Amended IN Assembly March 10, 2022 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2739Introduced by Assembly Member PattersonFebruary 18, 2022 An act to amend Sections 123636 and 123660 of, and to add Section 123636.1 to, the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTAB 2739, as amended, Patterson. Stillbirth: research. Existing law, commencing August 1, 2022, establishes the California Pregnancy-Associated Review Committee (committee) under the State Department of Public Health (department) to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. Existing law requires the committee to publish its findings every 3 years, as a part of a specified department publication relating to severe maternal morbidity.Existing law declares that the Fetal and Infant Mortality Review (FIMR) process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss. Existing law requires each county to annually report infant deaths to its respective local health department. Existing law requires local health departments, upon appropriation by the Legislature, to establish a FIMR committee to investigate infant deaths to prevent fetal and infant death, as specified, and requires the local health departments that participate in the FIMR process to annually investigate, track, and review cases of term infants, as defined, who were born following labor with the outcome of intrapartum stillbirth, early neonatal death, or postneonatal death.This bill would additionally require the committee to collect and include in its published findings data from counties participating in the FIMR process. The bill would specify that intrapartum stillbirth for purposes of the FIMR process means stillbirth at 20 weeks or more of gestation. The bill would require the department to establish a process to accept information from members of the public who have experienced stillbirth and who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the FIMR. The bill would require the department to make various resources available for individuals who have experienced stillbirth, and would authorize the department to contract with one or more nonprofit entities that provide services relating to stillbirth to perform the departments duties, if the department determines that it would be more cost-effective to do so.Existing law requires each fetal death in which the fetus has advanced to or beyond the 20th week of uterogestation to be registered with the local registrar of births and deaths. Existing law requires the local registrar to issue, upon the request of the mother or father of the fetus, a Certificate of Still Birth, as specified. Existing law requires a physician in attendance on the delivery of a fetus to state on the certificate of fetal death the time of fetal death or delivery, the direct causes of the fetal death, any conditions that gave rise to these causes, and other medical and health data as may be required on the certificate.This bill would declare the intent of the Legislature to enact legislation relating to research on the occurrence and preventability of stillbirths in California.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 123636 of the Health and Safety Code is amended to read:123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.SEC. 2. Section 123636.1 is added to the Health and Safety Code, to read:123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.SEC. 3. Section 123660 of the Health and Safety Code is amended to read:123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.SECTION 1.It is the intent of the Legislatute to enact legislation relating to research on the occurence and preventability of stillbirths in California.
Amended IN Assembly March 10, 2022 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2739Introduced by Assembly Member PattersonFebruary 18, 2022 An act to amend Sections 123636 and 123660 of, and to add Section 123636.1 to, the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGESTAB 2739, as amended, Patterson. Stillbirth: research. Existing law, commencing August 1, 2022, establishes the California Pregnancy-Associated Review Committee (committee) under the State Department of Public Health (department) to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. Existing law requires the committee to publish its findings every 3 years, as a part of a specified department publication relating to severe maternal morbidity.Existing law declares that the Fetal and Infant Mortality Review (FIMR) process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss. Existing law requires each county to annually report infant deaths to its respective local health department. Existing law requires local health departments, upon appropriation by the Legislature, to establish a FIMR committee to investigate infant deaths to prevent fetal and infant death, as specified, and requires the local health departments that participate in the FIMR process to annually investigate, track, and review cases of term infants, as defined, who were born following labor with the outcome of intrapartum stillbirth, early neonatal death, or postneonatal death.This bill would additionally require the committee to collect and include in its published findings data from counties participating in the FIMR process. The bill would specify that intrapartum stillbirth for purposes of the FIMR process means stillbirth at 20 weeks or more of gestation. The bill would require the department to establish a process to accept information from members of the public who have experienced stillbirth and who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the FIMR. The bill would require the department to make various resources available for individuals who have experienced stillbirth, and would authorize the department to contract with one or more nonprofit entities that provide services relating to stillbirth to perform the departments duties, if the department determines that it would be more cost-effective to do so.Existing law requires each fetal death in which the fetus has advanced to or beyond the 20th week of uterogestation to be registered with the local registrar of births and deaths. Existing law requires the local registrar to issue, upon the request of the mother or father of the fetus, a Certificate of Still Birth, as specified. Existing law requires a physician in attendance on the delivery of a fetus to state on the certificate of fetal death the time of fetal death or delivery, the direct causes of the fetal death, any conditions that gave rise to these causes, and other medical and health data as may be required on the certificate.This bill would declare the intent of the Legislature to enact legislation relating to research on the occurrence and preventability of stillbirths in California.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO
Amended IN Assembly March 10, 2022
Amended IN Assembly March 10, 2022
CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION
Assembly Bill
No. 2739
Introduced by Assembly Member PattersonFebruary 18, 2022
Introduced by Assembly Member Patterson
February 18, 2022
An act to amend Sections 123636 and 123660 of, and to add Section 123636.1 to, the Health and Safety Code, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2739, as amended, Patterson. Stillbirth: research.
