| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.256 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEBOSLEY. |
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| 5 | 5 | | 0650H.01I DANARADEMANMILLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Torepealsection192.990,RSMo,andtoenactinlieuthereofthreenewsectionsrelatingto |
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| 8 | 8 | | maternalcare. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Section192.990,RSMo,isrepealedandthreenewsectionsenactedinlieu |
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| 11 | 11 | | 2thereof,tobeknownassections192.258,192.990,and192.1030,toreadasfollows: |
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| 12 | 12 | | 192.258.1.Forpurposesofthissection,thefollowingtermsmean: |
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| 13 | 13 | | 2 (1)"Localpublichealthagency",acountyhealthcenterboardestablished |
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| 14 | 14 | | 3underchapter205,acountyhealthdepartment,acityhealthdepartmentoragency,a |
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| 15 | 15 | | 4combinedcityandcountyhealthdepartmentoragency,amulticountyhealth |
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| 16 | 16 | | 5departmentoragency,oranyothercountyorcityhealthauthority; |
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| 17 | 17 | | 6 (2)"Terminfants",infantswhoareatthirty-sixweeksormoreofgestation. |
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| 18 | 18 | | 7 2.(1)Eachcountyshallannuallyreportinfantdeathstothelocalpublichealth |
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| 19 | 19 | | 8agencyoragencieswithjurisdictionoverthecountyoranypartofthecounty. |
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| 20 | 20 | | 9 (2)Thedatashallbeaggregatedtoensuredatareflectshowregionalizedcare |
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| 21 | 21 | | 10systemsare,orshouldbe,collaboratingtoimprovefetalandinfanthealthoutcomes |
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| 22 | 22 | | 11basedonstandardstatisticalmethodsforaccuratedisseminationofpublichealthdata |
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| 23 | 23 | | 12withoutriskingaconfidentialityorotherdisclosurebreach. |
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| 24 | 24 | | 13 (3)Thedatashallbedisaggregatedbyracialandethnicidentity. |
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| 25 | 25 | | 14 3.Subjecttoappropriation,alocalpublichealthagencyshallestablishafetal |
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| 26 | 26 | | 15andinfantmortalityreviewcommitteetoinvestigateinfantdeathstopreventfetaland |
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| 27 | 27 | | 16infantdeathifbothofthefollowingapplywithrespecttothelocalpublichealth |
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| 28 | 28 | | 17agency'sjurisdiction: |
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| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 (1)Thejurisdictionhasfiveormoreinfantdeathsinasingleyear;and |
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| 31 | 31 | | 19 (2)Thejurisdictionhasaninfantdeathratethatishigherthanthestate'sinfant |
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| 32 | 32 | | 20deathratefortwoconsecutiveyears. |
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| 33 | 33 | | 21 4.Thedepartmentofhealthandseniorservicesshallestablishafetalandinfant |
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| 34 | 34 | | 22mortalityreviewprocessinwhichalllocalpublichealthagenciesmayvoluntarily |
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| 35 | 35 | | 23participate.Alocalpublichealthagencythatparticipatesinthefetalandinfant |
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| 36 | 36 | | 24mortalityreviewprocessestablishedbythedepartmentofhealthandseniorservices |
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| 37 | 37 | | 25shalldoallofthefollowing: |
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| 38 | 38 | | 26 (1)Annuallyinvestigate,track,andreviewaminimumamountoftwenty |
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| 39 | 39 | | 27percentofthejurisdiction'scasesofterminfantswhowerebornfollowinglaborwith |
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| 40 | 40 | | 28theoutcomeofintrapartumstillbirth,earlyneonataldeath,orpostneonataldeath, |
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| 41 | 41 | | 29focusingondemographicgroupsthataredisproportionatelyimpactedbyinfantdeath. |
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| 42 | 42 | | 30Ajurisdictionthathasfewerthanfiveinfantdeathsinayearshallinvestigateatleast |
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| 43 | 43 | | 31oneinfantdeath; |
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| 44 | 44 | | 32 (2)Establishacommitteeforfetalandinfantmortalityreviewsledbylocal |
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| 45 | 45 | | 33publichealthagencies.Thecommitteeshallincludemembersofthecommunitybut |
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| 46 | 46 | | 34shallnotincludeanyoneemployedbyalawenforcementagency.Injurisdictionsin |
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| 47 | 47 | | 35whichthecoroner,medicalexaminer,orothermedicalprofessionalisemployedbylaw |
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| 48 | 48 | | 36enforcement,theseindividualscanshareinformationwiththecommitteeintheir |
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| 49 | 49 | | 37medicalprofessionalcapacityonly.Thecommitteeshallbesubjecttothefollowing |
