Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S2734 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	SENATE . . . . . . . . . . . . . . No. 2734
2	2	The Commonwealth of Massachusetts
3	3	_______________
4	4	In the One Hundred and Ninety-Third General Court
5	5	(2023-2024)
6	6	_______________
7	7	SENATE, April 22, 2024.
8	8	The committee on Public Health, to whom was referred the petitions (accompanied by
9	9	bill, Senate, No. 1415) of Liz Miranda, Lindsay N. Sabadosa, Paul W. Mark, Tram T. Nguyen
10	10	and other members of the General Court for legislation relative to birthing justice in the
11	11	Commonwealth, report the accompanying bill (Senate, No. 2734).
12	12	For the committee,
13	13	Julian Cyr 1 of 40
14	14	FILED ON: 4/18/2024
15	15	SENATE . . . . . . . . . . . . . . No. 2734
16	16	The Commonwealth of Massachusetts
17	17	_______________
18	18	In the One Hundred and Ninety-Third General Court
19	19	(2023-2024)
20	20	_______________
21	21	An Act relative to birthing justice in the Commonwealth..
22	22	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
23	23	of the same, as follows:
24	24	1 SECTION 1. Chapter 118E of the General Laws is hereby amended by inserting after
25	25	2Section 10L the following: -
26	26	3 Section 10M. The division shall provide coverage of screenings by pediatricians for
27	27	4postpartum depression in parents of newly born children during any visit to a pediatrician’s
28	28	5office taking place for up to one year from the date of the child’s birth.
29	29	6 SECTION 2. Chapter 38 of the general laws is hereby amended by inserting after section
30	30	72A the following section: --
31	31	8 Section 2B. As used in this section, the term below shall have the following meaning: -
32	32	9 “Authorized local health agency”, shall mean a health board, department, or other
33	33	10governmental entity that is authorized by the department of public health to receive timely data
34	34	11relative to fetal and infant deaths for assessing, planning, improving and monitoring the service
35	35	12systems and community resources that support child and maternal health. 2 of 40
36	36	13 The department of public health shall establish a process for designating authorized local
37	37	14health agencies. This process may include reasonable criteria regarding the level of expertise,
38	38	15workforce capacity, or organizational capacity. Authorized local health agencies shall be
39	39	16authorized to conduct in-depth fetal infant mortality review of each individual infant and fetal
40	40	17death occurring within their jurisdiction, in order to identify local factors associated with fetal
41	41	18and infant deaths and inform public health policy programs.
42	42	19 For each case of fetal or infant death to be reviewed, authorized local health agencies are
43	43	20hereby authorized to collect relevant data from a variety of sources, which may include physician
44	44	21and hospital records in addition to relevant community program records. Authorized local health
45	45	22agencies are authorized to collect, and the department is authorized to provide, timely access to
46	46	23vital records and other data reasonably necessary for fetal and infant mortality review.
47	47	24 The department may issue additional guidance through policy or regulation, consistent
48	48	25with this section, regarding the process for conducting fetal infant mortality reviews by
49	49	26authorized local health agencies, which may include guidance from the National Fetal and Infant
50	50	27Mortality Review Program.
51	51	28 SECTION 3. Section 9 of chapter 13 of the General Laws, as appearing in the 2022
52	52	29Official Edition, is hereby amended by inserting, in line 7, after the word “counselors” the
53	53	30following words:- , the board of registration in midwifery.
54	54	31 SECTION 4. Said chapter 13, as so appearing, is hereby further amended by adding the
55	55	32following section:-
56	56	33 Section 110. (a) There shall be within the department of public health a board of
57	57	34registration in midwifery. The board shall consist of 8 members to be appointed by the governor, 3 of 40
58	58	355 of whom shall be midwives with not less than 5 years of experience in the practice of
59	59	36midwifery and who shall be licensed under sections290 to 302, inclusive, of chapter 112, 1 of
60	60	37whom shall be a physician licensed to practice medicine under section 2 of said chapter 112 with
61	61	38experience working with midwives, 1 of whom shall be a certified nurse-midwife licensed to
62	62	39practice midwifery under section 80B of said chapter 112 and 1 of whom shall be a member of
63	63	40the public. Four of the members of the board of registration in midwifery shall have experience
64	64	41working on the issue of racial disparities in maternal health. When making the appointments, the
65	65	42governor shall consider the recommendations of organizations representing certified professional
66	66	43midwives in the commonwealth. The appointed members shall serve for terms of 3 years. Upon
67	67	44the expiration of a term of office, a member shall continue to serve until a successor has been
68	68	45appointed and qualified. A member shall not serve for more than 2 consecutive terms; provided,
69	69	46however, that a person who is chosen to fill a vacancy in an unexpired term of a prior board
70	70	47member may serve for 2 consecutive terms in addition to the remainder of that unexpired term. A
71	71	48member may be removed by the governor for neglect of duty, misconduct, malfeasance or
72	72	49misfeasance in the office after a written notice of the charges against the member and sufficient
73	73	50opportunity to be heard thereon. Upon the death or removal for cause of a member of the board,
74	74	51the governor shall fill the vacancy for the remainder of that member’s term after considering
75	75	52suggestions from a list of nominees provided by organizations representing certified professional
76	76	53midwives in the commonwealth. For the initial appointment of the board, the 5 members
77	77	54required to be licensed midwives shall be persons with at least 5 years of experience in the
78	78	55practice of midwifery who meet the eligibility requirements set forth in subsection (a) of section
79	79	56295 of chapter 112. Members of the board shall be residents of the commonwealth. 4 of 40
80	80	57 (b) Annually, the board shall elect from its membership a chair and a secretary who shall
81	81	58serve until their successors have been elected and qualified. The board shall meet not less than 4
82	82	59times annually and may hold additional meetings at the call of the chair or upon the request of
83	83	60not less than 4 members. A quorum for the conduct of official business shall be a majority of
84	84	61those appointed. Board members shall serve without compensation but shall be reimbursed for
85	85	62actual and reasonable expenses incurred in the performance of their duties. The members shall be
86	86	63public employees for the purposes of chapter 258 for all acts or omissions within the scope of
87	87	64their duties as board members.
88	88	65 SECTION 5. Section 1E of chapter 46 of the General Laws, as so appearing, is hereby
89	89	66amended by inserting after the definition of “Physician” the following definition:-
90	90	67 “Licensed midwife,” a midwife licensed to practice by the board of registration in
91	91	68midwifery as provided in sections 290 to 302 of chapter 112.
92	92	69 SECTION 6. Section 3B of said chapter 46, as so appearing, is hereby amended by
93	93	70inserting after the word “physician”, in line 1, the following words:- or licensed midwife.
94	94	71 SECTION 7. Section 1 of chapter 94C of the general laws, as so appearing, is hereby
95	95	72amended by inserting after the definition of “Isomer” the following definition:-
96	96	73 “Licensed midwife,” a midwife licensed to practice by the board of registration in
97	97	74midwifery as provided in sections 290 to 302 of chapter 112.
98	98	75 SECTION 8. Section 7 of said chapter 94C, as so appearing, is hereby amended by
99	99	76adding the following new subsection:- 5 of 40
100	100	77 (j) The commissioner shall promulgate regulations which provide for the automatic
101	101	78registration of licensed midwives, upon the receipt of the fee as herein provided, to issue written
102	102	79prescriptions in accordance with the provisions of sections 290 of chapter 112 and the
103	103	80regulations issued by the board of registration in midwifery under said section 293 of chapter
104	104	81112, unless the registration of such licensed midwife has been suspended or revoked pursuant to
105	105	82the provisions of section 13 or section 14 or unless such registration is denied for cause by the
106	106	83commissioner pursuant to the provisions of chapter 30A. Prior to promulgating such regulations,
107	107	84the commissioner shall consult with the board of registration in midwifery.
