N.Y. Public Health Law § 2509: Maternal mortality review board

§ 2509. Maternal mortality review board. 1. (a) There is hereby

established in the department the maternal mortality review board for

the purpose of reviewing maternal deaths and maternal morbidity and

developing and disseminating findings, recommendations, and best

practices to contribute to the prevention of maternal mortality and

morbidity. The board shall assess the cause of death, factors leading to

death and preventability for each maternal death reviewed and, in the

discretion of the board, cases of severe maternal morbidity, and shall

develop and disseminate strategies for reducing the risk of maternal

mortality and morbidity, including risk resulting from racial, economic,

or other disparities. The commissioner may delegate the authority to

conduct maternal mortality reviews.

(b) The commissioner may enter into an agreement with the city of New

York providing:

(i) that the functions of the state board relating to maternal deaths

and severe maternal morbidity occurring within the city of New York

shall be conducted by the city board;

(ii) the city board shall provide to the state board the results of

its reviews, relevant information in the possession of the city board,

and the recommendations of the city board; and

(iii) the department and the state board shall provide information and

assistance to the city board for the performance of its functions.

(c) Nothing in this section shall prevent the city of New York from

establishing, without an agreement with the commissioner, a board

relating to maternal deaths and severe maternal morbidity occurring

within the city of New York.

2. As used in this section, unless the context requires otherwise:

(a) "Advisory council" and "council" mean the advisory council on

maternal mortality and morbidity, established under this section.

(b) "Board" means a maternal mortality review board established by

this section, referred to in this section as the "state board", or a

board operating under this section established by the city of New York,

with or without an agreement with the commissioner, referred to in this

section as the "city board".

(c) "Maternal death" means the death of a woman during pregnancy or

within a year from the end of pregnancy.

(d) "Severe maternal morbidity" or "morbidity" means unexpected

outcomes of pregnancy, labor, or delivery that result in significant

short- or long-term consequences to a woman's health.

(e) "City commissioner" means the commissioner of the New York city

department of health and mental hygiene.

3. (a) The members of the state board shall be comprised of

multidisciplinary experts in the field of maternal mortality, women's

health and public health, and shall include health care professionals or

other experts who serve and are representative of the racial, ethnic,

and socioeconomic diversity of the women and mothers of the state and,

to the extent possible, the medically underserved areas of the state or

areas of the state with disproportionately high occurrences of maternal

mortality or morbidity.

(b) The state board shall be composed of at least fifteen members, all

of whom shall be appointed by the commissioner.

(c) The terms of the state board members shall be three years. The

commissioner may choose to reappoint state board members to additional

three year terms.

(d) A majority of the appointed membership of the state board, no less

than three, shall constitute a quorum.

(e) When any member of the state board fails to attend three

consecutive regular meetings, unless such absence is for good cause,

that membership may be deemed vacant for purposes of the appointment of

a successor.

(f) Meetings of the state board shall be held at least twice a year

but may be held more frequently as deemed necessary, subject to request

of the department.

(g) Members of the state and city boards shall be indemnified under

section seventeen of the public officers law or section fifty-k of the

general municipal law, as the case may be.

(h) Members of the state board shall not be compensated for their

participation on the board but shall receive reimbursement for their

ordinary and necessary expenses of participation.

(i) Membership on a board shall not disqualify any person from holding

any public office or employment.

4. (a) The commissioner may request and shall receive upon request

from any department, division, board, bureau, commission, local health

departments or other agency of the state or political subdivision

thereof or any public authority, such information, including but not

limited to death records, medical records, autopsy reports, toxicology

reports, hospital discharge records, birth records and any other

information that will help the department under this section to properly

carry out its functions, powers and duties. The commissioner, or the

city commissioner for the maternal deaths or maternal morbidity

occurring within the vital statistics registration district of the city

of New York may request and shall receive upon request from any

department, division, board, commission or other agency under the

authority of the city of New York as well as hospitals established

pursuant to article twenty-eight of this chapter, birthing facilities,

medical examiners, coroners and coroner physicians and any other

facility providing services associated with maternal mortality or

maternal morbidity, such information, including, but not limited to,

death records, medical records, autopsy reports, toxicology reports,

hospital discharge records, birth records and any other information that

will help the department under this section to properly carry out its

functions, powers and duties.

(b) The commissioner and the city commissioner shall receive and may

solicit voluntary information, including oral or written statements,

relating to any maternal death and case of severe maternal morbidity,

from any family member or other interested party (including the patient

in a case of severe maternal morbidity) relating to any case that may

come before the board. Oral statements received under this paragraph

shall be transcribed or summarized in writing. The commissioner and the

city commissioner shall transmit that information to the board

considering the case.