Existing law, commencing August 1, 2022, establishes the California Pregnancy-Associated Review Committee (committee) under the State Department of Public Health (department) to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. Existing law requires the committee to publish its findings every 3 years, as a part of a specified department publication relating to severe maternal morbidity.Existing law declares that the Fetal and Infant Mortality Review (FIMR) process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss. Existing law requires each county to annually report infant deaths to its respective local health department. Existing law requires local health departments, upon appropriation by the Legislature, to establish a FIMR committee to investigate infant deaths to prevent fetal and infant death, as specified, and requires the local health departments that participate in the FIMR process to annually investigate, track, and review cases of term infants, as defined, who were born following labor with the outcome of intrapartum stillbirth, early neonatal death, or postneonatal death.This bill would additionally require the committee to collect and include in its published findings data from counties participating in the FIMR process. The bill would specify that intrapartum stillbirth for purposes of the FIMR process means stillbirth at 20 weeks or more of gestation. The bill would require the department to establish a process to accept information from members of the public who have experienced stillbirth and who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the FIMR. The bill would require the department to make various resources available for individuals who have experienced stillbirth, and would authorize the department to contract with one or more nonprofit entities that provide services relating to stillbirth to perform the departments duties, if the department determines that it would be more cost-effective to do so.Existing law requires each fetal death in which the fetus has advanced to or beyond the 20th week of uterogestation to be registered with the local registrar of births and deaths. Existing law requires the local registrar to issue, upon the request of the mother or father of the fetus, a Certificate of Still Birth, as specified. Existing law requires a physician in attendance on the delivery of a fetus to state on the certificate of fetal death the time of fetal death or delivery, the direct causes of the fetal death, any conditions that gave rise to these causes, and other medical and health data as may be required on the certificate.This bill would declare the intent of the Legislature to enact legislation relating to research on the occurrence and preventability of stillbirths in California.
Existing law, commencing August 1, 2022, establishes the California Pregnancy-Associated Review Committee (committee) under the State Department of Public Health (department) to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. Existing law requires the committee to publish its findings every 3 years, as a part of a specified department publication relating to severe maternal morbidity.
Existing law declares that the Fetal and Infant Mortality Review (FIMR) process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss. Existing law requires each county to annually report infant deaths to its respective local health department. Existing law requires local health departments, upon appropriation by the Legislature, to establish a FIMR committee to investigate infant deaths to prevent fetal and infant death, as specified, and requires the local health departments that participate in the FIMR process to annually investigate, track, and review cases of term infants, as defined, who were born following labor with the outcome of intrapartum stillbirth, early neonatal death, or postneonatal death.
This bill would additionally require the committee to collect and include in its published findings data from counties participating in the FIMR process. The bill would specify that intrapartum stillbirth for purposes of the FIMR process means stillbirth at 20 weeks or more of gestation. The bill would require the department to establish a process to accept information from members of the public who have experienced stillbirth and who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the FIMR. The bill would require the department to make various resources available for individuals who have experienced stillbirth, and would authorize the department to contract with one or more nonprofit entities that provide services relating to stillbirth to perform the departments duties, if the department determines that it would be more cost-effective to do so.