108	108	85 SECTION 9. Section 9 of said chapter 94C, as so appearing, is hereby amended by
109	109	86inserting in paragraph (a), after the words “certified nurse midwife as provided in section 80C of
110	110	87said chapter 112” the following words:- , licensed midwife as limited by subsection (j) of said
111	111	88section 7 and section 290 of said chapter 112.
112	112	89 SECTION 10. Section 9 of said chapter 94C, as so appearing, is hereby further amended
113	113	90in paragraph (b), by inserting after the words “midwife” in each place that they appear, the
114	114	91following words:- , licensed midwife.
115	115	92 SECTION 11. Said section 9 of said chapter 94C, as so appearing, is hereby further
116	116	93amended in paragraph (b), by inserting after the words “nurse-midwifery”, in line 5, the
117	117	94following word:- , midwifery.
118	118	95 SECTION 12. Section 9 of said chapter 94C is further amended in paragraph (c), by
119	119	96inserting after the words “certified nurse midwife” in each place that they appear, the following
120	120	97words:- , licensed midwife. 6 of 40
121	121	98 SECTION 13. The definition of “medical peer review committee” in section 1 of chapter
122	122	99111 of the General Laws, as so appearing, is hereby amended by adding the following sentence:-
123	123	100“Medical peer review committee” shall include a committee or association that is authorized by a
124	124	101midwifery society or association to evaluate the quality of midwifery services or the competence
125	125	102of midwives and suggest improvements in midwifery practices to improve patient care.
126	126	103 SECTION 14. Section 202 of said chapter 111, as so appearing, is hereby amended by
127	127	104inserting, in the second and third paragraphs, after the words “physician in attendance”, in each
128	128	105instance, the following words:- or midwife in attendance.
129	129	106 SECTION 15. Said section 202, as so appearing, is hereby further amended by inserting,
130	130	107in the fourth paragraph, after the words “physician in attendance” the following words:- or
131	131	108without the attendance of a midwife,.
132	132	109 SECTION 16. Section 204 of said chapter 111, as so appearing, is hereby amended by
133	133	110inserting, in lines 7, 12 and 28, after the word “medicine”, in each instance, the following word:-
134	134	111, midwifery.
135	135	112 SECTION 17. Chapter 112 of the General Laws, as so appearing, is hereby amended by
136	136	113adding the following new sections:-
137	137	114 Section 290. As used in sections 290 to 302, inclusive, of this chapter, the following
138	138	115words shall have the following meanings unless the context clearly requires otherwise:
139	139	116 “Board”, the board of registration in midwifery, established under section 110 of chapter
140	140	11713. 7 of 40
141	141	118 “Certified nurse-midwife”, a nurse with advanced training and who has obtained
142	142	119certification by the American Midwifery Certification Board.
143	143	120 “Certified professional midwife”, a professional independent midwifery practitioner who
144	144	121has obtained certification by the NARM."
145	145	122 “Client”, a person under the care of a licensed midwife, as described by a written
146	146	123statement pursuant to section 298 of this chapter.
147	147	124 “Licensed midwife”, a person registered by the board to practice midwifery in the
148	148	125commonwealth under sections290 to 302, inclusive, of this chapter.
149	149	126 “MBC”, the midwifery bridge certificate issued by the NARM or its successor credential.
150	150	127 “MEAC”, the Midwifery Education Accreditation Council or its successor organization.
151	151	128 “Midwifery”, the practice of providing primary care to a client and newborn during the
152	152	129preconception, antepartum, intrapartum and postpartum periods.
153	153	130 “NARM”, the North American Registry of Midwives or its successor organization.
154	154	131 Section 291. Nothing in sections290 to 302, inclusive, of this chapter shall limit or
155	155	132regulate the practice of a licensed physician, certified nurse-midwife, or licensed basic or
156	156	133advanced emergency medical technician. The practice of midwifery shall not constitute the
157	157	134practice of medicine, certified nurse-midwifery or emergency medical care.
158	158	135 Section 292. (a) The board shall: 8 of 40
159	159	136 (i) adopt rules and promulgate regulations governing licensed midwives and the practice
160	160	137of midwifery to promote public health, welfare and safety, consistent with the essential
161	161	138competencies identified by the NARM;
162	162	139 (ii) administer the licensing process, including, but not limited to:
163	163	140 (A) receiving, reviewing, approving, rejecting and issuing applications for licensure;
164	164	141 (B) renewing, suspending, revoking and reinstating licenses;
165	165	142 (C) investigating complaints against persons licensed under sections 276 to 288,
166	166	143inclusive, of this chapter;
167	167	144 (D) holding hearings and ordering the disciplinary sanction of a person who violates
168	168	145sections 276 to 288, inclusive, of this chapter or a regulation of the board;
169	169	146 (iii) establish administrative procedures for processing applications and renewals;
170	170	147 (iv) have the authority to adopt and provide a uniform, proctored examination for
171	171	148applicants to measure the qualifications necessary for licensure;
172	172	149 (v) develop practice standards for licensed midwives that shall include, but not be limited
173	173	150to:
174	174	151 (A) adoption of ethical standards for licensed midwives and apprentice midwives;
175	175	152 (B) maintenance of records of care, including client charts;
176	176	153 (C) participation in peer review; and 9 of 40
177	177	154 (D) development of standardized informed consent, reporting and written emergency
178	178	155transport plan forms;
179	179	156 (vi) establish and maintain records of its actions and proceedings in accordance with
180	180	157public records laws; and
181	181	158 (vii) adopt professional continuing education requirements for licensed midwives seeking
182	182	159renewal consistent with those maintained by the NARM.
183	183	160 (b) Nothing in this section shall limit the board’s authority to impose sanctions that are
184	184	161considered reasonable and appropriate by the board. A person subject to any disciplinary action
185	185	162taken by the board under this section or taken due to a violation of any other law, rule or
186	186	163regulation may file a petition for judicial review pursuant to section 64 of this chapter.
187	187	164 (c) A licensed midwife shall accept and provide care to clients only in accordance with
188	188	165the scope and standards of practice identified in the rules adopted pursuant to this section.
189	189	166 (d) Notwithstanding any other provision in this section, the board shall not issue any
190	190	167regulations that require a licensed midwife to practice under the supervision of or in
191	191	168collaboration with another healthcare provider or to enter into an agreement, written or
192	192	169otherwise, with another healthcare provider.
193	193	170 Section 293. A licensed midwife duly registered to issue written prescriptions in
194	194	171accordance with the provisions of subsection (j) of section 7 of chapter 94C may order, possess,
195	195	172purchase, and administer pharmaceutical agents consistent with the scope of midwifery practice,
196	196	173including without limitation antihemorrhagic agents including but not limited to oxytocin,
197	197	174misoprostol and methergine; intravenous fluids for stabilization; vitamin K; eye prophylaxes; 10 of 40
198	198	175oxygen; antibiotics for Group B Streptococcal antibiotic prophylaxes; Rho (D) immune globulin;
199	199	176local anesthetic; epinephrine; and other pharmaceutical agents identified by the board, however,
200	200	177that nothing in this section shall be construed to permit a licensed midwife’s use of
201	201	178pharmaceutical agents which are (a) controlled substances as described by Title 21 U.S.C.
202	202	179Section 812 or in chapter 94C, except for those listed in schedule VI; or (b) not identified by
203	203	180rules and regulations promulgated by the board of registration in midwifery as consistent with
204	204	181the scope of midwifery practice.
205	205	182 Section 294. A person who desires to be licensed and registered as a licensed midwife
206	206	183shall apply to the board in writing on an application form prescribed and furnished by the board.
