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| 9 | 9 | | S TATE OF RHODE IS LAND |
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| 10 | 10 | | IN GENERAL ASSEMBLY |
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| 11 | 11 | | JANUARY SESSION, A.D. 2023 |
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| 12 | 12 | | ____________ |
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| 13 | 13 | | |
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| 14 | 14 | | A N A C T |
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| 15 | 15 | | RELATING TO HEALTH AND SAFETY -- OFFICE OF STATE MEDICAL EXAMINERS |
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| 16 | 16 | | Introduced By: Senator Joshua Miller |
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| 17 | 17 | | Date Introduced: March 22, 2023 |
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| 18 | 18 | | Referred To: Senate Health & Human Services |
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| 19 | 19 | | (Dept. of Health) |
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| 20 | 20 | | |
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| 21 | 21 | | It is enacted by the General Assembly as follows: |
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| 22 | 22 | | SECTION 1. Section 23-4-3 of the General Laws in Chapter 23-4 entitled "Office of State 1 |
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| 23 | 23 | | Medical Examiners" is hereby amended to read as follows: 2 |
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| 24 | 24 | | 23-4-3. Functions. 3 |
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| 25 | 25 | | The office of state medical examiners shall be responsible for: 4 |
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| 26 | 26 | | (1) The investigation of deaths within the state that, in its judgment, might reasonably be 5 |
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| 27 | 27 | | expected to involve causes of death enumerated in this chapter; 6 |
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| 28 | 28 | | (2) For the conduct of inquests when requested by the attorney general; 7 |
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| 29 | 29 | | (3) For the performance of autopsies, including the retention, examination, and appropriate 8 |
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| 30 | 30 | | disposal of tissue, when appropriate, for deaths that, in its judgment, might reasonably be expected 9 |
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| 31 | 31 | | to involve causes of deaths enumerated in this chapter; 10 |
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| 32 | 32 | | (4) For the written determination of the causes of death investigated pursuant to this 11 |
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| 33 | 33 | | chapter; 12 |
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| 34 | 34 | | (5) For the presentation to the courts of Rhode Island of expert testimony relating to the 13 |
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| 35 | 35 | | cause of death; 14 |
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| 36 | 36 | | (6) For the keeping of complete records, including names, places, circumstances, and 15 |
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| 37 | 37 | | causes of deaths, of deaths investigated and reported, copies of which shall be delivered to the 16 |
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| 38 | 38 | | attorney general and of which written determinations of causes of death shall be made available for 17 |
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| 39 | 39 | | public inspection; 18 |
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| 40 | 40 | | (7) For the burial of bodies for which there is no other existing legal responsibility to do 19 |
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| 41 | 41 | | |
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| 42 | 42 | | |
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| 44 | 44 | | so; 1 |
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| 45 | 45 | | (8) For the development and enforcement of procedures for the pronouncement of death 2 |
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| 46 | 46 | | and for the transplantation of organs from bodies of persons who have died within the state; 3 |
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| 47 | 47 | | (9)(i) For a multidisciplinary team review of child fatalities with the goal to decrease the 4 |
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| 48 | 48 | | prevalence of preventable child deaths and report recommendations for community- and systems-5 |
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| 49 | 49 | | intervention strategies. A child death-review team shall include, but is not limited to, representation 6 |
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| 50 | 50 | | from state agencies, health care, child welfare, and law enforcement; and 7 |
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| 51 | 51 | | (ii) The work product of the child death-review team shall be confidential and protected 8 |
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| 52 | 52 | | under all applicable laws, including the federal Health Insurance Portability and Accountability Act 9 |
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| 53 | 53 | | of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of title 5) 10 |
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| 54 | 54 | | and shall be exempt from the provisions of chapter 2 of title 38 and shall be deemed privileged 11 |
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| 55 | 55 | | pursuant to § 23-17.21-8; 12 |
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| 56 | 56 | | (10) The department of health shall work with the department of children, youth and 13 |
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| 57 | 57 | | families and the office of the child advocate to develop a process to ensure the timely availability 14 |