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| 50 | 50 | | 38provisions: |
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| 51 | 51 | | 39 (a)Alldataandrecordsobtained,prepared,created,andmaintainedin |
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| 52 | 52 | | 40anticipationofareviewmeetingshallbeconfidential.Dataandrecordsprepared, |
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| 53 | 53 | | 41created,andmaintainedinanticipationofareviewmeetingshallnotbesubjectto |
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| 54 | 54 | | 42publicrecordsrequests,subpoena,orcivilprocessesandshallnotbeadmissiblein |
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| 55 | 55 | | 43evidenceinconnectionwithanyadministrative,judicial,executive,legislative,orother |
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| 56 | 56 | | 44proceeding; |
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| 57 | 57 | | 45 (b)Allparticipantsengagedinandassociatedwiththereviewprocessshallsign |
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| 58 | 58 | | 46aconfidentialityagreementthatstatessuchparticipantswillnotdiscussorshare |
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| 59 | 59 | | 47informationaboutindividualcasesandtheproceedingsofthereviewmeetingoutside |
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| 60 | 60 | | 48themeeting.Thisshallnotprecludethecommitteefrompublishing,orfromotherwise |
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| 61 | 61 | | 49makingavailableforpublicinspection,statisticalcompilationsorreportsthatarebased |
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| 62 | 62 | | 50onconfidentialinformation,providedthatthosecompilationsorreportsshallnot |
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| 63 | 63 | | 51containpersonallyidentifyinginformationorotherinformationthatcouldbeusedto |
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| 64 | 64 | | 52ultimatelyidentifytheindividualsconcernedandshallutilizestandardpublichealth |
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| 65 | 65 | | 53reportingpracticesforaccuratedisseminationofthesedataelements,especiallywith |
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| 66 | 66 | | HB256 2 54regardtothereportingofsmallnumberssoasnottoinadvertentlyriskabreachof |
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| 67 | 67 | | 55confidentialityorotherdisclosure;and |
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| 68 | 68 | | 56 (c)Totheextentprescribedbysection537.035,membersofthecommittee, |
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| 69 | 69 | | 57personsattendingacommitteemeeting,andpersonswhopresentinformationtoa |
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| 70 | 70 | | 58committeeshallnotbequestionedinanyadministrative,civil,orcriminalproceeding |
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| 71 | 71 | | 59regardinginformationpresentedin,oropinionsformedasaresultof,ameeting.This |
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| 72 | 72 | | 60paragraphshallnotprohibitapersonfromtestifyingtoinformationobtained |
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| 73 | 73 | | 61independentlyofthecommitteeorthatispublicinformation.Ahealthcareprovider, |
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| 74 | 74 | | 62healthcarefacility,orpharmacyprovidingaccesstomedicalrecordsunderthissection |
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| 75 | 75 | | 63shallnotbeheldliableforcivildamagesorbesubjecttoanycriminalordisciplinary |
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| 76 | 76 | | 64actionforgoodfaitheffortsinprovidingtherecords; |
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| 77 | 77 | | 65 (3)Conductvoluntaryinterviewswithindividualswhohaveexperiencedchild |
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| 78 | 78 | | 66lossorsurvivingfamilymembersofmaternalorinfantdeathwhohaveknowledgeof |
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| 79 | 79 | | 67theevent.Theinterviewshallincludequestionstodetermineifthepregnantpersonhad |
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| 80 | 80 | | 68concernsaboutperinatalcareduringanypointintheperson'spregnancyor |
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| 81 | 81 | | 69postpartumcare,whetherthereweredisagreementsaboutcareofferedandreceived, |
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| 82 | 82 | | 70andwhetherthepregnantpersonhadaskedforcertaincarethatwasdeniedornot |
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| 83 | 83 | | 71received; |
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| 84 | 84 | | 72 (4)Conductareportorinvestigation,tothedegreepracticable,withallmedical |
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| 85 | 85 | | 73staffinvolvedwithamaternalorinfantdeath;and |
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| 86 | 86 | | 74 (5)Offergriefcounselingtosurvivingfamilymembers. |
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| 87 | 87 | | 75 5.Counties,hospitals,birthingcenters,andstateentitiesshallprovidetolocal |
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| 88 | 88 | | 76publichealthagenciesdeathrecords,medicalrecords,autopsyreports,toxicology |
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| 89 | 89 | | 77reports,hospitaldischargerecords,birthrecords,andanyotherinformationthatwill |
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| 90 | 90 | | 78helpthelocalpublichealthagencyconductthefetalandinfantmortalityreviewwithin |
