HOUSE 3rd Reading Unamended February 25, 2015 HOUSE Amended 2nd Reading February 24, 2015First Regular Session Seventieth General Assembly STATE OF COLORADO REENGROSSED This Version Includes All Amendments Adopted in the House of Introduction LLS NO. 15-0143.01 Kristen Forrestal x4217HOUSE BILL 15-1111 HOUSE SPONSORSHIP McCann, Ginal, Primavera, Tate SENATE SPONSORSHIP Crowder, Newell House Committees Senate Committees Public Health Care & Human Services Appropriations A BILL FOR AN ACT Concerning the creation of a maternal mortality committee in the department of public health and environment. Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.) The bill creates the Colorado maternal mortality review committee (committee) for the purpose of reviewing maternal mortality cases that occur in Colorado, identifying the causes of maternal mortality, and developing recommendations to prevent further maternal mortalities. The chief medical officer in the department of public health and environment (department) is directed to appoint up to 25 members to serve on the committee. The committee is required to review maternal mortalities, outline trends and patterns, develop and disseminate recommendations for the prevention of maternal mortalities, compile reports on maternal mortalities for distribution, and serve as a link to other maternal mortality review teams. The bill requires certain health care providers and law enforcement officials to provide health information and medical records to the department concerning each maternal mortality for access by the members of the committee. The medical records and information and activities of the committee are confidential. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, add article 47 to title 25 as follows: ARTICLE 47 Maternal Mortality Prevention Act 25-47-101. Short title. This article shall be known and may be cited as the "Maternal Mortality Prevention Act". 25-47-102. Legislative declaration. (1) The general assembly finds and declares that: (a) Colorado currently ranks twenty-ninth out of fifty, or worse than sixty percent of the states in the United States, in terms of its maternal mortality rate; (b) Maternal mortalities are a serious public health concern and have a tremendous family and societal impact; (c) Maternal mortalities are significantly underestimated and inadequately documented, which impedes efforts to identify and reduce or eliminate the causes of death; (d) The federal centers for disease control and prevention has determined that maternal mortalities should be reviewed through state-based maternal mortality reviews in order to institute the systemic changes needed to decrease maternal mortality; (e) There is a need to establish a program to review maternal mortalities and to develop strategies for the prevention of maternal mortalities in Colorado; (f) The prevention of maternal mortalities is a community responsibility, and professionals from a variety of disciplines have expertise that can promote the safety and well-being of pregnant and postpartum women; (g) The multi-disciplinary reviews of the deaths that occur among pregnant and postpartum women can lead to a greater understanding of the causes of and methods for preventing maternal mortality; and (h) The protection of the health and welfare of the mothers in this state is an important goal of the citizens of this state, and rate of death among pregnant and postpartum women is a serious public health concern that requires legislative action. (2) Therefore, it is the intent of the general assembly to create a maternal mortality review committee within the department of public health and environment to review maternal mortalities and to develop strategies for the prevention of maternal mortalities. 25-47-103. Definitions. As used in this article: (1) "Committee" means the Colorado maternal mortality review committee created in section 25-47-104. (2) "Department" means the department of public health and environment. (3) "Maternal mortality" means a woman who was pregnant at the time of her death or within one year postpartum. (4) (a) "Medical record" means the written or graphic documentation, sound recording, or computer record pertaining to medical, mental health, and health care services, including medical marijuana services, performed at the direction of a physician or other licensed health care provider on behalf of a patient by a physician, dentist, nurse, direct-entry midwife, service provider, emergency medical service provider, mental health professional, prehospital provider, or other health care personnel. (b) "Medical record" includes diagnostic documentation such as X rays, electrocardiograms, electroencephalograms, and other test results and data entered into the prescription drug use monitoring program under section 12-42.5-403, C.R.S. (c) "Medical record" includes autopsy reports. 