ARIZONA STATE SENATE

RESEARCH STAFF

TO:                  MEMBERS OF THE SENATE

CHERIE STONE

LEGISLATIVE RESEARCH ANALYST

HEALTH & HUMAN SERVICES COMMITTEE

Telephone: (602) 926-3171

HEALTH & HUMAN SERVICES COMMITTEE

DATE:            January 28, 2019

SUBJECT:      Strike everything amendment to S.B. 1040, relating to maternal morbidity; mortality; report

Purpose

An emergency measure that establishes the Advisory Committee on Maternal Fatalities and Morbidity (Committee) and specifies duties and requirements of the Committee.

Background

Established in 1993, the Child Fatality Review Team (CFRT) was formed to reduce preventable child fatalities through the creation of preventative strategies, interdisciplinary training, community-based education and data-driven recommendations. In 2011, the CFRT, which oversees the review of all child deaths in Arizona, formed the Maternal Mortality Review Subcommittee (MMRS) to review all pregnancy-associated deaths, to identify factors that may prevent maternal mortality and make recommendations for system changes. According to the Child Fatality Review Program 2017 annual report, the review process begins at the local level where teams of multi-disciplinary professionals volunteer their time to meet and discuss child death cases. Reviews are conducted to analyze the manner and cause of each death with the intent to identify key factors of preventability. The CFRT meets annually to review the results of the local team’s findings, discuss areas of prevention and approve an annual report. The Department of Health Services (DHS) aids both the CFRT and the MMRS, manages the CFRT database and provides administrative support to the program through community partnerships.

Current statute defines maternal fatalities associated with pregnancy as the death of a woman while she is pregnant or within one year after the end of her pregnancy (A.R.S. § 36-3501). Maternal morbidity refers to physical or mental illness or disability directly related to pregnancy or childbirth.

There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1. Requires the Director of DHS to appoint members to the Committee to recommend improvements to information collection concerning the incidence and causes of maternal fatalities and severe maternal morbidity.

2. Establishes that the Committee consists of the following members:

a) the Director of DHS or their designee who will serve as chairperson of the Committee;

b) a representative of a contractor from each service area designated by the Arizona Health Care Cost Containment System (AHCCCS);

c) a representative of AHCCCS;

d) a representative of the Indian Health Services;

e) three licensed obstetricians, two of whom must be licensed maternal fetal medicine specialists;

f) a certified nurse midwife;

g) two representatives of nonprofit organizations that provide education, services or research related to maternal fatalities and morbidity;

h) a representative of Arizona's health information organization;

i) a representative of a public health organization; and

j) two representatives of organizations that represent hospitals in Arizona.

3. Directs the Committee to submit a report with recommendations concerning the improvement of information collection on the incidence and causes of maternal fatalities and severe maternal morbidity to the chairpersons of the House of Representatives (House) and Senate Health and Human Services Committees, or their successor committees, by December 31, 2019.

4. Requires DHS to submit a report to the Governor, the Speaker of the House and the President of the Senate and provide a copy to the Secretary of State on the incidence and causes of maternal fatalities and morbidity that includes all readily available data through the end of 2019.

5. Repeals the DHS reporting requirement on July 1, 2021.

6. Becomes effective on the signature of the Governor, if the emergency clause is enacted.