted astinuch as 3 5 possible while enabling the panel to accoinplish its work. :The iules mustestablish aprotocol: to - preserve con?dentiality; specify the manner in which .fa1i1ily_.an__d authoifized representatives Will be .I - 7 and .1naintain'public confidence in the protection'o'findividually"t identi?able information. V-Rules adoptedpursuant t_o'tliis_siibsecti_oti aretoutinCieichnical111165 de?n?di?Ti?S .l I I I i'E'm'ei'geincy In yi-ewofitlieemergency the 'piielainble, tliis_legis1ati_o11 takes effect .. - 7:.This adds. to the-po_weiflsiof the ?anel coordinatOI review based on fetal death I I Ilceiti?cates.? The to_-the_d_u_t_ies_of the-panelcoordinator review/bf the The ainen'dine'ntpi?ohibits the from reviewing cases . - - I. -- - . Ln 1599-2.dpc i Proposed-Amendment to LT) 1599 Senator I. I 2010 I i . 1599-.doci. LB 1599, .An Act: Regarding-the Maternal and Infant Death Review Panel Emergency preamble. Whereas, acts and resolves of the Legislature donot become effective until 90days after adjournment unless enacted as emergencies?Whereas, the statute establishing the maternal and infant death review panel includes arepeal Whereas, unless action is taken in the l24th Legislattn'e to preyent the repeal, the panel's work, ?which furthers the public healthand welfare, will ceaseWhereas, in the judgment of the Legislature, these facts create an emergency within the meaning . of the Constitution of Maine and require the following legislation as immediater necessary for the .- - a preservation of the public peace, health and safety; now, thereforeenacted by the People of the State of _Maine as follows: .7 S_ec._ .1. 22 MRSA ?_261_is amended .t_o_read: Thedepartinent shall establish the maternal and infant death review panel in accordancewith i - 1, De?nitions. As used in this section, unless the context otherwise indicates, the following .~tenIlS haVethe followingmeanings"Center" means the MaineCenter for Disease control and PreVention. a I B. "Deceased person" means a woman Who died during pregnancy or within 42 days of giving 4 . birth or a child who died within 1, year of birth. For the purposes of this section onlv. ?deceased person includes a fetus that did not survive until birth in a case in which the pregtancv was expected to go to term. - "Director" means the director of the center. "Panel" means thematernal and infant deathreviewpanel established under this _se_ction.__* E. ."Panel coordinator". means an employee of the. center who is appointed by the director or a . -- . person designated by, the panel coordinator. The panel coordinatormust ,be a licensed physician orregistered nurse or otherhealth care professional licensed orregistered in this state.1Membership. The panel consists of health care and social service providers, public health 9 - officials, law enforcement of?cers and other persons with professional expertise on maternal and . infant health andmortality. The director shall appoint the members of the panel, who serve at the . 2nd\amend LD 1599x7100- pleasure thie'director?. The director shall appoint-an employee'of the center to serve as'pa?el coordinator._ . j. .. .. 7 Contact With authorized 'l'epreSentatives. The ?rst-contact pursuant to this'section with 3 parent or parents or other authorized representative of a deceased person may not occur prior to 4 months?afterthedeathandmuSt:' I Be by letter from the State Health Of?cer on letterhead cf the center; and I I VI B. Include a separate invitation toi'participate in a review of the death of the" deceased person from a statewide o'rganiZation dedicated to "improving the health of babies by preVenting birth 3 defects, premature birth and infant mortalityDuties and powers'tof panel-teardinator. The panel Coerdinator has the followmg duties and powersThe'panel cOordinatOr shall review the deaths of all women during pregnancy or within 42 I days of giving birth and, the majority of cases in which a'fetus did not surviVe until birth when the pregnancv was expected to go to term and the majority of deaths of infants under 1 year of age, with selection of cases of infant death basedon the need to review particular causes of - death or obtaining a representative sample of 'all deaths. . I i . The panel coordinator mav undertake a review based upon death-Certi?cateinformation" accessible ??orn an Internet website maintained bv the department; I I PriOr to. accessing medical records, the panel coordinator Shall obtain permiSSion in all cases for access to those records from the parent or parents or other authorized representative of the . deceased personf - - C. Prior to conducting a v0luntary interview-,vthe panel coordinatOr shall obtain'permission inf - all cases' for the interview from the parent or parents or other authorized representative of the .deceasedperson'. j_ . I I The-panel coordinator may-conduct- 'v01untaryinterviews With the parent or parents of a deceased child Or other relevant family members of a deceased person; The purpose of the I . voluntary interview is limited to gathering information or data for the purposes of the panel in summary or abstract form' Without family names or_ patient identi?ers. A person who conduCts. _interviews .under this paragraph must meet the quali?cations for panel coordinator and also have professional experience or training in bereavement services. A- person' conducting an - interview under this paragraph may make a referral fer bereavement counseling. i . E. The panel coordinatOr shall prepare a summary or abstract 0f relevant infonnatiOn regarding the deceased person, as determined'to be useful to the panel, but without the name 'or identi?er__ {of the deceased'person, and shall present the summary or abStract to the panel._ S. Duties and poWers of panel. :The'panel has the following-duties and powers; - I A. I The panel Shall" conduct Comprehensive multidi's'ciplinaryi reviews of data presented by the W'panelcoordinatori. . . i I The panel shall-present an'annual'repOrt to the department and to the joint standing committee of the Legislature haVing jurisdiction over health and human Services matters; The - report'must identify factors Contributing to maternal and infant death in the State, determine the and Weaknesses of the current maternal and infant health care delivery System and 'malce'recommendations to the department to decrease the rate of maternal and infant death;_ 3 2nd\amend Ln 1599.doc . - The?panel shall "offer a Copy of the annual report to the parent or parents or other authorized representative of the deceased person that granted permission to the panel coordinator for a - . 'a i. ?311111th intcivicwunder subsection 4, paragraph C. - . C. The panel shall share the results of its data reviews and recommendations with the child ,death and-serious injury review panel established pursuant to section 4004, subsection 1, - '.'paragraph E. The maternal and infant death review panel may request and reviewdata ??om the child death and serious injuly review panel, regardless of any prior work by the child death and Limitations. The panel coordinator may not proceed with reviews of medical records or - 3. voluntary inteivicws without the permission of the parent 91' parents or other authorized - representative _.of the deceasedperson. The panel coordinator may not phOtocopy or retain copies cf medical records. In performing workunderthis section, the panel coordinator shall minimize the burdenimposed on health care practitioners,hospitals and facilities. I Duty to report: noti?cation. A physician. physician assistant, nurse. nurse Midwife or i midwife who was the primary care provider for a woman who died during pregnancy or within 42 days of giving birth or wlzose?ferus did not survive until birth, or a child who died within 1 year of birth shall within 30 days after the death of that person report the death to the panel in the manner speci?ed by I I rule adopted by the panel. A person who reports a death to the'panel under this subsection shall,'at the . time of death or of making the report, provide noticelto the parent or parents or other authorized .- representative of the deceased person of the report to the panel._ i . 1 7. Con?dentiality, - All records created or maintained pursuant to this section, other than if reports provided under subsection 5, paragraph B, are protected as provided in this subsection. The are con?dential under section 42, subsection 5. The records are not" open to public . - . inSpection, are not public records for the purposes of Title 1, chapter 13,?subchapter. 1 and are not :.subject to subpoenaor civil process nor admissible in evidence in connection with any judicial, executive, legislativeor other proceeding . -. .. 8. Immunity. A health care practitioner, hospital or health care facility or the employee or .3 agent of that person or entity is not subj ect to civil or criminal liability arising from the disclosure . iorfurnishing'of records or information to the panel pursuant to this section; . 1 I - . 19'. Funding. The department may accept any public'or private funds to carry out the-purposes . ofthissection; - - .- .I 10. Ruiemaking. The department shall adopt rules to implement this section, including rules on collecting information and data, selecting members of the panel, collecting and using individually identi?able health information and conducting reviews under this section. The rules . I must ensure that access to individually identi?able health infonnation is restricted as much as I 3 possible while enabling the panel to accomplish its work. The rules must establish a protocol to I preserve con?dentiality, specify the manner inwhich family and authorizedrepresentatives will be contacted for permission and maintain public con?dence in the protection of individually ?identi?ableinformation. Rules adopted pursuant to this subsection are routine technical rules as - de?ned in Title 5, chapter 375, subchapter 2-A. I - - 3" Emergency clause; lnvie'w of the. emergency Cited in the'preamhle, this legislation takes effeet I whe'n'app'rovedsmith}: . . This bill 1*etluires health care prOViders to report't'o the matemal'a'nd infant death review panel I I I all deaths o'f'i'nfants'under one year of age and women during pregnancy and'Within 42days of giving birth and to prbvidenotice of the repert, at the time of death or at the time of making the report, to the . parent or parents Or authorizedrepresentative of the deceased person. The bill'repeals the ending date" ofJan'uary l, 2011 ofthe maternal and infant death review panel. i I The amendment adds to the p0wers 'o'fthe panel Coordinator review based on death Certificate ity?ormation from an Internet website maintained by the department. The amendment adds to the duties ?of the panel coordinator review of the majority of cases in. which a fetus did nOtsurviVe until birth- when the pregnancy was expected to go to term; The amendment requires a' physician, physician assistant, nurse; nurse midwife 0r midwife who was the primary care provider for a woman who died a? during pregnancy er within 4.2 days of giving birth or whOse fetus did not survive until birth, or a' Child'_ who died within 1 year-of birth to report the death to the panel and to provide notice to the parent or I parents or other authorized representative ofthe deceased person of the report to the panel. LD 1599.doc . 