ASSEMBLY, No. 4936
STATE OF NEW JERSEY
INTRODUCED JANUARY 17, 2019
Assemblywoman LINDA S. CARTER
District 22 (Middlesex, Somerset and Union)
Assemblywoman ANNETTE CHAPARRO
District 33 (Hudson)
Assemblywoman VALERIE VAINIERI HUTTLE
District 37 (Bergen)
Assemblywomen Speight, Murphy, Lampitt, Reynolds-Jackson, Tucker, Mosquera, McKnight, Lopez, Downey and Jasey
Establishes maternal health care pilot program to evaluate shared decision-making tool developed by DOH and used by hospitals providing maternity services, and by birthing centers.
CURRENT VERSION OF TEXT
As reported by the Assembly Appropriations Committee on March 18, 2019, with amendments.
An Act establishing a maternal health care pilot program.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Commissioner of Health shall develop a shared decision-making tool 1[for use by every hospital] , which the commissioner shall make available to hospitals1 that provides inpatient maternity services 1[,]1 and 1[every birthing center which is] and birthing centers1 licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.). 1Use of the shared decision-making tool shall be voluntary on the part of maternity care hospitals and licensed birthing centers.1 The purpose of the shared decision-making tool shall be to:
(1) improve knowledge of the benefits and risks of, and best practice standards for, the provision of maternity care;
(2) increase collaboration between a 1[maternal] maternity care1 patient and the patient’s health care provider to assist the patient in making informed decisions about the maternity care 1[they receive] the patient receives1;
(3) improve patient experiences during, and reduce adverse outcomes related to, or associated with, pregnancy; and
(4) encourage 1[a maternal patient] maternity care patients1 to create a birth plan stating the patient’s preferences during the stages of labor, delivery, and postpartum.
b. The shared decision-making tool shall consist of patient decision aids including, but not 1[be]1 limited to:
(1) electronic or printed standardized patient questionnaires designed by hospitals and birthing centers, 1[and] which shall be1 made available to 1[a maternal patient] maternity care patients1;
(2) educational fact sheets containing information about:
(a) choosing a health care provider, hospital, or birthing center;
(b) early labor supportive care techniques and other non-pharmacologic methods that support the onset of active labor, reduce stress and anxiety for 1[a maternal patient and the patient’s family] maternity care patients and their families1, and improve coping and pain management;
(c) potential maternal and neonatal complications that may be associated with non-medically indicated pre-term labor inductions;
(d) the benefits of carrying pregnancies to full-term and the benefits of operative vaginal deliveries to reduce the risk of perinatal morbidity and mortality; and
(e) the risks associated with cesarean section procedures; and
(3) brochures and other multimedia tools that inform and educate 1[a maternal patient] maternity care patients1 about critical maternal conditions and the available treatment options and interventions for such events, and 1[their associated] the1 advantages 1[and] ,1 disadvantages 1, and risk factors associated with each available treatment option and intervention1.
2. a. The Commissioner of Health shall implement a three-year pilot program 1[to] under which a select number of maternity care hospitals and licensed birthing centers, as determined by the commissioner, will utilize and1 evaluate the shared decision-making tool developed pursuant to section 1 of this act. The commissioner shall 1[solicit proposals from hospitals that provide inpatient maternity services and from birthing centers which are licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and which] develop a process for maternity care hospitals and licensed birthing facilities that1 are interested in participating in the pilot program 1to apply or otherwise request to participate1. The commissioner shall 1[review the proposals and] determine the total number of maternity care hospitals and licensed birthing centers to be included in the pilot program, except that, at a minimum, the commissioner shall1 select 1at least1 one hospital or birthing facility from 1each of1 the northern, central, and southern regions of the State 1for inclusion1.
b. The hospitals or birthing centers that are selected by the commissioner to participate in the pilot program shall 1[design] use1 a 1standardized,1 comprehensive evaluation process 1, to be designed by the commissioner,1 that assesses the effectiveness of the shared decision-making tool in improving 1[maternal] maternity1 care and reducing adverse outcomes related to, or associated with, pregnancy by collecting and analyzing information, during the pilot program period, about maternal outcomes, including, but not limited to:
(1) the number and percentage of 1[maternal] maternity care1 patients who underwent non-medically indicated labor induction procedures, and the number and percentage of 1[maternal] maternity care1 patients who underwent medically indicated induction procedures;
(2) the number and percentage of 1[maternal] maternity care1 patients who underwent non-medically indicated cesarean section procedures, and the number and percentage of 1[maternal] maternity care1 patients who underwent medically indicated cesarean section procedures;
(3) the number and percentage of 1[maternal] maternity care1 patients who underwent vaginal deliveries;
(4) the number and percentage of 1[maternal] maternity care1 patients who delivered at 41 or more weeks of gestation;
(5) the number and percentage of 1[maternal] maternity care1 patients who delivered after 34 weeks of gestation, but before 41 or more weeks of gestation;
(6) the number and percentage of 1[maternal] maternity care1 patients who created a birth plan pursuant to paragraph (4) of subsection a1.1 of section 1 of this act; and
(7) any other information related to a 1[maternal] maternity care1 patient’s prenatal, postnatal, labor, and delivery care that 1[is deemed] the commissioner deems1 necessary.
3. a. Within one year after the 1[expiration date of this act] expiration of the pilot program established pursuant to section 2 of this act1, 1[the hospitals that provide inpatient maternity services and the birthing centers licensed that are] each maternity care hospital and licensed birthing center1 selected by the Commissioner of Health to participate in the pilot program 1[established pursuant to section 2 of this act]1 shall prepare, and submit to the commissioner, to the Governor, and 1, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1),1 to the Legislature 1[pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1)]1, a report on the effectiveness of the shared-decision making tool developed pursuant to section 1 of this act.
b. The 1[report] reports submitted pursuant to subsection a. of this section1 shall be based on the information collected as part of the 1standardized1 evaluation process designed by the 1[hospitals and birthing centers] commissioner1 pursuant to subsection b. of section 2 of this act, and shall 1[make] include1 recommendations 1[on how] for improvements to the shared decision-making tool and recommendations regarding Statewide implementation of1 the shared decision-making tool 1[can be implemented in hospitals and birthing centers throughout the State]1.
4. This act shall take effect on the first day of the 1[six month next following] 360 days after1 the date of enactment, and shall expire 1[three years thereafter] upon the final submission of all of the reports that are required pursuant to subsection a. of section 3 of this act1. The Commissioner of Health may take such anticipatory administrative action in advance of the effective date as shall be necessary for the implementation of this act.