Existing law requires each fetal death in which the fetus has advanced to or beyond the 20th week of uterogestation to be registered with the local registrar of births and deaths. Existing law requires the local registrar to issue, upon the request of the mother or father of the fetus, a Certificate of Still Birth, as specified. Existing law requires a physician in attendance on the delivery of a fetus to state on the certificate of fetal death the time of fetal death or delivery, the direct causes of the fetal death, any conditions that gave rise to these causes, and other medical and health data as may be required on the certificate.
This bill would declare the intent of the Legislature to enact legislation relating to research on the occurrence and preventability of stillbirths in California.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 123636 of the Health and Safety Code is amended to read:123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.SEC. 2. Section 123636.1 is added to the Health and Safety Code, to read:123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.SEC. 3. Section 123660 of the Health and Safety Code is amended to read:123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.SECTION 1.It is the intent of the Legislatute to enact legislation relating to research on the occurence and preventability of stillbirths in California.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 123636 of the Health and Safety Code is amended to read:123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
SECTION 1. Section 123636 of the Health and Safety Code is amended to read:
### SECTION 1.
123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.(b) The purposes of the committee include, but are not limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.(4) Examining racial disparities and making recommendations on the prevention of racial disparities.(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.(B) Members of the medical team who were present or involved in the deceased individuals direct care.(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:(A) At least one obstetrician.(B) At least one certified nurse-midwife.(C) At least one certified professional midwife.(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.(G) At least one doula.(H) At least one person from a community-based organization that works in perinatal health.(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.(K) At least one person from a native tribe, preferably with experience in perinatal health.(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.(M) At least one family physician.(N) At least one emergency room physician familiar with perinatal health.(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).(4) The committee may create subcommittees, as needed, to carry out its duties.(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
123636. (a) The California Pregnancy-Associated Review Committee is hereby established under the State Department of Public Health to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the state. The department, in collaboration with the designated state perinatal quality collaborative, shall oversee the committee. The committee may incorporate the membership of the California Pregnancy-Associated Mortality Review Committee, as it existed on December 31, 2021.
(b) The purposes of the committee include, but are not limited to, all of the following:
(1) Identifying and reviewing all pregnancy-related deaths, including the cause, contributing factors, and disseminating findings.
(2) Analyzing common indicators of severe maternal morbidity to identify prevention opportunities and reduce near-miss experiences.
(3) Making recommendations on best practices to prevent maternal mortality and morbidity, including, but not limited to, addressing socioeconomic impacts, as well as various environmental impacts, including global warming, on pregnancy outcomes.
(4) Examining racial disparities and making recommendations on the prevention of racial disparities.
(5) Tracking and examining disparities experienced by lesbian, bisexual, transgender, intersex, and gender-nonconforming individuals and reporting findings, to the extent possible.
(6) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.
(c) (1) In addition to reviewing medical records, death certificates, and other pertinent reports, committee review of maternal deaths shall include, to the degree practicable, for populations experiencing disparity, voluntary interview with the following individuals:
(A) Pertinent surviving family members or support people present with direct knowledge of, or involvement in, the event, including the patient in cases of severe maternal morbidity. The committee shall transcribe or summarize in writing any oral statements received pursuant to this paragraph.
(B) Members of the medical team who were present or involved in the deceased individuals direct care.
(2) In determining the practicality of the interviews pursuant to subparagraphs (A) and (B), the committee may prioritize interviews with populations that have a documented higher rate of maternal death.
(d) (1) The committee shall publish its findings to the public every three years as part of the publication of data on severe maternal morbidity, as required pursuant to Section 123630.4. The committees findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.
(2) In addition to the information required pursuant to paragraph (1), the committee shall collect and include in its published findings data from counties participating in the Fetal and Infant Mortality Review process established pursuant to Section 123660.
(e) (1) The committee shall be composed of a minimum of 13 members. The members shall be comprised of multidisciplinary personnel and experts in the field of maternal mortality and morbidity, data analysis in maternal and fetal health, womens health, clinicians in maternal health, anesthesiology, pathology, and perinatology, and representatives from various public health entities, and shall include all of the following:
(A) At least one obstetrician.
