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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
AMENDED
child fatality; maternal mortality
Purpose
Establishes the Maternal Mortality Review Program (MMR Program), consisting of members and staff of the Maternal Mortality Review Committee (Committee), to evaluate the incidence, causes and preventability of pregnancy associated deaths. Outlines Committee membership and duties of the MMR Program.
Background
The State Child Fatality Review Team (State CFR Team) is established within the Department of Health Services (DHS), consisting of the head, or designee, of 9 various state offices and entities, and 10 additional outlined members appointed by the Director of DHS. Duties of the State CFR Team include but are not limited to: 1) developing a child fatalities data collection system; 2) providing training to cooperating agencies, individuals and local review teams on the use of the child fatalities data system; 3) conducting and submitting an annual statistical report on the incidence and causes of child fatalities in Arizona during the past fiscal year; 4) developing standards and protocols for local review teams and providing training and technical assistance to these teams; 5) developing protocols for child fatality investigations; 6) educating the public regarding the incidence and causes of child fatalities, and the public's role in preventing these deaths; and 7) informing the Governor and Legislature of the need for specific recommendations regarding unexplained infant death (A.R.S. § 36-3501).
Laws 2011, Chapter 143 added the requirement that the State CFR Team also evaluate the incidence and causes of maternal fatalities associated with pregnancy in Arizona and defined maternal fatalities associated with pregnancy as the death of a woman while pregnant or within one year after the end of the pregnancy. The MMR Program and Committee were created by DHS in 2012 to address this added requirement. The MMR Program currently conducts reviews of all pregnancy associated deaths in Arizona. Maternal deaths are classified into one of the following categories: 1) pregnancy related death; 2) pregnancy associated death; 3) not pregnancy related or associated; and 4) unable to determine. Once categorized, the Committee focuses on the cause of death for pregnancy related and pregnancy associated deaths. The comprehensive review examines whether the death was preventable or not and if there were any underlying causes. If the death is considered preventable, the Committee makes recommendations on what could have been done to change the outcome (DHS).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Establishes the MMR Program to evaluate the incidence, causes and preventability of pregnancy-associated deaths.
2. Transfers, from the State CFR Team to the MMR Program, the responsibility to evaluate the incidence and causes of maternal fatalities associated with pregnancy in Arizona.
3. Removes the requirement that the chairperson of a local child fatality review team review the death certificates of all women who die within the team's jurisdiction.
4. Requires the MMR Program to:
a) coordinate and facilitate case reviews by the Committee;
b) develop a data collection system for maternal fatalities;
c) provide training to cooperating agencies and individuals related to identification, review and dissemination processes;
d) produce a statistical report, by May 15 of each even-numbered year, on the incidence and causes of pregnancy-related deaths in Arizona;
e) submit the outlined report with the Committee's recommendations for preventing maternal fatalities to the Governor, President of the Senate, Speaker of the House of Representatives and to the chairpersons of the Health and Human Services Committees of the Senate and House of Representatives, or the Health and Human Services Committees' successor committees; and
f) study the adequacy of statutes, ordinances, rules, training and services to determine which changes are needed to decrease the incidence of preventable maternal fatalities.
5. Requires the MMR Program to receive access to all information and records regarding:
a) a child whose fatality or near fatality is being reviewed by a child fatality review team or the child's family; and
b) pregnancy-associated maternal fatalities, as prescribed.
6. Prohibits members of the MMR Program, persons attending an MMR Program meeting and persons who present information to the MMR Program from being questioned in any civil or criminal proceedings related to information presented at or opinions formed as a result of the meeting.
7. Instructs the Committee to collaborate with the MMR Program to produce prevention recommendations that address the contributing factors leading to preventable pregnancy-associated deaths.
8. Specifies that the MMR Program is composed of the Committee and the Committee's staff.
9. Requires the Director of DHS to appoint members of the Committee.
10. Requires the Director of DHS or the Director's designee to serve as a cochairperson of the Committee and the Committee to elect a second cochairperson from the Committee's membership.
11. Prescribes minimum Committee membership requirements including:
a) two licensed obstetricians, with at least one obstetrician who is a maternal fetal medicine specialist;
b) a certified and licensed nurse midwife;
c) a representative from a nonprofit organization that provides education, services or research related to maternal and child health;
d) a representative from an organization that represents hospitals in Arizona;
e) a behavioral health professional;
f) a domestic or interpersonal violence specialist;
g) a forensic pathologist or toxicologist;
h) an individual with personal or community-level experience in maternal health issues;
i) a representative from the Arizona Health Care Cost Containment System;
j) a representative from the Department of Child Safety;
k) a representative from the Arizona Perinatal Trust; and
l) a representative of Indian Health Services.
12. Specifies that at least one member of the Committee must be from a county with a population of fewer than 500,000 persons.
13. Specifies that Committee members are not eligible for compensation, except that appointed members may be reimbursed for travel expenses incurred as a result of the member's official duties.
14. Defines pregnancy-associated death as a death that occurs during pregnancy or within one year after the end of pregnancy.
15. Removes the definition of maternal fatalities associated with pregnancy.
16. Makes technical and conforming changes.
17. Becomes effective on the general effective date.
Amendments Adopted by Committee
· Makes technical changes.
Amendments Adopted by Committee of the Whole
· Clarifies that either a pathologist or a toxicologist, rather than both, must be appointed to serve on the Committee.
Senate Action
HHS 2/5/25 DPA 6-0-1
Prepared by Senate Research
March 4, 2025
MM/KS/slp