207	207	184The applicant shall include in the application statements under oath satisfactory to the board
208	208	185showing that the applicant possesses the qualifications described under section 281 prior to any
209	209	186examination which may be required under section 278. The secretary of administration and
210	210	187finance, pursuant to section 3B of chapter 7, shall establish a license application fee, a license
211	211	188renewal fee and any other fee applicable under sections 276 to 288, inclusive, of this chapter;
212	212	189provided, however, that such license applicant and license renewal fees shall not exceed $200
213	213	190biennially. The board, in consultation with the secretary of administration and finance, shall
214	214	191institute a process for applicants to apply for a financial hardship waiver, which may reduce or
215	215	192fully exempt an applicant from paying the fee pursuant to this section. Fees collected by the
216	216	193board shall be deposited into the Quality in Health Professions Trust Fund pursuant to section
217	217	19435X of chapter 10 to support board operations and administration and to reimburse board
218	218	195members for actual and necessary expenses incurred in the performance of their official duties. 11 of 40
219	219	196 Section 295. (a) To be eligible for registration and licensure by the board as a licensed
220	220	197midwife, an applicant shall: (i) be of good moral character; (ii) be a graduate of a high school or
221	221	198its equivalent; and (iii) possess a valid certified professional midwife credential from the NARM.
222	222	199 (b) An applicant for a license to practice midwifery as a certified professional midwife
223	223	200shall submit to the board proof of successful completion of a formal midwifery education and
224	224	201training program as follows:
225	225	202 (i) a certificate of completion or equivalent from an educational program or institution
226	226	203accredited by the MEAC; or
227	227	204 (ii) an MBC, provided that an applicant: (1) is certified as a certified professional
228	228	205midwife within 5 years after the effective date of this section and completed a midwifery
229	229	206education and training program from an educational program or institution that is not accredited
230	230	207by the MEAC; or (2) is licensed as a professional midwife in a state that does not require
231	231	208completion of a midwifery education and training program from an educational program or
232	232	209institution that is accredited by the MEAC.
233	233	210 Section 296. The board may license in a like manner, without examination, any midwife
234	234	211who has been licensed in another state under laws which, in the opinion of the board, require
235	235	212qualifications and maintain standards substantially the same as those of this commonwealth for
236	236	213licensed midwives, provided, however, that such midwife applies and remits fees as provided for
237	237	214in section 293.
238	238	215 Section 297. (a) The board may, after a hearing pursuant to chapter 30A, revoke, suspend
239	239	216or cancel the license of a licensed midwife, or reprimand or censure a licensed midwife, for any
240	240	217of the reasons set forth in section 61 of this chapter. 12 of 40
241	241	218 (b) No person filing a complaint or reporting information pursuant to this section or
242	242	219assisting the board at its request in any manner in discharging its duties and functions shall be
243	243	220liable in any cause of action arising out of providing such information or assistance; provided,
244	244	221however, that the person making the complaint or reporting or providing such information or
245	245	222assistance does so in good faith and without malice.
246	246	223 Section 298. When accepting a client for care, a licensed midwife shall obtain the client’s
247	247	224written informed consent signed by both the midwife and the client. The board shall prescribe a
248	248	225form to use in obtaining such consent.
249	249	226 Section 299. A licensed midwife shall prepare, in a form prescribed by the board, a
250	250	227written plan for the appropriate delivery of emergency care. The plan shall include, but not be
251	251	228limited to: (i) consultation with other health care providers; (ii) emergency transfer; and (iii)
252	252	229access to neonatal intensive care units and obstetrical units or other patient care areas.
253	253	230 Section 300. A health care provider that consults with or accepts a transport, transfer or
254	254	231referral from a licensed midwife, or that provides care to a client of a licensed midwife or such
255	255	232client’s newborn, shall not be liable in a civil action for personal injury or death resulting from
256	256	233an act or omission by the licensed midwife, unless the professional negligence or malpractice of
257	257	234the health care provider was a proximate cause of the injury or death.
258	258	235 Section 301. (a) The board may petition any court of competent jurisdiction for an
259	259	236injunction against any person practicing midwifery or any branch thereof without a license
260	260	237granted pursuant to sections290 to 302, inclusive, of this chapter. Proof of damage or harm
261	261	238sustained by any person shall not be required for issuance of such injunction. Nothing in this
262	262	239section shall relieve a person from criminal prosecution for practicing without a license. 13 of 40
263	263	240 (b) Nothing in this section shall prevent or restrict the practice, service or activities of:
264	264	241 (i) a person licensed in the commonwealth from engaging in activities within the scope of
265	265	242practice of the profession or occupation for which such person is licensed; provided, however,
266	266	243that such person does not represent to the public, directly or indirectly, that such person is
267	267	244licensed under sections290 to 302, inclusive, and that such person does not use any name, title or
268	268	245designation indicating that such person is licensed under said sections290 to 302, inclusive; or
269	269	246 (ii) a person employed as a midwife by the federal government or an agency thereof if
270	270	247that person provides midwifery services solely under the direction and control of the
271	271	248organization by which such person is employed;
272	272	249 (iii) a traditional birth attendant who provides midwifery services if no fee is
273	273	250contemplated, charged or received, and such person has cultural or religious traditions that have
274	274	251historically included the attendance of traditional birth attendants at birth, and the birth attendant
275	275	252serves only individuals and families in that distinct cultural or religious group;
276	276	253 (iv) persons who are members of Native American communities and provide traditional
277	277	254midwife services to their communities; or
278	278	255 (v) any person rendering aid in an emergency.
279	279	256 Section 302. A licensed midwife, registered by the board of registration in midwifery
280	280	257pursuant to sections290 to 302, inclusive, of this chapter, who provides services to any person or
281	281	258beneficiary covered by Title XIX of the Social Security Act or MassHealth pursuant to section
282	282	2599A of chapter 118E, may accept the Medicaid or MassHealth approved rate as payment in full 14 of 40
283	283	260for such services; provided, that a licensed midwife who accepts the Medicaid or MassHealth
284	284	261approved rate pursuant to this section shall be reimbursed at said rate for such services.
285	285	262 SECTION 18. Chapter 118E of the General Laws, as so appearing, is hereby amended in
286	286	263section 10A by adding the words “licensed midwife,” after the word “physician,” in line 15 and
287	287	264after the word “pediatrician,” in line 20, by striking out every use of the word “mother” and
288	288	265inserting in place the phrase “gestational parent” and by inserting at the end of the section the
289	289	266following sentence:- The division shall provide coverage for midwifery services including
290	290	267prenatal care, childbirth and postpartum care provided by a licensed midwife regardless of the
291	291	268site of services.
292	292	269 SECTION 19. The board established pursuant to section 110 of chapter 13 of the General
293	293	270Laws shall adopt rules and promulgate regulations pursuant to this act within 1 year from the
294	294	271effective date of this act.
295	295	272 SECTION 20. The board established pursuant to section 110 of chapter 13 of the General
296	296	273Laws shall promulgate regulations for the licensure of individuals practicing midwifery prior to
297	297	274the date on which the board commences issuing licenses; provided, however, that individuals
298	298	275practicing midwifery in the commonwealth as of the date on which the board commences issuing
299	299	276licenses shall have 2 years from that date to complete the requirements necessary for licensure.
300	300	277 SECTION 21. Nothing in this act shall preclude a person who was practicing midwifery
301	301	278before the effective date of this act from practicing midwifery in the commonwealth until the
302	302	279board establishes procedures for the licensure of midwives pursuant to this act.