4233' LB. 1599 Date: (Filing No. HEALTH AND HUMAN SERVICES Reproduced and distributed under the direction of the Secretary of the Senate. STATE OF MAINE SENATE 124TH LEGISLATURE SECOND REGULAR SESSION COMMITTEE AMENDMENT to SP. 606, 1599, Bill, ?An Act Regarding the Maternal and Infant Death Review Panel? Amend the bill by striking out everything after the enacting clause and before the emergency clause and inserting the following: - 'Sec. 1. 22 MRSA ?261, as enacted by PL 2005,. c. 467, is amended to read: ?261. Maternal and infant death review panel The department shall establish the maternal and infant death review panel in accordance with this section. 1. De?nitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. ?Center? means the Maine Center for Disease Control and Prevention. B. "Deceased person" means a woman who died during pregnancy or within '42 days. of giving birth or a child who died within 1 year of birth. C. "Director" means the director of the center. 01. "Family" means a woman who has experienced a fetal death or the parent or parents or other authorized representative of a deceased person. D. "Panel" means the maternal and infant death review panel established under this section. E. "Panel coordinator? means an employee of the center who is appointed by the director or a person designated by the panel coordinator. The panel coordinator must be a licensed physician or registered nurse or other health care professional licensed or registered in this State. 2. Membership. The panel consists of health care and social service providers, I public health of?cials, law enforcement officers and other persons with professional expertise on maternal and infant health and mortality. The director shall appoint the Page 1 oo-r ox o?Lp?n D?Ir?ly?tv?QF?i J: OKDOO MN DJ \0 43-h r??O COMMITTEE to SP. 606, L.D. l599 members of the panel, who serve at the pleasure of the director. The director shall appoint an employee of the center to serve as panei coordinator. 3. contact with family. The. first contact pursuant to this section with a?parenter ers'en the family may .not occur prior to 4 months after the death and must: A. Be by letter from the State Health Officer on letterhead of the center; and B. Include a?separaate an invitation to participate in a review of the death of the deceased person or the fetal death ??om a statewide organization dedicated to improving the health of babies by preventing birth defects, premature birth and infant mortality. Duties and powers of panel Coordinator. The panel coordinator has the following duties and powers. A. The panel coordinator shall review the deaths of all women during pregnancy or within 42 days of giving birth, the maioritv of cases in which a fetal death occurs after 28 weeks of gestation and the majority of deaths of infants under 1 year of age, with selection of cases of infantdeath based on the need to review particular causes of death or obtaining the needto obtain a representative sample of all deaths. A?l. The panel coordinator may have access to the death certificates of deceased persons and to fetal death certi?cates of fetal deaths occurring after 28 weeks of gestation. B. Prior to accessing medical records, the panel coordinator shall obtain permission in all cases for access to those records from the C. Prior to conducting a voluntary interview, the panel coordinator shall obtain permission in ail cases for the interview from the D. The panel coordinator may conduct voluntary interviews with the parent?family. The purpose of the voluntary interview is limited to gathering information or data for the purposes of the panel in summary or abstract form without names or patient identi?ers. A person who conducts interviews under this paragraph must meet the qualifications for panel coordinator and also have professional experience or training in bereavement services. A person conducting an interview under this paragraph may make a referral for bereavement counseling. E. The panel coordinator shall prepare a summary or abstract of relevant information regarding the case, as determined to be use?rl to the panel, but without the name or identifier of the deceased person or the woman who experienced a fetal death, and shall present the summary or abstract to the panel. 5. Duties and powers of panel. The panel has the following duties and powers; A. The panel shall conduct comprehensive multidisciplinary reviews of data presented by the panel coordinator. Page o?d ounce-q NNHv??u?Ir?d LAD.) UJN J). J). COMMITTEE to SP. 606, LE). 