(B) At least one certified nurse-midwife.
(C) At least one certified professional midwife.
(D) At least one hospital-based registered nurse or advanced practice nurse experienced in perinatal health.
(E) A clinician or patient advocate from a birthing center, if not already represented by a member otherwise listed.
(F) At least one public member with relevant personal experience related to maternal morbidity or maternal mortality who has experienced birth and does not fit in another classification.
(G) At least one doula.
(H) At least one person from a community-based organization that works in perinatal health.
(I) At least one person from an organization that works with populations that have disproportionately high occurrences of maternal mortality and morbidity.
(J) At least one person who is an expert on mental and behavioral health, preferably with experience in perinatal health.
(K) At least one person from a native tribe, preferably with experience in perinatal health.
(L) At least one representative of the Maternal, Child, and Adolescent Health Division of the department.
(M) At least one family physician.
(N) At least one emergency room physician familiar with perinatal health.
(2) The committee shall prioritize for membership members who are representative of the diversity and geographic locations of the pregnant people in populations with disproportionately high occurrences of maternal mortality and morbidity.
(3) The State Public Health Officer shall appoint a maternal mortality expert to be a member of the committee as the chair of the committee. The chair shall appoint the other members of the committee in accordance with the criteria specified in paragraph (1).
(4) The committee may create subcommittees, as needed, to carry out its duties.
(f) The committee may request from any state department, division, commission, local health department, or other agency of the state or political subdivision thereof, or any public authority, as well as hospitals, birthing facilities, medical examiners, coroners, coroner physicians, and any other facility or individual providing services associated with maternal mortality, and those individuals and entities shall provide 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 committee to properly carry out its functions, powers, and duties. The committee shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.
(g) Except as otherwise provided by this article, all proceedings and activities of the committee, all opinions of the members of the committee that are formed as a result of the committees proceedings and activities, and all records obtained, created, or maintained by the committee, including written reports and records of interviews or oral statements, shall be confidential, and in accordance with Sections 1157 and 1157.5 of the Evidence Code, shall not be subject to public inspection, discovery, subpoena, or introduction into evidence in any civil, criminal, legislative, administrative, or other proceeding.
(h) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to this article, or in any report that is prepared.
(i) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of the committee shall not be questioned in any civil, criminal, legislative, administrative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee. However, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independently of the members participation on the committee, or as an expert witness in maternal death cases unrelated to their case review as a member of the committee.
(j) This section does not prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.
(k) A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
SEC. 2. Section 123636.1 is added to the Health and Safety Code, to read:123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.
SEC. 2. Section 123636.1 is added to the Health and Safety Code, to read:
### SEC. 2.
123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.
123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.
123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:(A) Grief counseling.(B) Support groups.(C) Education regarding events following a stillbirth.(D) Funeral information.(E) Other literature or information relating to stillbirth.(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.
123636.1. (a) The department shall establish a process to accept information from members of the public who have experienced stillbirth who wish to provide their information relating to the cause of the stillbirth, demographic information about the mother, and any other maternal factors specified under the Fetal and Infant Mortality Review process pursuant to Section 123660. In establishing the process required by this section, the department shall ensure compliance with all applicable confidentiality laws.
(b) (1) The department shall provide individuals who have experienced stillbirth and their families with access to resources, including, but not limited to, all of the following:
(A) Grief counseling.
(B) Support groups.
(C) Education regarding events following a stillbirth.
(D) Funeral information.
(E) Other literature or information relating to stillbirth.
(2) The department may contract with one or more nonprofit entities that provide services relating to stillbirth to perform its duties under this subdivision, if the department determines that it would be more cost-effective to do so.
SEC. 3. Section 123660 of the Health and Safety Code is amended to read:123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.
SEC. 3. Section 123660 of the Health and Safety Code is amended to read:
### SEC. 3.
123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.
123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.
123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.(b) (1) Each county shall annually report infant deaths to the local health department.(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(B) The data shall be disaggregated by racial and ethnic identity.(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:(A) The county has five or more infant deaths in a single year.(B) The county has a death rate that is higher than the states death rate for two consecutive years.(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.(5) Offer grief counseling to surviving family members.(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.