303	303	280 SECTION 22. Chapter 118E of the General Laws is hereby amended by adding the
304	304	281following section:- 15 of 40
305	305	282 Section 80. The division shall provide coverage for services rendered by a certified nurse
306	306	283midwife designated to engage in the practice of nurse-midwifery by the board of registration in
307	307	284nursing pursuant to section 80C of chapter 112; provided, however, that the following conditions
308	308	285are met: (1) the service rendered is within the scope of the certified nurse midwife’s
309	309	286authorization to practice by the board of registration in nursing; (2) the policy or contract
310	310	287currently provides benefits for identical services rendered by a health care provider licensed by
311	311	288the commonwealth; and (3) the reimbursement for the services provided shall be in the same
312	312	289amount as the reimbursement paid under the policy to a licensed physician performing the
313	313	290service in the area served. An insurer may not reduce the reimbursement paid to a licensed
314	314	291physician to achieve compliance with this section.
315	315	292 SECTION 23. Section 47E of Chapter 175 of the General Laws, as so appearing, is
316	316	293hereby amended by adding the following sentences:- The reimbursement for the services
317	317	294provided pursuant to this section shall be in the same amount as the reimbursement paid under
318	318	295the policy to a licensed physician performing the service in the area served. An insurer may not
319	319	296reduce the reimbursement paid to a licensed physician in order to comply with this section.
320	320	297 SECTION 24. Chapter 176A of the General Laws is hereby amended by inserting after
321	321	298section 8OO the following section:-
322	322	299 Section 8PP. Any contract between a subscriber and the corporation under an individual
323	323	300or group hospital service plan which is delivered, issued or renewed in the commonwealth shall
324	324	301provide as a benefit to all individual subscribers and members within the commonwealth and to
325	325	302all group members having a principal place of employment within the commonwealth for
326	326	303services rendered by a certified nurse midwife designated to engage in the practice of nurse- 16 of 40
327	327	304midwifery by the board of registration in nursing pursuant to section 80C of chapter 112;
328	328	305provided, however, that the following conditions are met: (1) the service rendered is within the
329	329	306scope of the certified nurse midwife’s authorization to practice by the board of registration in
330	330	307nursing; (2) the policy or contract currently provides benefits for identical services rendered by a
331	331	308health care provider licensed by the commonwealth; and (3) the reimbursement for the services
332	332	309provided shall be in the same amount as the reimbursement paid under the policy to a licensed
333	333	310physician performing the service in the area served. An insurer may not reduce the
334	334	311reimbursement paid to a licensed physician in order to comply with this section.
335	335	312 SECTION 25. Section 4G of Chapter 176B of the General Laws, as so appearing, is
336	336	313hereby amended by adding the following sentences:- The reimbursement for the services
337	337	314provided pursuant to this section shall be in the same amount as the reimbursement paid under
338	338	315the policy to a licensed physician performing the service in the area served. An insurer may not
339	339	316reduce the reimbursement paid to a licensed physician in order to comply with this section.
340	340	317 SECTION 26. Section 4 of Chapter 176G is of the General Laws, as so appearing, is
341	341	318hereby amended by adding the following subsection:-
342	342	319 (g) services rendered by a certified nurse midwife designated to engage in the practice of
343	343	320nurse-midwifery by the board of registration in nursing pursuant to section 80C of chapter 112,
344	344	321subject to the terms of a negotiated agreement between the health maintenance organization and
345	345	322the provider of health care services. The reimbursement for the services provided shall be in the
346	346	323same amount as the reimbursement paid under the policy to a licensed physician performing the
347	347	324service in the area served. An insurer may not reduce the reimbursement paid to a licensed
348	348	325physician in order to comply with this section. 17 of 40
349	349	326 SECTION 27. Chapter 32A of the General Laws is hereby amended by adding the
350	350	327following section:-
351	351	328 Section 34. The commission shall provide to any active or retired employee of the
352	352	329commonwealth insured under the group insurance commission coverage for services rendered by
353	353	330a certified nurse midwife designated to engage in the practice of nurse-midwifery by the board of
354	354	331registration in nursing pursuant to section 80C of chapter 112; provided, however, that the
355	355	332following conditions are met: (1) the service rendered is within the scope of the certified nurse
356	356	333midwife’s authorization to practice by the board of registration in nursing; (2) the policy or
357	357	334contract currently provides benefits for identical services rendered by a health care provider
358	358	335licensed by the commonwealth; and (3) the reimbursement for the services provided shall be in
359	359	336the same amount as the reimbursement paid under the policy to a licensed physician performing
360	360	337the service in the area served. An insurer may not reduce the reimbursement paid to a licensed
361	361	338physician to achieve compliance with this section.
362	362	339 SECTION 28. The department of public health shall promulgate regulations within 1 year
363	363	340from the effective date of this act, governing birth centers, consistent with standards set forth by
364	364	341the American Association of Birth Centers, including without limitation authorizing licensed
365	365	342professional midwives to practice in birth centers as primary birth attendants, director of birth
366	366	343centers, and director of clinical affairs. Licensed professional midwives practicing in licensed
367	367	344birth centers shall not be required to enter into any agreement for supervision or collaboration
368	368	345with any other healthcare provider or hospital. 18 of 40
369	369	346 SECTION 29. Section 51 of chapter 111 of the General Laws, as so appearing, is hereby
370	370	347amended by adding after the word “Gynecologists,” in line 106, the following words:- ,
371	371	348American College of Nurse Midwives, American Association of Birth Centers.
372	372	349 SECTION 30. (a) The department of public health shall promulgate revised regulations
373	373	350under the Code of Massachusetts Regulations 105 CMR 140.000 and 142.000 governing the
374	374	351facility and operation of licensed birth centers in consultation with Seven Sisters Birth Center,
375	375	352Neighborhood Birth Center, American College of Nurse Midwives Massachusetts Affiliate, and
376	376	353other entities operating or planning to open birth centers in Massachusetts to bring the
377	377	354regulations in accordance with chapter 111 of the General Laws and the standards of the
378	378	355American Association of Birth Centers or any successor organization, and to ensure safe,
379	379	356equitable and accessible birth options for birth center clients.
380	380	357 (b) The regulations shall include, but not be limited to, the following provisions:
381	381	358 (i) a licensed free-standing birth center shall have a detailed and written plan on the
382	382	359premises for transfer of a client to a nearby hospital providing obstetrical and newborn services
383	383	360as needed for emergency treatment beyond that provided by the birth center;
384	384	361 (ii) a licensed free-standing birth center shall develop policies and procedures to ensure
385	385	362coordination of ongoing care and transfer when complications occur which render the patient
386	386	363ineligible for birth center care during the antepartum, intrapartum or postpartum period;
387	387	364 (iii) the department shall not require a licensed free-standing birth center or the directors
388	388	365and providers on staff to practice under the supervision of a hospital or another health care
389	389	366provider or to enter into an agreement, written or otherwise, with another hospital or health care
390	390	367provider, or maintain privileges at a hospital; 19 of 40
391	391	368 (iv) a licensed free-standing birth center shall have an administrative director responsible
392	392	369for implementing and overseeing the operational policies of the birth center;
393	393	370 (v) a licensed free-standing birth center shall have a director of clinical affairs on staff
394	394	371who shall be a nurse midwife or physician licensed and in good standing in Massachusetts whose
395	395	372professional scope of practice includes preconception, prenatal, labor, birth, and postpartum care
396	396	373and early care of the newborn and who may be the primary attendants during the perinatal period
397	397	374in accordance with chapter 112 of the General Laws; and
398	398	375 (vi) birth attendants at licensed free-standing birth centers shall be midwives, physicians,
399	399	376or other providers licensed and in good standing in Massachusetts whose professional scope of
400	400	377practice includes preconception, prenatal, labor, birth, and postpartum care and early care of the
401	401	378newborn and who may be the primary attendants in accordance with chapter 112 of the General
402	402	379Laws.
403	403	380 SECTION 31. Only free-standing and hospital-affiliated birth centers licensed pursuant
404	404	381to 105 CMR 140.000 and 105 CMR 142.000 shall use the terms birth center or birthing center in
405	405	382their clinic's name.