25-47-104. Colorado maternal mortality review committee - creation - members - duties. (1) The Colorado maternal mortality review committee is hereby created in the department for the purpose of: (a) Reviewing specific cases of maternal mortality that occur in Colorado; (b) Identifying the causes of maternal mortality; and (c) Developing recommendations to prevent further maternal mortalities, including recommending legislation, policies, and rules that will support the health and safety of pregnant and postpartum women in Colorado and prevent future maternal mortalities. (2) The chief medical officer from the department shall appoint no more than twenty-five members to serve on the committee to serve for three-year terms. The chief medical officer may fill any vacancies on the committee. In making the appointments, the chief medical officer shall make an effort to include members from geographic areas throughout the state and to appoint members with knowledge of maternal mortality. The members of the committee who reside more than fifty miles from the location of the committee hearing shall receive the same per diem compensation and reimbursement of expenses as those provided for members of boards and commissions pursuant to section 24-34-102 (13), C.R.S., and for expenses incurred in traveling to and from the meetings of the committee. The committee may form special ad hoc panels to further investigate cases of maternal mortality resulting from specific causes when the need arises. (3) The committee shall: (a) Review each death in Colorado that is a maternal mortality; (b) Review medical records and other relevant data related to each maternal mortality; (c) Take steps to improve the quality and scope of data obtained through investigations and review of maternal mortalities; (d) Outline trends and patterns concerning maternal mortalities in Colorado; (e) Develop and disseminate recommendations for the prevention of maternal mortalities to policy makers, health care providers, health care facilities, and the general public; (f) Compile reports of aggregated, non-individually identifiable data on a routine basis for distribution in an effort to further study the causes and problems associated with maternal mortalities that may be distributed to the general assembly, health care providers and facilities, key government agencies, and others necessary to reduce the maternal mortality rate; (g) Serve as a link with maternal mortality review teams throughout the country and participate in national maternal mortality review team activities; and (h) Perform any other functions as resources allow to enhance the capability of the state of Colorado to reduce and prevent maternal mortalities. 25-47-105. Access to health records related to maternal mortalities. (1) Except as otherwise provided by law, the committee may access health information and medical records related to maternal mortalities at any time after three years from the date the maternal mortality occurred. A health care provider licensed or registered or a pharmacist licensed pursuant to title 12, C.R.S., and a hospital or health facility licensed pursuant to article 3 of this title shall provide health information and medical records to the department concerning each maternal mortality for access by the members of the committee. A law enforcement officer shall provide a police report that involves a maternal mortality to the committee upon request of the department. A health care provider, pharmacist, hospital, health facility, law enforcement officer, or coroner is not civilly or criminally liable for the release of health information or medical records when making a good-faith effort to comply with this subsection (1). (2) (a) The discussions in committee meetings or meetings of an ad hoc panel formed pursuant to section 25-47-104 (2), concerning details of a maternal mortality that would identify an individual involved are confidential and are not subject to section 24-6-402, C.R.S., unless the identity of an individual is not discussed. (b) The committee meeting notes and statements, health information, medical records, reports, and memoranda obtained by the committee that contain information that would identify an individual involved in a maternal mortality are confidential and shall not be subject to the "Colorado Open Records Act", part 2 of article 72 of title 24, C.R.S. (c) Information, records, reports, communications, notes, and memoranda that are confidential pursuant to paragraphs (a) and (b) of this subsection (2) are not subject to subpoena, discovery, or introduction into evidence in any civil or criminal proceeding, unless the subpoena is directed to a source that is separate and apart from the committee. Nothing in this section is construed to limit or restrict the right to discover or use in a civil or criminal proceeding information, records, reports, communications, notes, or memoranda that are available from another source separate and apart from the committee and that arise entirely independently of the committee's activities. (d) Each committee member shall sign a confidentiality agreement that indicates his or her adherence to paragraph (a) of this subsection (2). A person who knowingly violates the confidentiality agreement commits a class 3 misdemeanor and shall be punished in accordance with section 18-1.3-501, C.R.S. (e) Information, records, reports, notes, or memoranda that are confidential pursuant to paragraphs (a) and (b) of this subsection (2) are not admissible as evidence in any action in any court or before any tribunal, board, agency, or person and shall not be exhibited or disclosed in any way by any person unless the information was obtained from another source that is separate and apart from the committee, except as may be necessary for furthering the duties of the committee or in response to an alleged violation of a confidentiality agreement pursuant to paragraph (b) of this subsection (2). SECTION 2. Act subject to petition - effective date. This act takes effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly (August 5, 2015, if adjournment sine die is on May 6, 2015); except that, if a referendum petition is filed pursuant to section 1 (3) of article V of the state constitution against this act or an item, section, or part of this act within such period, then the act, item, section, or part will not take effect unless approved by the people at the general election to be held in November 2016 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.