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| 58 | 58 | | of autopsy reports on child deaths; 15 |
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| 59 | 59 | | (11)(i) For a multidisciplinary team review of drug-related overdose deaths with the goal 16 |
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| 60 | 60 | | of reducing the prevalence of these deaths by examining emerging trends in overdose, identifying 17 |
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| 61 | 61 | | potential demographic, geographic, and structural points for prevention, and other factors. The 18 |
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| 62 | 62 | | multidisciplinary team for review of drug-related overdose deaths may include, as determined by 19 |
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| 63 | 63 | | the director of the department of health, representatives from the department of health; the 20 |
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| 64 | 64 | | department of the attorney general; the Rhode Island state police; the department of corrections; 21 |
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| 65 | 65 | | the department of behavioral healthcare, developmental disabilities and hospitals; the Rhode Island 22 |
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| 66 | 66 | | Police Chiefs Association; the Hospital Association of Rhode Island; an emergency department 23 |
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| 67 | 67 | | physician; a primary care physician; an addiction medicine/treatment provider; a mental health 24 |
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| 68 | 68 | | clinician; a toxicologist; a recovery coach or other representative of the recovery community; and 25 |
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| 69 | 69 | | others as may be determined by the director of the department of health; 26 |
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| 70 | 70 | | (ii) The work product of the multidisciplinary team for review of drug-related overdose 27 |
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| 71 | 71 | | deaths shall be confidential and protected under all applicable laws, including the federal Health 28 |
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| 72 | 72 | | Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of health 29 |
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| 73 | 73 | | care information act (chapter 37.3 of title 5), and shall be exempt from the provisions of chapter 2 30 |
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| 74 | 74 | | of title 38, not subject to subpoena, discovery, or introduction into evidence in any civil or criminal 31 |
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| 75 | 75 | | proceeding, and not subject to disclosure beyond the team members (except to authorized 32 |
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| 76 | 76 | | employees of the department of health as necessary to perform its official duties pursuant to this 33 |
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| 77 | 77 | | subsection (11)); 34 |
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| 78 | 78 | | |
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| 79 | 79 | | |
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| 81 | 81 | | (iii) The multidisciplinary team shall report on or before December 1 of each year to the 1 |
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| 82 | 82 | | governor, the speaker of the house, and president of the senate, which report shall summarize the 2 |
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| 83 | 83 | | activities of the team, as well as the team’s findings, progress towards reaching its goals, and 3 |
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| 84 | 84 | | recommendations for any needed changes in legislation or otherwise; and 4 |
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| 85 | 85 | | (iv) [Deleted by P.L. 2021, ch. 21, § 1 and P.L. 2021, ch. 22, § 1.] 5 |
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| 86 | 86 | | (v) The multidisciplinary team, or Rhode Island department of health state employees 6 |
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| 87 | 87 | | appointed by the director of the department of health shall, as relatives of the deceased are willing, 7 |
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| 88 | 88 | | be empowered to gather information from such consenting relatives regarding the circumstances of 8 |
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| 89 | 89 | | the decedent's death. The information gathered shall remain confidential and publicly released as 9 |
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| 90 | 90 | | aggregate de-identified information. The information gathered will be utilized to help identify 10 |
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| 91 | | - | specific prevention and intervention strategies to prevent further deaths. The information gathered 11 |
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| 92 | | - | shall not be subject to subpoena, discovery, or introduction into evidence in any civil or criminal 12 |
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| 93 | | - | proceeding, and shall not be subject to disclosure beyond the team members except to authorized 13 |
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| 94 | | - | employees of the department of health as necessary to perform its official duties pursuant to 14 |
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| 95 | | - | subsection (11) of this section, and except as aggregate de-identified information. 15 |
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| 96 | | - | (12)(i) For a multidisciplinary maternal mortality review committee for review of maternal 16 |
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| 97 | | - | deaths of women that occur during pregnancy, delivery, or within one year of the end of pregnancy 17 |
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| 98 | | - | with the goal of reducing the prevalence of such deaths by examining emerging trends in such 18 |