406	406	383 SECTION 32. Chapter 118E of the General Laws is hereby amended by inserting after
407	407	384section 10N the following section:-
408	408	385 Section 10R: Medicaid Coverage for Doula Services.
409	409	386 (A) For purposes of this section, the following terms shall have the following meanings: 20 of 40
410	410	387 “Maternal and infant health outcomes” include outcomes arising for the gestational
411	411	388parent including pregnancy complications, maternal morbidity, infant mortality, and preterm
412	412	389births.
413	413	390 “Doula Services” are physical, emotional, and informational support, but not medical
414	414	391care, provided by trained doulas to individuals and families during and after pregnancy, labor,
415	415	392childbirth, miscarriage, stillbirth, adoption or pregnancy loss. Doula services include but are not
416	416	393limited to:
417	417	394 (1) continuous labor support;
418	418	395 (2) prenatal, postpartum, and bereavement home or in-person visits throughout the
419	419	396perinatal period, lasting until 1 year after birth, pregnancy loss, stillbirth, or miscarriage;
420	420	397 (3) accompanying pregnant individuals to health care and social services appointments;
421	421	398 (4) providing support to individuals for loss of pregnancy or infant from conception
422	422	399 through one year postpartum, or, for adoptive parents of an infant, until their adopted
423	423	400infant reaches one year of age;
424	424	401 (5) connecting clients to community-based and state and federally funded resources,
425	425	402including those which address social determinants of health;
426	426	403 (6) making oneself available (being on-call) around the time of birth or loss as well as
427	427	404providing support for any concerns of pregnant individuals throughout pregnancy and until one
428	428	405year after birth, pregnancy loss, stillbirth, adoption or miscarriage. 21 of 40
429	429	406 (7) providing support for other individuals providing care for a birthing parent, including
430	430	407a birthing parent’s partner and family members.
431	431	408 (B) Coverage of Doula Services:
432	432	409 (1) The Division shall provide coverage of doula services to pregnant individuals and
433	433	410postpartum individuals up to 12 months following the end of the pregnancy, as well as adoptive
434	434	411parents of infants until the infants reach one year of age, who are eligible for medical assistance
435	435	412under this chapter and/or through Title XIX or Title XXI of the Social Security Act. The
436	436	413Division shall provide the same coverage of doula services to pregnant and postpartum
437	437	414individuals who are not otherwise eligible for medical assistance under this chapter or Titles XIX
438	438	415or XXI of the Social Security Act solely because of their immigration status.
439	439	416 (2) The Division must cover continuous support through labor and childbirth, and at least
440	440	417up to six doula visits across the prenatal and one-year postpartum period, or until an adopted
441	441	418infant reaches one year of age, including at least two postpartum visits, without the need for prior
442	442	419authorization. The Division must also establish a procedure to determine whether and how many
443	443	420additional doula visits are required.
444	444	421 (C) Creation of Doula Advisory Committee: There is hereby created a Doula Advisory
445	445	422Committee.
446	446	423 (1) The committee shall consist of 10-12 members to be appointed by the commissioner
447	447	424of public health, or designee. 22 of 40
448	448	425 (a) All but 2 of the members must be practicing doulas from the community; the
449	449	426remaining 2 members must be individuals from the community who have experienced pregnancy
450	450	427as a MassHealth member and are not practicing doulas.
451	451	428 (b) Among the members described in (a) above:
452	452	429 (i) at least 1 member must be a person who identifies as belonging to the LGBTQIA+
453	453	430community;
454	454	431 (iii) at least 1 member must be a person who has experienced a severe maternal
455	455	432morbidity, a perinatal mental health or mood disorder, or a near-death experience while pregnant
456	456	433or in maternity care;
457	457	434 (iv) at least 1 member must be a person who identifies as a person with disabilities or
458	458	435disabled person;
459	459	436 (c) The members of the committee shall represent a diverse range of experience levels-
460	460	437from doulas new to the practice to more experienced doulas.
461	461	438 (d) The members of the committee shall represent an equitable geographic distribution
462	462	439from across the commonwealth, including counties with demonstrated inequities in maternal and
463	463	440infant health outcomes.
464	464	441 (2) The committee must be convened within six months of passage of this law.
465	465	442 (3) Of the initial appointments to the Doula Advisory Committee, half shall be appointed
466	466	443to a term of 2 years and half shall be appointed to a term of 18 months. Thereafter, all terms shall
467	467	444be 2 years. The commissioner of public health, or designee, shall fill vacancies as soon as
468	468	445practicable. 23 of 40
469	469	446 (4) At least once every 8 weeks, the Division must meet with the Doula Advisory
470	470	447Committee to consult about at least the following:
471	471	448 (a) the scope of doula services covered by MassHealth;
472	472	449 (b) doula competencies required for reimbursement by MassHealth, and standards of
473	473	450proof or demonstration of those competencies;
474	474	451 (c) the recruitment of a diverse workforce of doulas to provide services to MassHealth
475	475	452members;
476	476	453 (d) the development of comprehensive and high quality continuing education and training
477	477	454that is free or low-cost to doulas with demonstrated financial need for such training, as well as
478	478	455the development of mentorship and career growth opportunities for doulas providing services to
479	479	456MassHealth members, that will promote diversity in the doula workforce;
480	480	457 (e) the performance of any third-party administrators of MassHealth’s doula coverage
481	481	458program, and standards and processes around billing for and prompt reimbursement of doula
482	482	459services;
483	483	460 (f) establishing grievance procedures for doulas, MassHealth members, and health care
484	484	461providers about MassHealth’s coverage of doula services and/or the provision of doula services
485	485	462to MassHealth members;
486	486	463 (g) outreach to the public and stakeholders about how to access doula care for
487	487	464MassHealth members, and about the availability of and advantages of doula care;
488	488	465 (h) the evaluation and collection of data on the provision of, outcomes of, access to, and
489	489	466satisfaction with doula care services provided to MassHealth members; 24 of 40
490	490	467 (i) maintaining a reimbursement rate for doula services that incentivizes and supports a
491	491	468diverse workforce representative of the communities served, and establishing a recurring
492	492	469timeframe to review that rate in light of inflation and changing costs of living in the
493	493	470commonwealth;
494	494	471 (j) how to ensure that MassHealth’s doula reimbursement program is directed towards the
495	495	472goal of reducing inequities in maternal and infant health outcomes among racial, ethnic, and
496	496	473cultural populations who reside in all areas within the commonwealth, as evidenced by the most
497	497	474current perinatal data supplied by the department of public health.
498	498	475 (5) Each year, the Doula Advisory Committee must, by a majority vote of a quorum of its
499	499	476members, select an individual to serve as its chairperson for a one year term. The Doula
500	500	477Advisory Committee may replace the chairperson in the same manner mid-term.
501	501	478 (6) The Doula Advisory Committee may, by a majority vote of a quorum of its members,
502	502	479reduce the frequency of meetings with MassHealth to less than once every 8 weeks.
503	503	480 (7) The division and the Department of Public Health shall seek resources to offer
504	504	481reasonable compensation to members of the Doula Advisory Committee for fulfilling their
505	505	482duties, and must reimburse members for actual and necessary expenses incurred while fulfilling
506	506	483their duties.
507	507	484 (8) The division, in partnership with the Doula Advisory Committee, shall conduct at
508	508	485least 1 public hearing or forum each year until three years after passage of this law. The purposes
509	509	486of these hearings or forums shall be to gather feedback from the public and to inform the public
510	510	487about MassHealth’s coverage of doula care. 25 of 40
511	511	488 SECTION 33. Chapter 111 of the General Laws is hereby amended by inserting in
512	512	489section 70E after “Every patient or resident of a facility shall have the right:”:
513	513	490 (p) to have their birth doula’s continuous presence during labor and delivery. Facilities
514	514	491shall not place an undue burden on a patient’s doula’s access to clinical labor and delivery
515	515	492settings and shall not arbitrarily exclude a patient’s doula from such settings. A patient’s doula
516	516	493shall not count towards the patient’s support person limitations imposed by the medical facility
517	517	494in which the patient is giving birth.
