HOUSE OF REPRESENTATIVES
TWENTY-SEVENTH LEGISLATURE, 2014
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO INFANT MORTALITY.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Infant mortality, or deaths to infants during the first year of life and measured as the rate of infant deaths per one thousand live births, has long been understood to be a reflection of how well society takes care of its most vulnerable population. Infant mortality is a multifactorial phenomenon, with rates reflecting a society’s commitment to the provision of high quality health care, adequate food and good nutrition, safe and stable housing, a healthy psychosocial and physical environment, and sufficient income to prevent impoverishment. As such, the ability to prevent infant deaths and to address long-standing disparities in infant mortality rates among population groups is a barometer of society’s commitment to the health and well-being of all women, children, and families.
Because of its multifactorial nature, risk factors for infant mortality include factors related to women’s health a year prior to conception and pregnancy, factors related to the pregnancy experience, factors associated with the birth and newborn experience, and factors associated with the child’s health and well-being in the first year of life. Thus, there are many points of intervention and approaches for reducing infant mortality. Approaches are as disparate as expanding access to primary care or family planning prior to pregnancy, perinatal support services for screening and interventions to prevent substance abuse, high quality prenatal care, specialty treatments for preterm or sick infants, parent-family support services, immunizations, and safe housing and healthy neighborhoods.
Reducing the rate of infant mortality has received significant national attention in recent years. The infant mortality rate has remained relatively constant since 2000 despite declines in prior years. In 2009, Hawaii's infant mortality rate was 5.9 deaths per one thousand births, well behind many other industrialized nations. Preterm births and infant losses are enormous costs to families, health care systems, schools, and national prosperity. The Institute of Medicine estimates that preterm births in the United States had an annual societal economic cost of approximately $26,200,000,000 in 2005.
A comprehensive public policy to address infant mortality and eliminate disparities is a public health priority. Improving life-long health outcomes for women and families are also essential for quality health care in the community.
The purpose of this Act is to:
(1) Establish a comprehensive maternal and child health quality improvement program and Hawaii maternal and child health quality improvement collaborative within the department of health; and
(2) Require the department of health to develop and publish a statewide comprehensive maternal and child health quality improvement strategic plan.
SECTION 2. 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- Comprehensive maternal and child health quality improvement program; established. (a) The department of health shall establish, administer, and maintain a statewide comprehensive maternal and child health quality improvement program.
(b) The goals of the comprehensive maternal and child health quality improvement program shall be to:
(1) Improve statewide coordination of infant mortality reduction planning and oversight;
(2) Oversee the implementation of evidence-based health practices; and
(3) Generally and comprehensively address social determinants of health and other demonstrated factors that contribute to reducing infant mortality.
§321- Hawaii maternal and child health quality improvement collaborative; established. (a) There is established within the department of health for administrative purposes the Hawaii maternal and child health quality improvement collaborative.
The collaborative shall:
(1) Approve the maternal and child health quality improvement strategic plan as specified in section 321- ;
(2) Advise the maternal and child health quality improvement program on how best to meet the goals and objectives of the strategic plan;
(3) Provide recommendations to the department of health on improving the quality, availability, and coordination of services of the maternal and child health quality improvement program; and
(4) Promote collaboration among public agencies and private stakeholders to reduce infant mortality in the State.
(b) The collaborative shall consist of interested parties to include:
(1) Thirteen voting members, appointed by the governor, who shall reflect geographic diversity and the diverse interests of stakeholders, including consumers, employers, insurers, and health care providers;
(2) The director of health or the director's designee, who shall serve as an ex-officio, voting member; and
(3) The director of human services, or the director's designee, who shall serve as an ex-officio, voting member.
(c) The department shall convene public and private entities and agencies involved in the reduction of infant mortality.
(d) Members shall serve without compensation but shall be reimbursed for expenses, including travel expenses, necessary for the performance of their duties.
§321- Comprehensive maternal and child health quality improvement strategic plan; social determinants of health focus.
(a) The department of health shall develop and publish a statewide comprehensive maternal and child health quality improvement strategic plan to reduce infant mortality in the State. The department shall publish the initial strategic plan no later than January 1, 2016.
(b) The plan shall include strategies to address social determinants of health as they relate to reducing infant mortality.
(c) Perinatal core measure set data gathered and analyzed in section 321- shall inform policy recommendations.
(d) The department of health shall present the strategic plan to the Hawaii maternal and child health quality improvement collaborative for its approval. Upon approval, the strategic plan shall guide policy development related to infant mortality reduction in Hawaii."
SECTION 3. Chapter 321, Hawaii Revised Statutes, is amended by adding two new sections to part XXVI to be appropriately designated and to read as follows:
"§321- Provider responsibilities. (a) Each hospital within the State shall establish written policies regarding inductions of newborn deliveries or cesarean sections that are not medically indicated prior to thirty-nine weeks of gestation following guidelines adopted by the American College of Obstetricians and Gynecologists.
§321- Reporting requirements; health care providers. Each licensed birthing facility in the State shall report to the department of health, in a manner and at intervals determined by the department, the perinatal core measure set data that is required to be submitted to the Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Hospital Organizations, or both."
SECTION 4. Section 321-323, Hawaii Revised Statutes is amended by adding the definition of "social determinants of health" to be appropriately inserted and to read as follows:
""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."
SECTION 5. 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 2014-2015 for the purposes of this Act, including the hiring of necessary staff.
The sum appropriated shall be expended by the department of health for the purposes of this Act.
SECTION 6. New statutory material is underscored.
SECTION 7. This Act shall take effect on July 1, 2014.
Infant Mortality; Maternal and Child Health; Program; Collaborative; Strategic Plan
Establishes a Comprehensive Maternal and Child Health Quality Improvement Program and Hawaii Maternal and Child Health Quality Improvement Collaborative within the Department of Health. Requires the Department of Health to develop and publish a strategic plan on maternal and child health quality improvement. Effective July 1, 2014. (HB2040 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.