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| 91 | 91 | | 79thirtydaysofarequestmadeinwritingbyalocalpublichealthagency.Thelocalpublic |
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| 92 | 92 | | 80healthagencyshallnotrequest,andhealthcareprovidersshallnotprovide,reports, |
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| 93 | 93 | | 81testimony,orotherinformationproducedasaresultofactivitiesundertakenbyapeer |
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| 94 | 94 | | 82reviewcommittee,asdefinedinsection537.035,thathastheresponsibilitytoevaluateor |
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| 95 | 95 | | 83improvethequalityofcarerenderedinahospital. |
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| 96 | 96 | | 84 6.(1)Thereisherebycreatedinthestatetreasurythe"FetalandInfant |
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| 97 | 97 | | 85MortalityReviewFund",whichshallconsistofmoneysappropriatedtoitbythegeneral |
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| 98 | 98 | | 86assemblyandanygifts,contributions,grants,orbequestsreceivedfromfederal,private, |
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| 99 | 99 | | 87orothersources.Thestatetreasurershallbecustodianofthefund.Inaccordancewith |
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| 100 | 100 | | 88sections30.170and30.180,thestatetreasurermayapprovedisbursements.Thefund |
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| 101 | 101 | | 89shallbeadedicatedfundand,uponappropriation,moneysinthisfundshallbeused |
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| 102 | 102 | | 90solelyasprovidedinthissection. |
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| 103 | 103 | | HB256 3 91 (2)Notwithstandingtheprovisionsofsection33.080tothecontrary,anymoneys |
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| 104 | 104 | | 92remaininginthefundattheendofthebienniumshallnotreverttothecreditofthe |
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| 105 | 105 | | 93generalrevenuefund. |
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| 106 | 106 | | 94 (3)Thestatetreasurershallinvestmoneysinthefundinthesamemanneras |
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| 107 | 107 | | 95otherfundsareinvested.Anyinterestandmoneysearnedonsuchinvestmentsshallbe |
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| 108 | 108 | | 96creditedtothefund. |
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| 109 | 109 | | 192.990.1.Thereisherebyestablishedwithinthedepartmentofhealthandsenior |
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| 110 | 110 | | 2servicesthe"Pregnancy-AssociatedMortalityReviewBoard"toimprovedatacollectionand |
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| 111 | 111 | | 3reportingwithrespecttomaternaldeaths.Thedepartmentmaycollaboratewithlocalitiesand |
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| 112 | 112 | | 4withotherstatestomeetthegoalsoftheinitiative. |
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| 113 | 113 | | 5 2.Forpurposesofthissection,thefollowingtermsshallmean: |
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| 114 | 114 | | 6 (1)"Department",theMissouridepartmentofhealthandseniorservices; |
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| 115 | 115 | | 7 (2)"Maternaldeath"or"maternalmortality", thedeathofawomanwhilepregnant |
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| 116 | 116 | | 8orduringtheone-yearperiodfollowingthedateoftheendofpregnancy,regardlessofthe |
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| 117 | 117 | | 9causeofdeathandregardlessofwhetheradelivery,miscarriage,ordeathoccursinsideor |
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| 118 | 118 | | 10outsideofahospital; |
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| 119 | 119 | | 11 (3)"Severematernalmorbidity",unexpectedoutcomesofpregnancy,labor,or |
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| 120 | 120 | | 12deliverythatresultinsignificantshort-termorlong-termconsequencestothepregnant |
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| 121 | 121 | | 13person'smentalorphysicalhealth. |
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| 122 | 122 | | 14 3.Theboardshallbecomposedofnomorethaneighteenmembers,withachair |
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| 123 | 123 | | 15electedfromamongitsmembership.Theboardshallmeetatleasttwiceperyearandshall |
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| 124 | 124 | | 16approvethestrategicpriorities,fundingallocations,workprocesses,andproductsofthe |
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| 125 | 125 | | 17board.Membersoftheboardshallbeappointedbythedirectorofthedepartment.Members |
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| 126 | 126 | | 18shallservefour-yearterms,exceptthattheinitialtermsshallbestaggeredsothat |
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| 127 | 127 | | 19approximatelyone-thirdservethree-,four-,andfive-yearterms. |
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| 128 | 128 | | 20 4.Theboardshallhaveamultidisciplinaryanddiversemembershipthatrepresentsa |
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| 129 | 129 | | 21varietyofmedicalandnursingspecialties,including,butnotlimitedto,obstetricsand |
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| 130 | 130 | | 22maternal-fetalcare,aswellasstateorlocalpublichealthofficials,epidemiologists, |
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| 131 | 131 | | 23statisticians,communityorganizations,geographicregions,andotherindividualsor |