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| 99 | | - | deaths, identifying potential demographic, geographic, and structural points for prevention, and 19 |
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| 100 | | - | other factors. This committee has the authority to request and receive data from vital records, 20 |
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| 101 | | - | healthcare providers, healthcare facilities, pharmacy records, and any other agencies or officials 21 |
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| 102 | | - | having information that is necessary for the committee to carry out its duties under this section. 22 |
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| 103 | | - | The multidisciplinary maternal mortality review committee shall include, but not be limited to, as 23 |
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| 104 | | - | determined by the director of the department of health, representation from state agencies; an 24 |
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| 105 | | - | obstetric provider from each hospital that delivers obstetrical care; a neonatal specialist; individua ls 25 |
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| 106 | | - | or organizations that represent the populations that are most affected by pregnancy-related deaths 26 |
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| 107 | | - | or pregnancy-associated deaths and lack of access to maternal healthcare services; a perinatal 27 |
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| 108 | | - | pathologist; and a maternal fetal medicine specialist. This committee shall develop 28 |
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| 109 | | - | recommendations for the prevention of maternal deaths and disseminate findings and 29 |
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| 110 | | - | recommendations to policy makers, healthcare providers, healthcare facilities, and the general 30 |
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| 111 | | - | public. 31 |
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| 112 | | - | (ii) The work product of the maternal mortality review committee shall be confidential and 32 |
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| 113 | | - | protected under all applicable laws, including the federal Health Insurance Portability and 33 |
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| 114 | | - | Accountability Act of 1996 and the Rhode Island confidentiality of health care information act 34 |
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| 91 | + | specific prevention and intervention strategies to prevent further deaths. 11 |
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| 92 | + | (12)(i) For a multidisciplinary maternal mortality review committee for review of maternal 12 |
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| 93 | + | deaths of women that occur during pregnancy, delivery, or within one year of the end of pregnancy 13 |
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| 94 | + | with the goal of reducing the prevalence of such deaths by examining emerging trends in such 14 |
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| 95 | + | deaths, identifying potential demographic, geographic, and structural points for prevention, and 15 |
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| 96 | + | other factors. This committee has the authority to request and receive data from vital records, 16 |
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| 97 | + | healthcare providers, healthcare facilities, pharmacy records, and any other agencies or officials 17 |
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| 98 | + | having information that is necessary for the committee to carry out its duties under this section. 18 |
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| 99 | + | The multidisciplinary maternal mortality review committee shall include, but not be limited to, as 19 |
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| 100 | + | determined by the director of the department of health, representation from state agencies; an 20 |
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| 101 | + | obstetric provider from each hospital that delivers obstetrical care; a neonatal specialist; individua ls 21 |
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| 102 | + | or organizations that represent the populations that are most affected by pregnancy-related deaths 22 |
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| 103 | + | or pregnancy-associated deaths and lack of access to maternal healthcare services; a perinatal 23 |
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| 104 | + | pathologist; and a maternal fetal medicine specialist. This committee shall develop 24 |
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| 105 | + | recommendations for the prevention of maternal deaths and disseminate findings and 25 |
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| 106 | + | recommendations to policy makers, healthcare providers, healthcare facilities, and the general 26 |
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| 107 | + | public. 27 |
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| 108 | + | (ii) The work product of the maternal mortality review committee shall be confidential and 28 |
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| 109 | + | protected under all applicable laws, including the federal Health Insurance Portability and 29 |
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| 110 | + | Accountability Act of 1996 and the Rhode Island confidentiality of health care information act 30 |
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| 111 | + | (chapter 37.3 of title 5) and shall be exempt from the provisions of chapter 2 of title 38 and shall 31 |
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| 112 | + | be deemed privileged pursuant to § 23-17.21-8. 32 |
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