Amended IN Senate March 25, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 492Introduced by Senator HurtadoFebruary 17, 2021 An act to amend Section 123630.4 of add Article 4.7 (commencing with Section 123635) to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, relating to maternal health. LEGISLATIVE COUNSEL'S DIGESTSB 492, as amended, Hurtado. Pregnancy-related death: data. Maternal health.Existing law requires the State Department of Public Health to track data on pregnancy-related deaths, including specified health conditions, indirect obstetric deaths, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium, and requires this data to be published at least once every 3 years.This bill would additional specify that the departments tracking of data on pregnancy-related deaths is to include deaths in which the attending physician is found to have been negligent in the death.This bill would rename the California Pregnancy-Associated Mortality Review Committee under the department as the Maternal Mortality Review Committee, and would require the committee to be composed of a minimum of 9 members, as specified. The bill would require the committee to, among other things, identify and review all pregnancy-related deaths and severe maternal morbidity and publish its findings and recommendations to the public.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Article 4.7 (commencing with Section 123635) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read: Article 4.7. Maternal Mortality Review Committee123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.SECTION 1.Section 123630.4 of the Health and Safety Code is amended to read:123630.4.(a)The State Department of Public Health shall track data on severe maternal morbidity, including, but not limited to, all of the following health conditions:(1)Obstetric hemorrhage.(2)Hypertension.(3)Preeclampsia and eclampsia.(4)Venous thromboembolism.(5)Sepsis.(6)Cerebrovascular accident.(7)Amniotic fluid embolism.(b)The data on severe maternal morbidity collected pursuant to subdivision (a) shall be published at least once every three years, after all of the following have occurred:(1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(2)The data has been disaggregated by racial and ethnic identity.(c)The State Department of Public Health shall track data on pregnancy-related deaths, including, but not limited to, all of the conditions listed in subdivision (a), indirect obstetric deaths, deaths in which the attending physician is found to have been negligent in the death, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium.(d)The data on pregnancy-related deaths collected pursuant to subdivisions (a) and (c) shall be published, at least once every three years, after all of the following have occurred:(1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(2)The data has been disaggregated by racial and ethnic identity. Amended IN Senate March 25, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 492Introduced by Senator HurtadoFebruary 17, 2021 An act to amend Section 123630.4 of add Article 4.7 (commencing with Section 123635) to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, relating to maternal health. LEGISLATIVE COUNSEL'S DIGESTSB 492, as amended, Hurtado. Pregnancy-related death: data. Maternal health.Existing law requires the State Department of Public Health to track data on pregnancy-related deaths, including specified health conditions, indirect obstetric deaths, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium, and requires this data to be published at least once every 3 years.This bill would additional specify that the departments tracking of data on pregnancy-related deaths is to include deaths in which the attending physician is found to have been negligent in the death.This bill would rename the California Pregnancy-Associated Mortality Review Committee under the department as the Maternal Mortality Review Committee, and would require the committee to be composed of a minimum of 9 members, as specified. The bill would require the committee to, among other things, identify and review all pregnancy-related deaths and severe maternal morbidity and publish its findings and recommendations to the public.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Amended IN Senate March 25, 2021 Amended IN Senate March 25, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 492 Introduced by Senator HurtadoFebruary 17, 2021 Introduced by Senator Hurtado February 17, 2021 An act to amend Section 123630.4 of add Article 4.7 (commencing with Section 123635) to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, relating to maternal health. LEGISLATIVE COUNSEL'S DIGEST ## LEGISLATIVE COUNSEL'S DIGEST SB 492, as amended, Hurtado. Pregnancy-related death: data. Maternal health. Existing law requires the State Department of Public Health to track data on pregnancy-related deaths, including specified health conditions, indirect obstetric deaths, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium, and requires this data to be published at least once every 3 years.This bill would additional specify that the departments tracking of data on pregnancy-related deaths is to include deaths in which the attending physician is found to have been negligent in the death.This bill would rename the California Pregnancy-Associated Mortality Review Committee under the department as the Maternal Mortality Review Committee, and would require the committee to be composed of a minimum of 9 members, as specified. The bill would require the committee to, among other things, identify and review all pregnancy-related deaths and severe maternal morbidity and publish its findings and recommendations to the public. Existing law requires the State Department of Public Health to track data on pregnancy-related deaths, including specified health conditions, indirect obstetric deaths, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium, and requires this data to be published at least once every 3 years. This bill would additional specify that the departments tracking of data on pregnancy-related deaths is to include deaths in which the attending physician is found to have been negligent in the death. This bill would rename the California Pregnancy-Associated Mortality Review Committee under the department as the Maternal Mortality Review Committee, and would require the committee to be composed of a minimum of 9 members, as specified. The bill would require the committee to, among other things, identify and review all pregnancy-related deaths and severe maternal morbidity and publish its findings and recommendations to the public. ## Digest Key ## Bill Text The people of the State of California do enact as follows:SECTION 1. Article 4.7 (commencing with Section 123635) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read: Article 4.7. Maternal Mortality Review Committee123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities.SECTION 1.Section 123630.4 of the Health and Safety Code is amended to read:123630.4.