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| 132 | 132 | | 24organizationsthataremostaffectedbymaternaldeathsandlackofaccesstomaternal |
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| 133 | 133 | | 25healthcareservices. |
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| 134 | 134 | | 26 5.Thedutiesoftheboardshallinclude,butnotbelimitedto: |
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| 135 | 135 | | 27 (1)Conductingongoingcomprehensive,multidisciplinaryreviewsofallmaternal |
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| 136 | 136 | | 28deaths; |
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| 137 | 137 | | 29 (2)Identifyingfactorsassociatedwithmaternaldeaths; |
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| 138 | 138 | | 30 (3)Reviewingmedicalrecordsandotherrelevantdata,whichshallinclude,tothe |
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| 139 | 139 | | 31extentavailable: |
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| 140 | 140 | | HB256 4 32 (a)Adescriptionofthematernaldeathsdeterminedbymatchingeachdeathrecordof |
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| 141 | 141 | | 33amaternaldeathtoabirthcertificateofaninfantorfetaldeathrecord,asapplicable,andan |
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| 142 | 142 | | 34indicationofwhetherthedelivery,miscarriage,ordeathoccurredinsideoroutsideofa |
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| 143 | 143 | | 35hospital; |
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| 144 | 144 | | 36 (b)Datacollectedfrommedicalexaminerandcoronerreports,asappropriate;and |
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| 145 | 145 | | 37 (c)Usingotherappropriatemethodsorinformationtoidentifymaternaldeaths, |
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| 146 | 146 | | 38includingdeathsfrompregnancyoutcomesnotidentifiedunderparagraph(a)ofthis |
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| 147 | 147 | | 39subdivision; |
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| 148 | 148 | | 40 (4)Consultingwithrelevantexperts,asneeded; |
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| 149 | 149 | | 41 (5)Analyzingcasestoproducerecommendationsforreducingmaternalmortality; |
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| 150 | 150 | | 42 (6)Analyzingcommonindicatorsofseverematernalmorbiditytoidentify |
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| 151 | 151 | | 43preventionopportunitiesandreducenear-missexperiences; |
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| 152 | 152 | | 44 (7)Disseminatingrecommendationstopolicymakers,healthcareprovidersand |
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| 153 | 153 | | 45facilities,andthegeneralpubliconbestpracticestopreventmaternalmortalityand |
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| 154 | 154 | | 46morbidityincluding,butnotlimitedto,addressingsocioeconomicandenvironmental |
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| 155 | 155 | | 47impacts,includingglobalwarming,onpregnancyoutcomes; |
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| 156 | 156 | | 48 [(7)] (8)Recommendingandpromotingpreventativestrategiesandmaking |
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| 157 | 157 | | 49recommendationsforsystemschanges, includingchangesindatacollectionand |
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| 158 | 158 | | 50investigatoryprocesses; |
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| 159 | 159 | | 51 [(8)](9)Protectingtheconfidentialityofthehospitalsandindividualsinvolvedinany |
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| 160 | 160 | | 52maternaldeaths; |
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| 161 | 161 | | 53 [(9)](10)Examiningracialandsocialdisparitiesinmaternaldeathsandmaking |
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| 162 | 162 | | 54recommendationsonthepreventionofracialandsocialdisparities; |
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| 163 | 163 | | 55 [(10)] (11)Trackingandexaminingdisparitiesexperiencedbylesbian,bisexual, |
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| 164 | 164 | | 56transgender,intersex,andgender-nonconformingindividualsandreportingfindings,to |
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| 165 | 165 | | 57theextentpossible; |
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| 166 | 166 | | 58 (12)Subjecttoappropriation,providingforvoluntaryandconfidentialcasereporting |
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| 167 | 167 | | 59ofmaternaldeathstotheappropriatestatehealthagencybyfamilymembersofthedeceased, |
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| 168 | 168 | | 60andotherappropriateindividuals,forpurposesofreviewbytheboard; |
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| 169 | 169 | | 61 [(11)](13)Makingpubliclyavailablethecontactinformationoftheboardforusein |
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| 170 | 170 | | 62suchreporting; |
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| 171 | 171 | | 63 [(12)] (14)Conductingoutreachtolocalprofessionalorganizations,community |
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| 172 | 172 | | 64organizations,andsocialservicesagenciesregardingtheavailabilityofthereviewboard;and |
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| 173 | 173 | | 65 [(13)] (15)Ensuringthatdatacollectedunderthissectionismadeavailable,as |
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| 174 | 174 | | 66appropriateandpracticable,forresearchpurposes,inamannerthatprotectsindividually |