518	518	495 SECTION 34. Chapter 111 of the General Laws is hereby amended by inserting after
519	519	496section 110C the following sections:-
520	520	497 Section 110D: Required Newborn Screening for Congenital Cytomegalovirus
521	521	498 For the purposes of this section, the following words shall, unless the context clearly
522	522	499requires otherwise, have the following meanings:-
523	523	500 “Birthing facility”, an inpatient or ambulatory health care facility licensed by the
524	524	501department of public health that provides birthing and newborn care services.
525	525	502 “cCMV”, Congenital Cytomegalovirus.
526	526	503 “cCMV) screening”, the identification of a newborn who may have cCMV infection or
527	527	504has cCMV confirmed through the use of a saliva or urine test.
528	528	505 “Department”, the department of public health. 26 of 40
529	529	506 “Newborn,” any liveborn infant who has not yet attained the age of 21 days from a birth
530	530	507occurring in the commonwealth or from a birth prior to transfer to a hospital in the
531	531	508commonwealth.
532	532	509 The department, in consultation with the perinatal advisory committee, shall develop
533	533	510evidence-based regulations for all hospitals and birthing facilities requiring cCMV screening
534	534	511within one year of the passage of this legislation.
535	535	512 The cCMV screening shall be performed using a saliva PCR test unless one is
536	536	513unavailable in which case a urine PCR test may be used. If positive, a saliva PCR test would
537	537	514require a confirmatory urine PCR test. The department may approve another test to conduct
538	538	515cCMV screening; provided, however, that the test shall be, at the discretion of the department, at
539	539	516least as accurate, widely available and cost-effective as a saliva or urine PCR test. A screening
540	540	517shall be performed within 21 days from the date of birth and before the newborn infant is
541	541	518discharged from the birthing facility to the care of the parent or guardian; provided, however,
542	542	519that the screening shall not be performed if the parent or guardian of the newborn infant objects
543	543	520to the screening based upon a sincerely held religious belief of the parent or guardian. The
544	544	521cCMV educational materials outlined in section 70I(b) shall be provided to the parent or
545	545	522guardian of the infant at the time of cCMV screening.
546	546	523 A hospital that provides birthing and newborn services or a birthing facility shall adopt
547	547	524protocols for cCMV screening using a saliva or urine PCR test or another test approved by the
548	548	525department under this section for all newborns prior to discharge, and not to exceed 21 days from
549	549	526the date of birth, based on the department’s regulations, on or before January 1, 2025. 27 of 40
550	550	527 The cost of providing the newborn cCMV screening shall be a covered benefit
551	551	528reimbursable by all health insurers, except for supplemental policies that only provide coverage
552	552	529for specific diseases, hospital indemnity, Medicare supplement or other supplemental policies. In
553	553	530the absence of a third-party payer, the charges for the newborn cCMV screening shall be paid by
554	554	531the commonwealth.
555	555	532 A hospital or birthing facility shall report annually to the department data including, but
556	556	533not limited to, the number of cCMV tests administered and the outcomes of said tests. The
557	557	534hospital or birthing facility shall inform, orally and in writing, a parent or guardian of the
558	558	535newborn infant the result of the cCMV screening test regardless of its outcome. This information
559	559	536shall also be provided in writing to the newborn infant's primary care physician and to the
560	560	537department through its electronic birth certificate system or such mechanism as specified by the
561	561	538department.
562	562	539 The department shall review the protocols required under this section and the
563	563	540implementation of these protocols as part of its birthing facility licensure review processes.
564	564	541 The department shall promulgate regulations to implement the cCMV screening program.
565	565	542 Nothing in this statute shall preclude newborns born at home from obtaining said cCMV
566	566	543screening.
567	567	544 Section 110E: Advisory Committee for CMV Screening Program
568	568	545 There is hereby established an advisory committee for the purpose of implementing the
569	569	546provisions of Section 110D. The advisory committee shall consist of the following members to
570	570	547be appointed by the commissioner of the department: a representative of the hospital industry; a 28 of 40
571	571	548primary care pediatrician or family practitioner; an otolaryngologist; a neonatologist; an
572	572	549infectious disease specialist; a clinician representing newborn nurseries; an audiologist; an
573	573	550ophthalmologist; an obstetrician-gynecologist; a representative of the commonwealth's early
574	574	551intervention program; 2 parents and/or guardians of a child impacted by cCMV; 2 medical
575	575	552professionals; a developer of preventative and/or therapeutic interventions for cCMV; a teacher
576	576	553of the deaf; and a representative of the department.
577	577	554 The advisory committee shall advise the department regarding the validity and cost of
578	578	555proposed cCMV regulations and/or cCMV screening and shall recommend standards for
579	579	556performing and interpreting screening tests based on the most current technological methods, for
580	580	557documenting test results and follow-up, and for facilitating interaction between professionals and
581	581	558agencies that participate in follow-up care. Members of the advisory committee shall serve
582	582	559without compensation. The advisory committee shall be provided support services by the
583	583	560department.
584	584	561 SECTION 35. Chapter 111 of the General Laws is hereby further amended by inserting
585	585	562after Section 70H the following section:-
586	586	563 Section 70I: Congenital cytomegalovirus; public information program; annual report
587	587	564 (a) The commissioner of the department shall establish, promote, and maintain a public
588	588	565information program regarding congenital cytomegalovirus, hereinafter referred to as cCMV.
589	589	566Such program shall be conducted throughout the commonwealth, and under said program, a
590	590	567hospital or birthing facility as defined in section 110D under this chapter or any healthcare
591	591	568provider, physician assistant, nurse or midwife who renders prenatal or postnatal care shall give
592	592	569expectant or new parents or guardians information provided by the department under subsection 29 of 40
593	593	570(b). Such information shall be made available at the first prenatal appointment or at a
594	594	571preconception visit if applicable, whichever is earliest.
595	595	572 (b) The department shall make available to any healthcare provider, physician assistant,
596	596	573nurse or midwife who renders prenatal or postnatal care or offers fertility counseling or care to a
597	597	574parent or guardian the following: (i) up-to-date evidence-based, written information about cCMV
598	598	575and universal cCMV screening that has been vetted by an appropriate group of medical experts
599	599	576as determined by the department in conjunction with the advisory committee as established in
600	600	577section 110E of said Chapter 111; provided, however, that the written information provided shall
601	601	578include preventative measures that can be taken throughout pregnancy, and (ii) contact or other
602	602	579referral information for additional educational and support resources. The department may also
603	603	580make such information available to any other person who seeks information about cCMV
604	604	581infections.
605	605	582 SECTION 36. Section 47C of chapter 175 is hereby amended by striking out the word
606	606	583“annually” and inserting in place thereof the following words:- once per calendar year.
607	607	584 SECTION 37. Chapter 111 of the General Laws, as appearing in the 2016 Official
608	608	585Edition, is hereby amended by inserting, after section 2J, the following new section:-
609	609	586 Section 2K. (a) As used in this section, the following words shall have the following
610	610	587meanings unless context clearly requires otherwise:
611	611	588 “Commissioner,” the commissioner of the department of public health.
612	612	589 “Department,” the department of public health.
613	613	590 “Fund,” the diaper benefits trust fund. 30 of 40
614	614	591 “Organization,” an entity, including but not limited to, that acts in whole or in part as a
615	615	592diaper bank, diaper distribution organization, food bank or food pantry.
616	616	593 “Pilot program,” an organization or organizations receiving funds from the department to
617	617	594provide diapers to low-income families with diaper-wearing infants and/or children.