(c) Before transmitting any information to the board, the commissioner

or the city commissioner shall remove all personal identifying

information of the woman, health care practitioner or practitioners or

anyone else individually named in such information, as well as the

hospital or facility that treated the woman, and any other information

such as geographic location that may inadvertently identify the woman,

practitioner or facility. This paragraph shall not preclude the

transmitting of information to the board that is reasonably necessary to

enable the board to perform an appropriate review under this section.

5. Each board:

(a) shall make and report findings and recommendations to the

commissioner, and in the case of the city board to the commissioner and

the city commissioner regarding the cause of death, factors leading to

death, and preventability of each maternal death case, and each case of

severe maternal morbidity reviewed by the board, by reviewing relevant

information for each case in the state or the city of New York, as the

case may be, and consulting with experts as needed to evaluate the

information for each death; and shall provide such findings and

recommendations, including best practices and strategies for reducing

the risk of maternal mortality and morbidity, to the advisory council;

provided that material provided to the advisory council shall not

include any information that would be confidential under this section;

(b) shall develop recommendations to the commissioner, and in the case

of the city board to the commissioner and the city commissioner for

areas of focus, including issues of severe maternal morbidity and issues

of racial, economic or other disparities in maternal outcomes;

(c) may, in addition to the findings and recommendations made under

this subdivision, and consistent with all applicable confidentiality

protections, bring any particular matter to the attention of the

commissioner or the city commissioner, and in the case of the city board

to the commissioner and the city commissioner;

(d) shall issue a report on its findings and recommendations every two

years, and may also issue reports more frequently. The reports shall be

public documents; and

(e) may request and shall receive the assistance of the commissioner

in the instance of the state board and the city commissioner in the

instance of the city board in carrying out its functions.

6. The commissioner and the city commissioner and the state and city

boards shall each keep confidential any information collected or

received under this section that includes personal identifying

information of the woman, health care practitioner or practitioners or

anyone else individually named in such information, as well as the

hospital or facility that treated the woman, and any other information

such as geographic location that may inadvertently identify the woman,

practitioner or facility, and shall use the information provided or

received under this section solely for the purposes of improvement of

the quality of health care of women and to prevent maternal mortality

and morbidity. This subdivision shall not preclude the transmitting of

information to the board that is reasonably necessary to enable the

board to perform an appropriate review under this section. All records

received, meetings conducted, reports, except those reports required to

be issued by the board by this section, and records made and maintained

and all books and papers obtained by the board shall be confidential and

shall not be made open or available, including under article six of the

public officers law, and shall be limited to board members as well as

those authorized by the commissioner or city commissioner. Such

information shall not be discoverable or admissible as evidence in any

action in any court or before any other tribunal, board, agency or

person.

7. The commissioner and the city commissioner, within their respective

legal authority, may use the recommendations and findings of the boards

to develop guidance and other actions relating to best practices, and

shall disseminate information relating to that guidance and other

actions to appropriate health care providers.

8. (a) There is hereby established in the department an advisory

council on maternal mortality and morbidity.

(b) The advisory council:

(i) may review the findings of the boards;

(ii) may develop recommendations on policies, best practices, and

strategies to prevent maternal mortality and morbidity;

(iii) may hold public hearings on those matters;

(iv) may make findings and issue reports, including an annual report,

on such matters; and

(v) may request and shall receive the assistance of the commissioner,

the city commissioner, and the boards in carrying out its functions.

(c) The advisory council shall consist of at least twenty members to

be determined by the commissioner. The commissioner shall appoint the

members of the council, at least ten of whom shall be on the

recommendation of the city commissioner. The commissioner shall appoint

the chair of the council.

(d) The members of the council shall be comprised of multidisciplinary

experts and lay persons knowledgeable in the field of maternal

mortality, women's health and public health and shall include members

who serve and are representative of the racial, ethnic, and

socioeconomic diversity of the women and mothers of the state, and to

the extent possible, the medically underserved areas of the state or

areas of the state with disproportionately high occurrences of maternal

mortality or morbidity.

(e) The terms of the council members shall be three years. The

commissioner may choose to reappoint council members to additional

three-year terms. Vacancies on the council shall be filled by

appointment by the commissioner, consistent with paragraph (c) of this

subdivision. A majority of the appointed membership of the council shall

constitute a quorum. When any member of the council fails to attend

three consecutive regular meetings, unless such absence is for good

cause, that membership may be deemed vacant for purposes of the

appointment of a successor.

(f) Meetings of the council shall be held at least twice a year.

(g) Members of the council shall be indemnified under section

seventeen of the public officers law. Members of the council shall not

be compensated for their participation on the council but shall receive

reimbursement for their ordinary and necessary expenses of

participation. Membership on the council shall not disqualify any person

from holding any public office or employment.