H.B. NO.




















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

     "§321-    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 all 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 improve statewide coordination of infant mortality planning and oversight; oversee the implementation of evidence-based practices; establish rules and policies to reduce infant mortality rates; and to generally and comprehensively address social determinants of health and other demonstrated factors that contribute to infant mortality.

     §321-    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 appointed by the governor and 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 to   reduce infant mortality reduction;

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

     (3)  Providing recommendations to the infant mortality program on improving the quality, availability, and coordination of the services of the infant mortality 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-    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 Hawaii.  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 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 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."


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

     "§321-    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   , 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 the expectant mother upon admission factual and scientific educational material, including those 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 expectant mother's medical condition or other circumstances.  Each facility shall document the expectant mother's receipt and acknowledgement of the educational material for each admission.

     §321-    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 reports shall contain at a minimum 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    ; and

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


     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 a baby 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; and are attributable in large part to health inequities and avoidable differences in health status among demographic groups."


     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $190,000 or so much thereof as may be necessary for fiscal year 2013-2014 to:

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

     (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.


     SECTION 5.  New statutory material is underscored.

     SECTION 6.  This Act, upon its approval, shall take effect on July 1, 2013.









Report Title:

Infant Mortality Reduction



Clarifies the role of the Department of Health in reducing infant mortality rates and creates the Infant Mortality Advisory Board.  Requires birthing facility reporting.




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