618	618	595Organizations may collaborate to maximize distribution in their respective regions.
619	619	596 (b) There shall be established and set up on the books of the commonwealth a fund to
620	620	597address diaper insufficiency that shall be administered by the commissioner. The fund shall be
621	621	598credited with: (i) revenue from appropriations or other money authorized by the general court
622	622	599and specifically designated to the fund; (ii) interest earned on such revenues; and (iii) funds from
623	623	600public and private sources such as gifts, grants and donations to further the pilot program.
624	624	601Amounts credited to the fund shall not be subject to further appropriation and any money
625	625	602remaining in the fund at the end of the fiscal year shall not revert to the General Fund.
626	626	603 (c) The department shall distribute resources from the fund by issuing a request for
627	627	604proposal through which an organization or organizations may apply. Funds received shall be
628	628	605used for one or more of the following purposes: (i) acquiring diapers, (ii) storing diapers, (iii)
629	629	606distributing diapers, (iv) organizing diaper drives, or (v) marketing the pilot program.
630	630	607 The department shall grant funds based on the demonstrated capacity and need of the
631	631	608applicant. The department shall fund up to 12 applicants no more than 2 of which shall be from
632	632	609the western region of the commonwealth; no more than 2 of which shall be from the central
633	633	610region of the commonwealth; no more than 2 of which shall be from the eastern region of the
634	634	611commonwealth; no more than 2 of which shall be from the southeastern region of the 31 of 40
635	635	612commonwealth; no more than 2 of which shall be from Cape Cod or the Islands; and no more
636	636	613than 2 of which shall be from the Merrimack valley.
637	637	614 Amounts received from private sources shall be approved by the commissioner of the
638	638	615department and subject to review before being deposited in the fund to ensure that pledged funds
639	639	616are not accompanied by conditions, explicit or implicit, on distributing diapers.
640	640	617 (d) Not later than one year after the implementation of each pilot program said
641	641	618department shall provide a report to the joint committee on children, families and persons with
642	642	619disabilities and to the house and senate committees on ways and means. The report shall include,
643	643	620but not be limited to: (i) the number of children receiving diapers through the pilot program; (ii)
644	644	621the number of households receiving diapers through the pilot program; (iii) the number of
645	645	622diapers distributed through the pilot program to families in each region; (iv) an explanation of
646	646	623the organization's distribution process and allocation determination; (v) the sources and the
647	647	624amounts remaining in the fund; (vi) if and how the pilot program was able to leverage additional
648	648	625support; (vii) the amounts distributed and the purpose of expenditures from the fund; and (viii)
649	649	626the advisability of expanding the pilot program.
650	650	627 SECTION 38. Section 51A of chapter 119 of the general laws is hereby amended in
651	651	628subsection (a) in the first paragraph by striking out the words:-
652	652	629 (iii) physical dependence upon an addictive drug at birth,
653	653	630 SECTION 39. Said section 51A is hereby further amended by inserting in subsection (a)
654	654	631after the second paragraph a new subsection: 32 of 40
655	655	632 (a ½) Separate from the reporting requirements under subsection (a), health care
656	656	633providers involved in the delivery or care of infants affected by in-utero substance exposure or a
657	657	634Fetal Alcohol Spectrum disorder, shall notify the Department of such condition in such infants as
658	658	635required under 42 U.S.C. § 1506a(b)(2)(B)(ii). Such notification shall not include the names or
659	659	636identifying information of the parents or the infant, shall not constitute a report that any parent
660	660	637has abused or neglected a child, and shall not trigger or require prosecution for any illegal action.
661	661	638 SECTION 40. (A) There is hereby created in the department of job and family services
662	662	639the Massachusetts commission on fatherhood. The commission shall consist of the following
663	663	640members:
664	664	641 (1) (a) Four members of the house of representatives appointed by the speaker of the
665	665	642house, not more than two of whom are members of the same political party. Two of the members
666	666	643must be from legislative districts that include a county or part of a county that is among the one-
667	667	644third of counties in this state with the highest number per capita of households headed by
668	668	645females.
669	669	646 (b) Two members of the senate appointed by the president of the senate, each from a
670	670	647different political party. One of the members must be from a legislative district that includes a
671	671	648county or part of a county that is among the one-third of counties in this state with the highest
672	672	649number per capita of households headed by females.
673	673	650 (2) The governor, or the governor's designee;
674	674	651 (3) One representative of the judicial branch of government appointed by the chief justice
675	675	652of the supreme court; 33 of 40
676	676	653 (4) The directors of health, job and family services, rehabilitation and correction, and
677	677	654youth services and the superintendent of public instruction, or their designees;
678	678	655 (5) Two representatives of the Massachusetts family and children first cabinet council
679	679	656created under section 121.37 of the Revised Code appointed by the chairperson of the council;
680	680	657 (6) Five representatives of the general public appointed by the governor. These members
681	681	658shall have extensive experience in issues related to fatherhood;
682	682	659 (7) One member of the Governor’s Council to Address Sexual Assault, Domestic
683	683	660Violence, and Human Trafficking.
684	684	661 (B) The appointing authorities of the Massachusetts commission on fatherhood shall
685	685	662make initial appointments to the commission within thirty days after the effective date of this
686	686	663section. Of the initial appointments to the commission made pursuant to divisions (A)(3), (5),
687	687	664and (6) of this section, three of the members shall serve a term of one year and four shall serve a
688	688	665term of two years. Members so appointed subsequently shall serve two-year terms. A member
689	689	666appointed pursuant to division (A)(I) of this section shall serve on the commission until the end
690	690	667of the general assembly from which the member was appointed or until the member ceases to
691	691	668serve in the chamber of the general assembly in which the member serves at the time of
692	692	669appointment, whichever occurs first. The governor or the governor's designee shall serve on the
693	693	670commission until the governor ceases to be governor. The directors and superintendent or their
694	694	671designees shall serve on the commission until they cease, or the director or superintendent a
695	695	672designee represents ceases, to be director or superintendent. Each member shall serve on the
696	696	673commission from the date of appointment until the end of the term for which the member was
697	697	674appointed. Members may be reappointed. 34 of 40
698	698	675 Vacancies shall be filled in the manner provided for original appointments. Any member
699	699	676appointed to fill a vacancy occurring prior to the expiration date of the term for which the
700	700	677member's predecessor was appointed shall serve on the commission for the remainder of that
701	701	678term. A member shall continue to serve on the commission subsequent to the expiration date of
702	702	679the member's term until the member's successor is appointed or until a period of sixty days has
703	703	680elapsed, whichever occurs first. Members shall serve without compensation but shall be
704	704	681reimbursed for necessary expenses.
705	705	682 (C) Said commission shall prepare a report each year that identifies resources available to
706	706	683fund fatherhood-related programs and explores the creation of initiatives to do the following: (a)
707	707	684build the parenting skills of fathers; (b) provide employment-related services for low-income,
708	708	685non-custodial fathers; (c) prevent unintentional fatherhood through pregnancy prevention
709	709	686programming ; (d) provide parenting skill development for fathers who are inmates in or have
710	710	687recently been released from imprisonment in a state correctional institution or any other
711	711	688detention facility so that these fathers are able to maintain or reestablish their relationships with
712	712	689their families; (e) reconcile fathers with their families; (f) increase public awareness of the
713	713	690critical role fathers play; and (g) consider other measures and programs that will address the
714	714	691issue of father absence or estrangement and to support families as the commission deems
715	715	692appropriate.
716	716	693 SECTION 41. Chapter 32A of the General Laws, is hereby amended by inserting after
717	717	694section 33 the following section:-
718	718	695 Section 34. The commission shall provide to any active or retired employee of the
719	719	696commonwealth who is insured under the group insurance commission coverage for the universal 35 of 40
720	720	697postpartum nurse home visiting program administered by the department of public health. Such
721	721	698coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and
722	722	699shall not be subject to any deductible.