(a)The State Department of Public Health shall track data on severe maternal morbidity, including, but not limited to, all of the following health conditions:(1)Obstetric hemorrhage.(2)Hypertension.(3)Preeclampsia and eclampsia.(4)Venous thromboembolism.(5)Sepsis.(6)Cerebrovascular accident.(7)Amniotic fluid embolism.(b)The data on severe maternal morbidity collected pursuant to subdivision (a) shall be published at least once every three years, after all of the following have occurred:(1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(2)The data has been disaggregated by racial and ethnic identity.(c)The State Department of Public Health shall track data on pregnancy-related deaths, including, but not limited to, all of the conditions listed in subdivision (a), indirect obstetric deaths, deaths in which the attending physician is found to have been negligent in the death, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium.(d)The data on pregnancy-related deaths collected pursuant to subdivisions (a) and (c) shall be published, at least once every three years, after all of the following have occurred:(1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach.(2)The data has been disaggregated by racial and ethnic identity. The people of the State of California do enact as follows: ## The people of the State of California do enact as follows: SECTION 1. Article 4.7 (commencing with Section 123635) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read: Article 4.7. Maternal Mortality Review Committee123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities. SECTION 1. Article 4.7 (commencing with Section 123635) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read: ### SECTION 1. Article 4.7. Maternal Mortality Review Committee123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities. Article 4.7. Maternal Mortality Review Committee123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities. Article 4.7. Maternal Mortality Review Committee Article 4.7. Maternal Mortality Review Committee 123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee.(b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area.(c) The purposes of the committee shall include, but not be limited to, all of the following:(1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity.(2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following:(A) Whether the medical provider played a role in the death.(B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program.(C) Whether there were any clusters of health issues occurring locally.(D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated.(3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes.(d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities. 123635. (a) The California Pregnancy-Associated Mortality Review Committee under the State Department of Public Health is hereby renamed as the Maternal Mortality Review Committee. (b) The committee shall be composed of a minimum of nine members, and shall include at least three members from the central valley and three members from the Los Angeles area. (c) The purposes of the committee shall include, but not be limited to, all of the following: (1) Identifying and reviewing all pregnancy-related deaths and severe maternal morbidity. (2) Investigating contributing factors to pregnancy-related deaths, including, but not limited to, all of the following: (A) Whether the medical provider played a role in the death. (B) Whether the person whose death is being investigated had health insurance, and whether it was through a commercial insurance policy or the Medi-Cal program. (C) Whether there were any clusters of health issues occurring locally. (D) Whether there were any clusters of health issues occurring at the workplace of the person whose death is being investigated. (3) Collecting and reviewing data from maternal death investigations and making recommendations about how to improve or streamline data collection and investigatory processes. (d) The committee shall publish its findings to the public, and the findings shall also include recommendations on how to prevent severe maternal morbidity and maternal mortality and how to reduce racial disparities. (a)The State Department of Public Health shall track data on severe maternal morbidity, including, but not limited to, all of the following health conditions: (1)Obstetric hemorrhage. (2)Hypertension. (3)Preeclampsia and eclampsia. (4)Venous thromboembolism. (5)Sepsis. (6)Cerebrovascular accident. (7)Amniotic fluid embolism. (b)The data on severe maternal morbidity collected pursuant to subdivision (a) shall be published at least once every three years, after all of the following have occurred: (1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach. (2)The data has been disaggregated by racial and ethnic identity. (c)The State Department of Public Health shall track data on pregnancy-related deaths, including, but not limited to, all of the conditions listed in subdivision (a), indirect obstetric deaths, deaths in which the attending physician is found to have been negligent in the death, and other maternal disorders predominantly related to pregnancy and complications predominantly related to the puerperium. (d)The data on pregnancy-related deaths collected pursuant to subdivisions (a) and (c) shall be published, at least once every three years, after all of the following have occurred: (1)The data has been aggregated by state regions, as defined by the State Department of Public Health, to ensure data reflects how regionalized care systems are or should be collaborating to improve maternal health outcomes, or other smaller regional sorting based on standard statistical methods for accurate dissemination of public health data without risking a confidentiality or other disclosure breach. (2)The data has been disaggregated by racial and ethnic identity.