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| 175 | 175 | | 67identifiableorpotentiallyidentifiableinformationandthatisconsistentwithstateandfederal |
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| 176 | 176 | | 68privacylaws. |
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| 177 | 177 | | HB256 5 69 6.(1)Theboard'sreviewofcasesofmaternalmortalityandmorbidityshall |
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| 178 | 178 | | 70include,tothedegreepracticable,forpopulationsexperiencingdisparity,voluntary |
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| 179 | 179 | | 71interviewswiththefollowingindividuals: |
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| 180 | 180 | | 72 (a)Pertinentsurvivingfamilymembersorsupportpeoplepresentwithdirect |
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| 181 | 181 | | 73knowledgeof,orinvolvementin,theevent,includingthepatientincasesofsevere |
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| 182 | 182 | | 74maternalmorbidity.Theboardshalltranscribeorsummarizeinwritinganyoral |
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| 183 | 183 | | 75statementsreceivedinaccordancewiththisparagraph;and |
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| 184 | 184 | | 76 (b)Membersofthemedicalteamwhowerepresentorinvolvedinthedeceased |
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| 185 | 185 | | 77individual'sdirectcare. |
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| 186 | 186 | | 78 (2)Indeterminingthepracticabilityoftheinterviewsundersubdivision(1)of |
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| 187 | 187 | | 79thissubsection,theboardmayprioritizeinterviewswithpopulationsthathavea |
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| 188 | 188 | | 80documentedhigherrateofmaternaldeath. |
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| 189 | 189 | | 81 7.Theboardmaycontractwithotherentitiesconsistentwiththedutiesoftheboard. |
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| 190 | 190 | | 82 [7.]8.(1)BeforeJune30,2020,andannuallythereafter,theboardshallsubmittothe |
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| 191 | 191 | | 83DirectoroftheCentersforDiseaseControlandPrevention,thedirectorofthedepartment,the |
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| 192 | 192 | | 84governor,andthegeneralassemblyareportonmaternalmortalityinthestatebasedondata |
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| 193 | 193 | | 85collectedthroughongoingcomprehensive,multidisciplinaryreviewsofallmaternaldeaths, |
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| 194 | 194 | | 86andanyotherprojectsoreffortsfundedbytheboard.Thedatashallbecollectedusingbest |
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| 195 | 195 | | 87practicestoreliablydetermineandincludeallmaternaldeaths,regardlessoftheoutcomeof |
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| 196 | 196 | | 88thepregnancyandshallincludedata,findings,andrecommendationsofthecommittee,and, |
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| 197 | 197 | | 89asapplicable,informationontheimplementationduringsuchyearofanyrecommendations |
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| 198 | 198 | | 90submittedbytheboardinapreviousyear. |
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| 199 | 199 | | 91 (2)Thereportshallbemadeavailabletothepubliconthedepartment'swebsiteand |
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| 200 | 200 | | 92thedirectorshalldisseminatethereporttoallhealthcareprovidersandfacilitiesthatprovide |
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| 201 | 201 | | 93women'shealthservicesinthestate. |
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| 202 | 202 | | 94 [8.]9.Thedirectorofthedepartment,orhisorherdesignee,shallprovidetheboard |
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| 203 | 203 | | 95withthecopyofthedeathcertificateandanylinkedbirthorfetaldeathcertificateforany |
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| 204 | 204 | | 96maternaldeathoccurringwithinthestate. |
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| 205 | 205 | | 97 [9.]10.Uponrequestbythedepartment,healthcareproviders,healthcarefacilities, |
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| 206 | 206 | | 98clinics,laboratories,medicalexaminers,coroners,lawenforcementagencies,driver'slicense |
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| 207 | 207 | | 99bureaus,otherstateagencies,andfacilitieslicensedbythedepartmentshallprovidetothe |
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| 208 | 208 | | 100departmentdatarelatedtomaternaldeathsfromsourcessuchasmedicalrecords,autopsy |
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| 209 | 209 | | 101reports,medicalexaminer'sreports,coroner'sreports,lawenforcementreports,motorvehicle |
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| 210 | 210 | | 102records,socialservicesrecords,andothersourcesasappropriate.Suchdatarequestsshallbe |
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| 211 | 211 | | 103limitedtomaternaldeathswhichhaveoccurredwithintheprevioustwenty-fourmonths.No |
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| 212 | 212 | | 104entityshallbeheldliableforcivildamagesorbesubjecttoanycriminalordisciplinaryaction |
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| 213 | 213 | | HB256 6 105whencomplyingingoodfaithwitharequestfromthedepartmentforinformationunderthe |
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| 214 | 214 | | 106provisionsofthissubsection. |