723	723	700 SECTION 42. Chapter 111 is hereby amended by adding after Section 243 the following
724	724	701section:-
725	725	702 Section 244. (a) The department shall design and implement a statewide universal
726	726	703postpartum nurse home visiting program. The program home visits will be available to all
727	727	704families with infants up to six months of age, including foster and adopted infants, residing
728	728	705within the commonwealth. The program must provide nurse home visiting services that are (1)
729	729	706based on criteria established by the United States Department of Health and Human Services for
730	730	707an evidence-based early childhood home visiting service delivery model; (2) provided by
731	731	708registered nurses licensed in the commonwealth; (3) provided to families, including adoptive and
732	732	709foster families, caring for infants six months of age of less; (4) provided in the family’s home;
733	733	710(5) aimed at improving outcomes in one of the following areas: (i) infant health and
734	734	711development; (ii) the family’s financial ability to care for their children; (iii) physical health of
735	735	712the gestational parent; (iv) mental health of all parents with custodial care of the infant; (v)
736	736	713parenting skills; (vi) infant care practices including safe sleep arrangements; (vii) infant feeding;
737	737	714and (viii) knowledge of other community resources from which the family may benefit.
738	738	715Participation for the family must be voluntary with no negative consequences for a family that
739	739	716declines to participate.
740	740	717 (b) Each eligible family shall receive at least one home visit during the infant’s first three
741	741	718months of life and one additional visit within the infant’s first six months of life. 36 of 40
742	742	719 (c) The program shall coordinate with each hospital and birthing facility in the
743	743	720commonwealth to ensure that a person who has given birth is advised of the benefits of receiving
744	744	721a home nurse visit and to allow for scheduling prior to the infant’s discharge from the hospital or
745	745	722birthing facility.
746	746	723 (d) The program shall develop a method for providing foster parents, adoptive parents,
747	747	724and gestational parents who gave birth outside of a hospital or birthing facility information about
748	748	725the program.
749	749	726 (e) The department may contract with agencies, individuals or groups for the provision of
750	750	727such services, subject to appropriation. The department shall begin implementation of the
751	751	728universal newborn nurse home visiting program first in those communities with the greatest
752	752	729inequities in maternal health outcomes, as identified by the department. The department shall
753	753	730scale up the program to achieve universal, statewide access within six years of the passage of this
754	754	731act.
755	755	732 (c) In designing the program designed in subsections (a) through (d) of this section, the
756	756	733department shall consult, coordinate, and collaborate, as necessary, with insurers that offer health
757	757	734benefit plans in the commonwealth, MassHealth officials, hospitals, local public health
758	758	735departments, birthing centers, existing early childhood home visiting programs, community-
759	759	736based organizations, and social service providers.
760	760	737 (d) A provider of universal postpartum nurse home visiting services shall determine
761	761	738whether any recipient for whom it provides said services are or may be eligible for coverage of
762	762	739said services through an alternative source. The department is the payer of last resort, and a
763	763	740provider shall request payment for services it provides from third-party payers pursuant to 37 of 40
764	764	741chapters 32A, 118E, 175, 176A, 176B, or 176G of the General Laws, before payment is
765	765	742requested from the department.
766	766	743 (e) The department shall collect and analyze data generated by the program to monitor
767	767	744and assess the effectiveness of universal postpartum nurse home visiting services. The
768	768	745department shall work with other state agencies to develop protocols for sharing data, including
769	769	746the timely sharing of data with primary care providers of care to the families with newborns
770	770	747receiving the services. Programs which are in receipt of state or federal funding for said services
771	771	748shall report such information as requested by the department for the purpose of monitoring,
772	772	749assessing the effectiveness of such programs, initiating quality improvement, and reducing health
773	773	750disparities.
774	774	751 SECTION 43. Chapter 118E of the General Laws, is hereby amended by inserting after
775	775	752section 10N the following section:-
776	776	753 Section 10O. The division and its contracted managed care organizations, accountable
777	777	754care organizations, health plans, integrated care organizations, third-party administrators, or
778	778	755other entities contracting with the division to administer benefits, shall provide coverage for
779	779	756universal postpartum nurse home visiting services, in accordance with operational standards set
780	780	757by the department of public health pursuant to section 244 of chapter 111 of the General Laws.
781	781	758Such coverage shall not be subject to any cost-sharing.
782	782	759 SECTION 44. Chapter 175 of the General Laws, is hereby amended by inserting after
783	783	760section 47PP the following section:-
784	784	761 Section 47QQ. An individual policy of accident and sickness insurance issued pursuant to
785	785	762section 108 that provides hospital expense and surgical expense insurance or a group blanket or 38 of 40
786	786	763general policy of accident and sickness insurance issued pursuant to section 110 that provides
787	787	764hospital expense and surgical expense insurance that is issued or renewed within the
788	788	765commonwealth shall provide coverage for universal postpartum nurse home visiting services, in
789	789	766accordance with operational standards set by the department of public health pursuant to section
790	790	767244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing,
791	791	768including co-payments and co-insurance, and shall not be subject to any deductible; provided,
792	792	769however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is
793	793	770governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
794	794	771of the prohibition on co-payments, coinsurance or deductibles for these services.
795	795	772 SECTION 45. Chapter 176A of the General Laws, is hereby amended by inserting after
796	796	773section 8KK the following section:-
797	797	774 Section 8LL. Any contract between a subscriber and the corporation under an individual
798	798	775or group hospital service plan which is delivered, issued or renewed within the
799	799	776commonwealthshall provide coverage for universal postpartum nurse home visiting services, in
800	800	777accordance with operational standards set by the department of public health pursuant to section
801	801	778244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing,
802	802	779including co-payments and co-insurance, and shall not be subject to any deductible; provided,
803	803	780however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is
804	804	781governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
805	805	782of the prohibition on co-payments, coinsurance or deductibles for these services.
806	806	783 SECTION 46. Chapter 176B of the General Laws, is hereby amended by inserting after
807	807	784section 4KK the following section:- 39 of 40
808	808	785 Section 4LL. Any subscription certificate under an individual or group medical service
809	809	786agreement delivered, issued or renewed within the commonwealth shall provide coverage for
810	810	787universal postpartum nurse home visiting services, in accordance with operational standards set
811	811	788by the department of public health pursuant to section 244 of chapter 111 of the General Laws.
812	812	789Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance,
813	813	790and shall not be subject to any deductible; provided, however, that co-payments, coinsurance or
814	814	791deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue
815	815	792Code and would lose its tax-exempt status as a result of the prohibition on co-payments,
816	816	793coinsurance or deductibles for these services.
817	817	794 SECTION 47. Chapter 176G of the General Laws, is hereby amended by inserting after
818	818	795section 4KK the following section:-
819	819	796 Section 4LL. Any individual or group health maintenance contract that is issued or
820	820	797renewed within the commonwealth shall provide coverage for universal postpartum nurse home
821	821	798visiting services, in accordance with operational standards set by the department of public health
822	822	799pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject
823	823	800to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any
824	824	801deductible; provided, however, that co-payments, coinsurance or deductibles shall be required if
825	825	802the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-
826	826	803exempt status as a result of the prohibition on co-payments, coinsurance or deductibles for these
827	827	804services.
828	828	805 SECTION 48. Chapter 32A of the General Laws, is hereby amended by inserting after
829	829	806section 33 the following section:- 40 of 40
830	830	807 Section 34. The commission shall provide to any active or retired employee of the
831	831	808commonwealth who is insured under the group insurance commission coverage for the universal
832	832	809postpartum nurse home visiting program administered by the department of public health. Such
833	833	810coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and
834	834	811shall not be subject to any deductible.