1.1 A bill for an act 1.2 relating to health; expanding maternal death studies conducted by the commissioner 1.3 of health to include maternal morbidity; amending Minnesota Statutes 2022, section 1.4 145.901. 1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.6 Section 1. Minnesota Statutes 2022, section 145.901, is amended to read: 1.7 145.901 MATERNAL MORBIDITY AND DEATH STUDIES. 1.8 Subdivision 1.Purpose.(a) The commissioner of health may conduct maternal morbidity 1.9and death studies to assist the planning, implementation, and evaluation of medical, health, 1.10and welfare service systems and to reduce the numbers of preventable adverse maternal 1.11outcomes and deaths in Minnesota. 1.12 (b) For purposes of this section, "maternal morbidity" has the meaning given to severe 1.13maternal morbidity by the Centers for Disease Control and Prevention, and includes an 1.14unexpected outcome of labor or delivery that results in significant short- or long-term 1.15consequences to a woman's health. 1.16 Subd. 2.Access to data.(a) The commissioner of health has access to medical data as 1.17defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined 1.18in section 13.83, subdivision 1, and health records created, maintained, or stored by providers 1.19as defined in section 144.291, subdivision 2, paragraph (c), without the consent of the subject 1.20of the data, and without the consent of the parent, spouse, other guardian, or legal 1.21representative of the subject of the data, when the subject of the data is a woman who died 1.22or experienced morbidities during a pregnancy or within 12 months of a fetal death, a live 1.23birth, or other termination of a pregnancy. 1Section 1. 23-00160 as introduced10/25/22 REVISOR SGS/KA SENATE STATE OF MINNESOTA S.F. No. 166NINETY-THIRD SESSION (SENATE AUTHORS: MORRISON and Mann) OFFICIAL STATUSD-PGDATE Introduction and first reading01/11/2023 Referred to Health and Human Services 2.1 The commissioner has access only to medical data and health records related to maternal 2.2morbidities and deaths that occur on or after July 1, 2000, including the names of the 2.3providers, clinics, or other health services such as family home visiting programs; the 2.4women, infants, and children (WIC) program; prescription monitoring programs; and 2.5behavioral health services, where care was received before, during, or related to the pregnancy 2.6or death. The commissioner has access to records maintained by family home visiting 2.7programs; the women, infants, and children (WIC) program; the prescription monitoring 2.8program; behavioral health services programs; substance use treatment facilities; law 2.9enforcement; and a medical examiner, a coroner, or hospitals or to hospital discharge data, 2.10for the purpose of providing the name and location of any pre-pregnancy, prenatal, 2.11postpartum, or other care received by the subject of the data up to one year after the end of 2.12the pregnancy. 2.13 (b) The provider or responsible authority that creates, maintains, or stores the data shall 2.14furnish the data upon the request of the commissioner. The provider or responsible authority 2.15may charge a fee for providing the data, not to exceed the actual cost of retrieving and 2.16duplicating the data. 2.17 (c) The commissioner shall make a good faith reasonable effort to notify the subject of 2.18the data, or the subject's parent, spouse, other guardian, or legal representative of the subject 2.19of the data before collecting data on the subject. For purposes of this paragraph, "reasonable 2.20effort" means one notice is sent by certified mail to the last known address of the subject 2.21of the data, or the subject's parent, spouse, guardian, or legal representative informing the 2.22recipient of the data collection and offering a public health nurse support visit if desired. 2.23 (d) The commissioner does not have access to coroner or medical examiner data that 2.24are part of an active investigation as described in section 13.83. 2.25 (e) The commissioner may request and receive from a coroner or medical examiner the 2.26name of the health care provider that provided prenatal, postpartum, or other health services 2.27to the subject of the data. 2.28 (f) The commissioner may access Department of Human Services data to identify sources 2.29of care and services to assist with the evaluation of welfare systems, including housing, to 2.30reduce preventable maternal deaths. 2.31 (g) The commissioner may request and receive law enforcement reports or incident 2.32reports related to the subject of the data. 2.33 Subd. 3.Management of records.After the commissioner has collected all data about 2.34a subject of a maternal morbidity or death study needed to perform the study, the data from 2Section 1. 23-00160 as introduced10/25/22 REVISOR SGS/KA 3.1source records obtained under subdivision 2, other than data identifying the subject, must 3.2be transferred to separate records to be maintained by the commissioner. Notwithstanding 3.3section 138.17, after the data have been transferred, all source records obtained under 3.4subdivision 2 possessed by the commissioner must be destroyed. 3.5 Subd. 4.Classification of data.(a) Data provided to the commissioner from source 3.6records under subdivision 2, including identifying information on individual providers, data 3.7subjects, or their children, and data derived by the commissioner under subdivision 3 for 3.8the purpose of carrying out maternal morbidity and death studies, are classified as confidential 3.9data on individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3.103, and 13.10, subdivision 1, paragraph (a). 3.11 (b) Information classified under paragraph (a) shall not be subject to discovery or 3.12introduction into evidence in any administrative, civil, or criminal proceeding. Such 3.13information otherwise available from an original source shall not be immune from discovery 3.14or barred from introduction into evidence merely because it was utilized by the commissioner 3.15in carrying out maternal morbidity and death studies. 3.16 (c) Summary data on maternal morbidity and death studies created by the commissioner, 3.17which does not identify individual data subjects or individual providers, shall be public in 3.18accordance with section 13.05, subdivision 7. 3.19 (d) Data provided by the commissioner of human services to the commissioner of health 3.20under this section retain the same classification the data held when retained by the 3.21commissioner of human services, as required under section 13.03, subdivision 4, paragraph 3.22(c). 3.23 Subd. 5.Maternal Morbidity and Mortality Review Committee.(a) The commissioner 3.24of health shall convene a Maternal Morbidity and Mortality Review Committee to conduct 3.25maternal morbidity and death study reviews, make recommendations, and publicly share 3.26summary information. The commissioner shall appoint members to the review committee, 3.27and membership may include but is not limited to medical examiners or coroners, 3.28representatives of health care institutions that provide care to pregnant women, obstetric 3.29and midwifery practitioners, Medicaid representatives, representatives of state agencies, 3.30individuals from communities with disparate rates of maternal morbidity and mortality, and 3.31other subject matter experts as appropriate. Committee membership shall not exceed 25 3.32members. The review committee shall review data from source records obtained under 3.33subdivision 2, other than data identifying the subject or the provider. 3Section 1. 23-00160 as introduced10/25/22 REVISOR SGS/KA 4.1 (b) A person attending a Maternal Morbidity and Mortality Review Committee meeting 4.2shall not disclose what transpired at the meeting, except as necessary to carry out the purposes 4.3of the review committee. The proceedings and records of the review committee are protected 4.4nonpublic data as defined in section 13.02, subdivision 13. Discovery and introduction into 4.5evidence in legal proceedings of case review committee proceedings and records, and 4.6testimony in legal proceedings by review committee members and persons presenting 4.7information to the review committee, shall occur in compliance with the requirements in 4.8section 256.01, subdivision 12, paragraph (e). 4Section 1. 23-00160 as introduced10/25/22 REVISOR SGS/KA