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| 215 | 215 | | 107 [10.]11.(1)Theboardshallprotecttheprivacyandconfidentialityofallpatients, |
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| 216 | 216 | | 108decedents,providers,hospitals,oranyotherparticipantsinvolvedinanymaternaldeathsor |
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| 217 | 217 | | 109anycasesofseverematernalmorbidity. Innocaseshallanyindividuallyidentifiable |
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| 218 | 218 | | 110healthinformationbeprovidedtothepublicorsubmittedtoaninformationclearinghouse. |
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| 219 | 219 | | 111 (2)Nothinginthissubsectionshallprohibittheboardordepartmentfrompublishing |
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| 220 | 220 | | 112statisticalcompilationsandresearchreportsthat: |
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| 221 | 221 | | 113 (a)Arebasedonconfidentialinformationrelatingtomortalityreviewsunderthis |
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| 222 | 222 | | 114section;and |
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| 223 | 223 | | 115 (b)Donotcontainidentifyinginformationoranyotherinformationthatcouldbe |
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| 224 | 224 | | 116usedtoultimatelyidentifytheindividualsconcerned. |
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| 225 | 225 | | 117 (3)Information,records,reports,statements,notes,memoranda,orotherdata |
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| 226 | 226 | | 118collectedunderthissectionshallnotbeadmissibleasevidenceinanyactionofanykindin |
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| 227 | 227 | | 119anycourtorbeforeanyothertribunal,board,agency,orperson.Suchinformation,records, |
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| 228 | 228 | | 120reports,notes,memoranda,dataobtainedbythedepartmentoranyotherperson,statements, |
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| 229 | 229 | | 121notes,memoranda,orotherdatashallnotbeexhibitednortheircontentsdisclosedinany |
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| 230 | 230 | | 122way,inwholeorinpart,byanyofficerorrepresentativeofthedepartmentoranyother |
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| 231 | 231 | | 123person.Nopersonparticipatinginsuchreviewshalldisclose,inanymanner,theinformation |
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| 232 | 232 | | 124soobtainedexceptinstrictconformitywithsuchreviewproject.Suchinformationshallnot |
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| 233 | 233 | | 125besubjecttodisclosureunderchapter610. |
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| 234 | 234 | | 126 (4)Allinformation,recordsofinterviews,writtenreports,statements,notes, |
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| 235 | 235 | | 127memoranda,orotherdataobtainedbythedepartment,theboard,andotherpersons,agencies, |
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| 236 | 236 | | 128ororganizationssoauthorizedbythedepartmentunderthissectionshallbeconfidential. |
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| 237 | 237 | | 129 (5)Allproceedingsandactivitiesoftheboard,opinionsofmembersofsuchboard |
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| 238 | 238 | | 130formedasaresultofsuchproceedingsandactivities,andrecordsobtained,created,or |
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| 239 | 239 | | 131maintainedunderthissection,includingrecordsofinterviews,writtenreports,statements, |
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| 240 | 240 | | 132notes,memoranda,orotherdataobtainedbythedepartmentoranyotherperson,agency,or |
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| 241 | 241 | | 133organizationactingjointlyorundercontractwiththedepartmentinconnectionwiththe |
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| 242 | 242 | | 134requirementsofthissection,shallbeconfidentialandshallnotbesubjecttosubpoena, |
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| 243 | 243 | | 135discovery,orintroductionintoevidenceinanycivilorcriminalproceeding;provided, |
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| 244 | 244 | | 136however,thatnothinginthissectionshallbeconstruedtolimitorrestricttherighttodiscover |
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| 245 | 245 | | 137oruseinanycivilorcriminalproceedinganythingthatisavailablefromanothersourceand |
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| 246 | 246 | | 138entirelyindependentoftheboard'sproceedings. |
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| 247 | 247 | | 139 (6)Membersoftheboardshallnotbequestionedinanycivilorcriminalproceeding |
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| 248 | 248 | | 140regardingtheinformationpresentedinoropinionsformedasaresultofameetingor |
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| 249 | 249 | | 141communicationoftheboard;provided,however,thatnothinginthissectionshallbe |
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| 250 | 250 | | HB256 7 142construedtopreventamemberoftheboardfromtestifyingtoinformationobtained |
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| 251 | 251 | | 143independentlyoftheboardorwhichispublicinformation. |
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| 252 | 252 | | 144 [11.]12.Thedepartmentmayusegrantprogramfundstosupporttheeffortsofthe |
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| 253 | 253 | | 145boardandmayapplyforadditionalfederalgovernmentandprivatefoundationgrantsas |