123660. (a) The Legislature finds that the Fetal and Infant Mortality Review process is used to identify and take action to prevent a wide range of local social, economic, public health, education, environmental, and safety factors that contribute to the tragedy of fetal and infant loss.
(b) (1) Each county shall annually report infant deaths to the local health department.
(A) The data shall be aggregated to ensure data reflects how regionalized care systems are, or should be, collaborating to improve fetal and infant health outcomes based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.
(B) The data shall be disaggregated by racial and ethnic identity.
(2) A local health department shall, subject to subdivision (e), establish a Fetal and Infant Mortality Review committee to investigate infant deaths to prevent fetal and infant death if both of the following apply with respect to the county:
(A) The county has five or more infant deaths in a single year.
(B) The county has a death rate that is higher than the states death rate for two consecutive years.
(c) A local public health department that participates in the Fetal and Infant Mortality Review process established by the department shall do all of the following:
(1) Annually investigate, track, and review a minimum amount of 20 percent of the countys cases of term infants who were born following labor with the outcome of intrapartum stillbirth, stillbirth at 20 weeks or more of gestation, early neonatal death, or postneonatal death, focusing on demographic groups that are disproportionately impacted by infant death. A county that has less than five deaths in a year shall investigate at least one death. For purposes of this section, term infants means infants who are at 36 weeks or more of gestation.
(2) Establish a committee for fetal and infant mortality reviews led by local health departments. The committee shall include members of the community, and shall not include anyone employed by a law enforcement agency. In counties where the coroner, medical examiner, or other medical professional is employed by law enforcement, these individuals can share information with the committee in their medical professional capacity only.
(A) All data and records obtained, prepared, created, and maintained in anticipation of a review meeting shall be confidential. Data and records prepared, created, and maintained in anticipation of a review meeting shall not be subject to public records requests, subpoena, or civil processes and shall not be admissible in evidence in connection with any administrative, judicial, executive, legislative, or other proceeding.
(B) All participants engaged in and associated with the review process shall sign a confidentiality agreement that states they will not discuss or share information about individual cases and the proceedings of the review meeting, outside of the meeting. This shall not preclude the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations or reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned, and shall utilize standard public health reporting practices for accurate dissemination of these data elements, especially with regard to the reporting of small numbers so as to inadvertently risk a breach of confidentiality or other disclosure.
(C) To the extent prescribed by Sections 1157 and 1157.5 of the Evidence Code, members of a team, persons attending a team meeting, and persons who present information to a team may not be questioned in any administrative, civil, or criminal proceeding regarding information presented in, or opinions formed as a result of, a meeting. This subparagraph does not prohibit a person from testifying to information obtained independently of the team or that is public information. A health care provider, health care facility, or pharmacy providing access to medical records pursuant to 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 the records.
(3) Conduct voluntary interviews with individuals who have experienced child loss or surviving family members of maternal or infant death who have knowledge of the event. The interview shall include questions to determine if the pregnant person had concerns about perinatal care during any point in their pregnancy or postpartum care, whether there were disagreements about care offered and received, and whether the pregnant person had asked for certain care that was denied or not received.
(4) Conduct a report or investigation, to the degree practicable, with all medical staff involved with the event.
(5) Offer grief counseling to surviving family members.
(d) Counties, hospitals, birthing centers, and state entities shall provide to local health departments death records, medical records, autopsy reports, toxicology reports, hospital discharge records, birth records, and any other information that will help the local health department conduct the fetal and infant mortality review within 30 days of a request made in writing by a local health department. The local health department shall not request, and health care providers shall not provide, reports, testimony, or other information produced as a result of activities undertaken by organized committees of a hospital medical staff or peer review body, as defined in Section 805 of the Business and Professions Code, that has the responsibility to evaluate or improve the quality of care rendered in a hospital.
(e) The requirements of this section apply to a local health department only upon the appropriation of funds by the Legislature for these purposes in the annual Budget Act or another act.
It is the intent of the Legislatute to enact legislation relating to research on the occurence and preventability of stillbirths in California.