HOUSE OF REPRESENTATIVES

H.B. NO.

909

TWENTY-SEVENTH LEGISLATURE, 2013

H.D. 2

STATE OF HAWAII

S.D. 1

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO INFANT MORTALITY PROGRAM.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


PART I

     SECTION  1.  Chapter 321, Hawaii Revised Statutes, is amended by adding three new sections to part XXV to be appropriately designated and to read as follows:

     "§321-A  Comprehensive infant mortality reduction program; established.  (a)  The department of health shall establish, administer, and maintain a statewide, comprehensive infant mortality reduction program.  The department shall convene for planning purposes and provide assistance to entities and agencies, public and private, involved in the reduction of infant mortality rates.

     (b)  It shall be a goal of the department of health to:

     (1)  Improve statewide coordination of infant mortality reduction planning and oversight;

     (2)  Oversee the implementation of evidence-based practices;

     (3)  Adopt rules and establish policies to reduce infant mortality rates; and

     (4)  Generally and comprehensively address social determinants of health and other demonstrated factors that contribute to infant mortality.

     §321-B  Hawaii infant mortality reduction advisory board, established.  (a)  There is established within the department of health for administrative purposes the Hawaii infant mortality reduction advisory board that shall be comprised of fifteen members, thirteen of whom are to be appointed by the governor, with the advice and consent of the senate, pursuant to section 26-34.  Members shall serve staggered terms of two years each so that the terms of no more than five members expire each year.

     (b)  The membership of the board shall reflect geographic diversity and the diverse interests of stakeholders, including consumers, employers, insurers, and healthcare providers.  The director of health and the director of human services shall be ex-officio, voting members of the board.

     (c)  The advisory board shall be responsible for:

     (1)  Approving the statewide biannual strategic plan updated every three years to reduce infant mortality;

     (2)  Advising the comprehensive infant mortality reduction program on how best to meet the goals and objectives of the infant mortality reduction strategic plan;

     (3)  Providing recommendations to the comprehensive infant mortality reduction program on improving the quality, availability, and coordination of the services of the comprehensive infant mortality reduction program; and

     (4)  Promoting collaboration among public agencies and private stakeholders to reduce infant mortality in the State.

     (d)  Members shall serve without compensation.

     §321-C  Infant mortality reduction strategic plan; social determinants of health focus.  (a)  The department shall develop and publish a statewide, comprehensive infant mortality reduction strategic plan to reduce infant mortality in the State.  The department shall publish the initial strategic plan no later than January 1, 2015.  The department shall review, revise, and publish an updated infant mortality reduction strategic plan three years following the date of the initial strategic plan, and every three years thereafter.

     (b)  The plan shall include strategies to address social determinants of health as they relate to infant mortality.

     (c)  The public shall have the opportunity to provide input relating to the infant mortality reduction strategic plan pursuant to chapter 91.

     (d)  The department shall present the strategic plan to the Hawaii infant mortality reduction advisory board for its approval.  Upon approval, the strategic plan shall guide all policy development related to the reduction of infant mortality in Hawaii."

PART II

     SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended by adding to part XXVI two new sections to be appropriately designated and to read as follows:

     "§321-D  Patient education; provider responsibilities.  (a)  Each facility shall distribute at least annually to all staff and providers with admitting privileges at that facility a copy of its written policies, adopted pursuant to section 321-C, prohibiting non-medically indicated induction of newborn deliveries prior to thirty-seven weeks of gestation.

     (b)  The department shall produce and distribute factual and scientific educational information addressing infant mortality, including pre-term birth, to all facilities.

     (c)  Each facility shall provide to a pregnant woman upon admission, factual and scientific educational material, including material produced and distributed by the department, regarding infant mortality and pre-term birth unless deemed by the attending physician to be unfeasible on account of the pregnant woman's medical condition or other circumstances.  Each facility shall document the pregnant woman's receipt and acknowledgement of the educational material for each admission.

     §321-E  Reporting requirements; health care providers.  (a)  Beginning January 1, 2014, each licensed birthing facility in the State shall report to the department, in a manner and at intervals determined by the department by rules adopted pursuant to chapter 91, information concerning pre-term birth.

     (b)  The report under subsection (a) shall contain, at a minimum, the following information for each reporting period:

     (1)  The number of live births at the birthing facility;

     (2)  The number of incidents of pre-term birth at the birthing facility;

     (3)  The medical and other causes that may have caused a pre-term birth;

     (4)  Individual, de-identified patient demographic data;

     (5)  The number of patients admitted to the facility who received factual and scientific educational material regarding infant mortality and pre-term birth pursuant to section 321-D; and

     (6)  Other information that the department specifies in rules adopted pursuant to chapter 91."

PART III

     SECTION 3.  Section 321-323 is amended by adding two new definitions to be appropriately inserted and to read as follows:

     ""Infant mortality" means the risk of an infant dying between birth and one year of age.

     "Social determinants of health" means the conditions in which people are born, grow, live, work and age, including the health system, provided that these conditions are attributable, in large part, to health inequities and avoidable differences in health status among demographic groups."

PART IV

     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2013-2014 to:

     (1)  Fund epidemiological and planning activities related to infant mortality reduction;

     (2)  Collect and analyze Hawaii-specific infant mortality data; and

     (3)  Identify social determinants of health as they relate to infant mortality.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

PART V

     SECTION 5.  The department of health shall convene a task force that includes representation from the department of health, birthing facilities in Hawaii, the Hawaii chapter of the American Congress of Obstetricians and Gynecologists, and the Healthcare Association of Hawaii.  The task force shall collect data about the number of elective pre-term deliveries in Hawaii.  The task force shall determine whether that number is so large that it poses a public health threat.  If it so finds, the task force shall develop approaches and measures for addressing the issue.  The task force shall also collect the data needed to determine whether Hawaii needs a point of care newborn screening program.  The task force shall submit a report to the legislature of its findings and recommendations, including any proposed legislation the task force deems necessary, no later than twenty days prior to the convening of the regular session of 2014.

PART VI

     SECTION 6.  In codifying the new sections added by sections 1 and 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

     SECTION 7.  New statutory material is underscored.

     SECTION 8.  This Act, upon its approval, shall take effect on January 1, 2050; provided that parts I through IV shall take effect on January 1, 2015.



 

Report Title:

Comprehensive Infant Mortality Reduction Program; Appropriation

 

Description:

Creates the Comprehensive Infant Mortality Reduction Program.  Clarifies the role of the Department of Health in establishing, administering, and maintaining a statewide, comprehensive infant mortality reduction program.  Addresses departmental duty to provide information to facilities, and provides duty to provide patients and report to departments, certain birth information.  Appropriates unspecified funds.  Creates a task force that is to be convened by the department of health to study and make recommendations on elective pre-term deliveries and point of care newborn screening.  Takes effect January 1, 2050.  Parts I through IV of the Act take effect January 1, 2015.  (SD1)

 

 

 

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