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| 254 | 254 | | 146needed.Thedepartmentmayalsoacceptprivate,foundation,city,county,orfederalmoneys |
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| 255 | 255 | | 147toimplementtheprovisionsofthissection. |
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| 256 | 256 | | 192.1030.1.Forpurposesofthissection,thefollowingtermsmean: |
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| 257 | 257 | | 2 (1)"Certifiednursemidwife",thesamemeaninggiventotheterminsection |
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| 258 | 258 | | 3335.016; |
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| 259 | 259 | | 4 (2)"Department",thedepartmentofhealthandseniorservices; |
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| 260 | 260 | | 5 (3)"Professionalmidwife",anymidwifeallowedtopracticeinthisstatein |
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| 261 | 261 | | 6accordancewiththeprovisionsofsection376.1753; |
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| 262 | 262 | | 7 (4)"Programsthattraincertifiednursemidwives",anurse-midwifery |
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| 263 | 263 | | 8educationprogramthatisrecognizedbythestateboardofnursingasproviding |
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| 264 | 264 | | 9educationnecessarytobecomeacertifiednursemidwife; |
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| 265 | 265 | | 10 (5)"Programsthattrainprofessionalmidwives",amidwiferyeducation |
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| 266 | 266 | | 11programthatprovidestheeducationnecessarytopracticeasamidwifeinthisstatein |
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| 267 | 267 | | 12accordancewiththeprovisionsofsection376.1753. |
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| 268 | 268 | | 13 2.Subjecttoappropriation,thedepartmentshallestablishaprogramto |
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| 269 | 269 | | 14contractwithprogramsthattraincertifiednursemidwivesandprogramsthattrain |
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| 270 | 270 | | 15professionalmidwivesinaccordancewiththeglobalstandardsformidwiferyeducation |
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| 271 | 271 | | 16andtheinternationaldefinitionoftheterm"midwife"asestablishedbythe |
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| 272 | 272 | | 17InternationalConfederationofMidwivesinordertoincreasethenumberofstudents |
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| 273 | 273 | | 18receivingqualityeducationandtrainingasacertifiednursemidwifeorasaprofessional |
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| 274 | 274 | | 19midwife. |
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| 275 | 275 | | 20 3.Thedepartmentshallcontractonlywithprogramsthattraincertifiednurse |
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| 276 | 276 | | 21midwivesandprogramsthattrainprofessionalmidwivesthat,atminimum,include,or |
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| 277 | 277 | | 22thatintendtocreate,acomponentoftrainingdesignedformedicallyunderserved |
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| 278 | 278 | | 23multiculturalcommunities,lowersocioeconomicneighborhoods,orruralcommunities, |
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| 279 | 279 | | 24andthatareorganizedtoprepareprogramgraduatesforserviceinthose |
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| 280 | 280 | | 25neighborhoodsandcommunities,orthatseektorecruitandretainraciallyand |
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| 281 | 281 | | 26ethnicallydiversestudents,underrepresentedgroups,orpeoplefromunderservedor |
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| 282 | 282 | | 27historicallymarginalizedcommunities. |
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| 283 | 283 | | 28 4.(1)Thedepartmentmayadoptstandardsandregulationsnecessarytocarry |
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| 284 | 284 | | 29outtheprovisionsofthissection.Inadoptingeligibilitystandardsforprogramsthat |
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| 285 | 285 | | 30traincertifiednursemidwivesandprogramsthattrainprofessionalmidwivesin |
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| 286 | 286 | | 31accordancewiththestandardssetforthinsubsections2and3ofthissection,the |
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| 287 | 287 | | HB256 8 32departmentmayacceptthoseeducationalstandardsandcompetenciesestablishedby |
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| 288 | 288 | | 33thestateboardofnursingorbytheprovisionsofsection376.1753.Thedepartment |
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| 289 | 289 | | 34shalltakecarenottoimplementeducationorcompetencystandardsbeyondwhatis |
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| 290 | 290 | | 35requiredbythestateboardofnursingortheprovisionsofsection376.1753thatcould |
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| 291 | 291 | | 36inadvertentlycreateanunnecessarybarrierfortrainingprogramstoobtainfundingfor |
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| 292 | 292 | | 37thetrainingofmidwivesinthisstate. |
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| 293 | 293 | | 38 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis |
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| 294 | 294 | | 39createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifit |
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| 295 | 295 | | 40complieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable, |
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| 296 | 296 | | 41section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers |
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| 297 | 297 | | 42vestedwiththegeneralassemblypursuanttochapter536toreview,todelaythe |
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| 298 | 298 | | 43effectivedate,ortodisapproveandannularulearesubsequentlyheldunconstitutional, |
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| 299 | 299 | | 44thenthegrantofrulemakingauthorityandanyruleproposedoradoptedafterAugust |
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| 300 | 300 | | 4528,2025,shallbeinvalidandvoid. |
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| 301 | 301 | | 46 5.Thedepartmentshalldevelopalternativestrategiestoprovidelong-term |
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| 302 | 302 | | 47stabilityfor,orexpansionof,thetrainingprovidedforunderthissection,suchas |
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| 303 | 303 | | 48throughfundingprovidedbyprivatefoundationsandadministeredbythedepartment |
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| 304 | 304 | | 49forthepurposesofcarryingoutthissection. |
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| 305 | 305 | | 50 6.Nothinginthissectionpreventsthedepartmentfromdevelopingaprotocolto |
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| 306 | 306 | | 51contractwithpotentialprogramsthattraincertifiednursemidwivesorpotential |
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| 307 | 307 | | 52programsthattrainprofessionalmidwivesinordertosupporttheinitialstartupofnew |
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| 308 | 308 | | 53trainingprogramsaslongastheeligibilityrequirementsofthissectionaremetorcanbe |
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| 309 | 309 | | 54metthroughanawardoffunds. |
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| 310 | 310 | | 55 7.Thedepartmentmaypaycontractedprogramsthattraincertifiednurse |
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| 311 | 311 | | 56midwivesandprogramsthattrainprofessionalmidwivesinanamountcalculatedbased |
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| 312 | 312 | | 57onasingleper-studentcapitationformula,orthroughanothermethod,inordertocover |
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| 313 | 313 | | 58thecostsofinnovativespecialprojectsorprograms. |
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| 314 | 314 | | 59 8.Fundsappropriatedtothedepartmentforpurposesofthissectionand |
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| 315 | 315 | | 60awardedbythedepartmenttoeligibleprogramsthattraincertifiednursemidwivesor |
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| 316 | 316 | | 61programsthattrainprofessionalmidwivesmaybeusedbythetrainingprogramto |
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| 317 | 317 | | 62developnewinitiatives,projects,orcurricula,ortoexpandexistinginitiatives,projects, |
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| 318 | 318 | | 63orcurricula.Awardedfundsmayalsobeusedforgeneralsupportandsustainabilityof |
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| 319 | 319 | | 64theoveralltrainingprogram,ortosustainspecificcomponentsofthetrainingprogram |
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| 320 | 320 | | 65including,butnotlimitedto,tuitionassistanceforstudents,supportforpreceptor |
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| 321 | 321 | | 66recruitment,orsupporttosustainpreceptortrainingsitesforstudents. |
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| 322 | 322 | | 67 9.(1)Thereisherebycreatedinthestatetreasurythe"MidwiferyEducation |
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| 323 | 323 | | 68Fund",whichshallconsistofmoneysappropriatedtoitbythegeneralassemblyand |
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| 324 | 324 | | HB256 9 69anygifts,contributions,grants,orbequestsreceivedfromfederal,private,orother |
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| 325 | 325 | | 70sources.Thestatetreasurershallbecustodianofthefund.Inaccordancewithsections |
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| 326 | 326 | | 7130.170and30.180,thestatetreasurermayapprovedisbursements.Thefundshallbea |
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| 327 | 327 | | 72dedicatedfundand,uponappropriation,moneysinthisfundshallbeusedsolelyas |
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| 328 | 328 | | 73providedinthissection. |
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| 329 | 329 | | 74 (2)Notwithstandingtheprovisionsofsection33.080tothecontrary,anymoneys |
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| 330 | 330 | | 75remaininginthefundattheendofthebienniumshallnotreverttothecreditofthe |
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| 331 | 331 | | 76generalrevenuefund. |
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| 332 | 332 | | 77 (3)Thestatetreasurershallinvestmoneysinthefundinthesamemanneras |
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| 333 | 333 | | 78otherfundsareinvested.Anyinterestandmoneysearnedonsuchinvestmentsshallbe |
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| 334 | 334 | | 79creditedtothefund. |
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| 335 | 335 | | âś” |
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| 336 | 336 | | HB256 10 |
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