1599 B. The panel shall present an annual report to the department and to the joint standing committee of the Legislature having jurisdiction over health and human services matters. The report must identify factors contributing to maternal and infant death in the State, determine the and weaknesses of the current maternal and infant health care delivery system and make recommendations to the department to decrease the rate of maternal and infant death. The panel shall offer a copy of the annual report to the person or persons that granted permission to the panel coordinator for a voluntary interview under subsection 4, paragraph C. C. The panel shall share the results of its data reviews and recommendations with the child death and serious injury review panel established pursuant to section 4004, subsection 1, paragraph E. The maternal and infant death review panel may request and review data from the child death and serious injury review panel, regardless of any prior work by the child death and serious injury review panel. 6. Limitations. The panel coordinator may not proceed with reviews of medical records or voluntary interviews without the permission of the family. The panel coordinator may not photocopy or retain copies of medical records or review cases of abortion. In performing work under this section, the pane] coordinator shall minimize the burden imposed on health carepractitioners, hospitals and facilities. 7-. Con?dentiality. All records created or maintained pursuant to this Section, other than reports provided under subsection 5, paragraph B, are protected as provided in this subsection. The records are con?dential under section 42, subsection 5. The records are not open to public inspection, are not public records for the purposes of Title 1, chapter 13, subchapter and are not subject to subpoena or civil process nor admissible in evidence in connection with any judicial, executive, legislative or other proceeding. 8. Immunity. A health care practitioner, hospital or health care facility or the employee or agent of that person or entity is not subject to civil or criminal liability arising from the disclosure or furnishing of records or information to the panel pursuant to this section. 9. Funding. The department may accept any public or private funds to carry out the purposes ofthis section. - 10. Rulemaking. The department shall adopt rules to implement this section, including rules on collecting information and data, selecting members of the panel, collecting and using individually identifiable health information and conducting reviews under this section. The rules must ensure that access to individually identifiable health information is restricted as much aslpossible while enabling the panel to accomplish its work. The rules must establish a protocol to preserve con?dentiality, specify the manner in which the famin will be contacted for permission and maintain public con?dence in the protection of individually identifiable information. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter Page 3 Nam?meow COMMITTEE to SP. 606, L.D. 1599 SUMMARY This amendment authorizes the maternal and infant death panel coordinator to have access to fetal death certi?cates. The amendment requires the panel coordinator to review the majority of fetal deaths occurring after 28 weeks' gestation. The amendment prohibits the panel coordinator from reviewing cases of abortion. It retains the other provisions of the bill, including repeal of the sunset on the maternal and infant death review panel on January 1, 201 l. FISCAL NOTE RIin mm (See attached) Page 4 Approved: 02/22/10 Wag: 124th MAENE LECESEJAVMJ Li) 1599 LR 2329(02) An Act Regarding the Maternal and Infant Death Review Panel Fiscal Note for Bill as Amended by Committee Amendment Committee: Health and Human Services Fiscal Note Required: Yes Fiscal Note Minor cost increase - General Fund Fiscal Detail and Notes Additional costs to the Center for Disease Control and Prevention in the Department of Health and Human Services can be absorbed by the center utilizing existing budgeted resources. Fiscal Note - Page 1 ofl Approved: 03/10/10 W421: 124th WENE LEGISLATURE LB 1599 LR 2329(03) An Act Regarding the Maternal and Infant Death Review Panel Fiscal Note for Bill as Engrossed with: (8-383) Committee: Health and Human Services Fiscal Note Minor cost increase General Fund Fiscal Detail and Notes Additional costs to the Center for Disease Control and Prevention in the Department of Health and'Human Services can be absorbed by the center utilizing existing budgeted resources. - Fiscal Note - Page of] or Con?rmation: COMMITTEE VOTING SHEET Committee: HEALTH AND HUMAN SERVICES Date: 3/10/10 . Motion: 0 :11 Motion by: 1! pr? Seconded by: - - Recommendation of those opposed to the Motion . d: Those cu L2 Voting in 8 a. '3 {:qu Favor of the 8 05 .3 Motion 2 ?41 Senators Joseph Brannigan Lisa Marrache? Peter Mills w, RepresentatiVes Anne Perry Matthew Peterson Patricia Jones Linda Sanborn Donald Soctomah Henry L. Joy James Campbell Sarah Lewin Meredith Strang Burgess Peter Stuckey Re Mark Eves TOTALS THE COMMITTEE ON Health and Human Services to which was referred the following: An Act Regarding the Maternal and Infant Death Review Panel . . (EMERGENCY) s.P. 606 I L.D.-1599 has had? the same under consideration, and asks leave to report that the same OUGHT TO PASS AS AMENDED BY COMMITTEE AMENDMENT . of Cumberland Signature) SEN. bf For the Committee (TYPE) I - - (Signatures) Rep. of (Town) and/or Sen. of (County) SENATE EURT Printed on reeYcled paper