LEGISLATIVE FISCAL ESTIMATE

[Second Reprint]

SENATE, No. 3375

STATE OF NEW JERSEY

218th LEGISLATURE

 

DATED: APRIL 3, 2019

 

 

SUMMARY

 

Synopsis:

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.

Type of Impact:

Four Year State Expenditure Increase; General Fund.

Four Year Potential Expenditure Increase; University Hospital.

Agencies Affected:

Department of Health; University Hospital.

 

Office of Legislative Services Estimate

Fiscal Impact

Four-Year Period

 

State Expenditure Increase

Indeterminate

 

University Hospital – Potential Expenditure Increase

Indeterminate

 

 

 

 

·         The Office of Legislative Services (OLS) concludes that this bill may result in an indeterminate increase in State expenditures to the Department of Health (DOH) due to the costs of: 1) developing a shared decision-making tool for improving maternity health care; and 2) designing an evaluation process to assess the effectiveness of the tool on maternal health outcomes.  The DOH may also experience recurring costs for the administration of a pilot program, limited to a three-year period, in which the tool will be utilized and evaluated by participating hospitals and birthing centers.  However, it is possible that the department can perform these additional tasks with current staff using existing resources.

 

·         University Hospital will potentially undertake additional expenditures related to the development and administration of patient questionnaires and the collection and reporting of information regarding maternal health outcomes only to the extent that it voluntarily applies to be part of the State pilot program and is ultimately selected to be a program participant by DOH.

 

 

BILL DESCRIPTION

 

This bill requires the Commissioner of Health to develop a shared decision-making tool for use, on a voluntary basis, by maternity care hospitals and licensed birthing centers.  The purpose of the shared decision-making tool would be to: improve knowledge of the benefits and risks of, and best practice standards for, the provision of maternity care; increase collaboration between a maternity care patient and the patient’s health care provider; improve patient experiences; and encourage a maternity care patient to create a birth plan.

     The shared decision-making tool would consist of patient decision aids including, but not limited to: electronic or printed standardized patient questionnaires designed by hospitals and birthing centers; educational fact sheets; and brochures and other multimedia tools that inform and educate maternity care patients.

     The bill directs the commissioner to implement a three-year pilot program to evaluate the shared decision-making tool, which includes the development of a standardized, comprehensive evaluation tool to be used by each hospital and birthing center participating in the pilot program.  The commissioner is directed to develop a process for hospitals and birthing centers to apply for or request to participate in the pilot program.  The commissioner will determine the total number of facilities to be included, with at least one hospital or birthing facility from the northern, central, and southern regions of the State being selected. 

     The hospitals or birthing centers selected by the commissioner to participate in the pilot program would use a standardized, comprehensive evaluation process, to be designed by the commissioner, which assesses the effectiveness of the shared decision-making tool in improving maternity care and reducing adverse outcomes.  The bill requires the hospitals and birthing centers selected by the commissioner, within one year of the expiration of pilot program to prepare and submit a report to the commissioner, to the Governor, and to the Legislature on maternal outcomes and recommendations for improvements to the shared decision-making tool and for its Statewide implementation. The effective date of bill is 360 days following the date of enactment.

 

 

FISCAL ANALYSIS

 

EXECUTIVE BRANCH

 

      None received.

 

OFFICE OF LEGISLATIVE SERVICES

 

      The OLS concludes that this bill may result in an indeterminate increase in State expenditures over a four-year period due to costs associated with: 1) the development of a shared decision-making tool for improving maternity health care; and 2) the design of an evaluation process to assess the effectiveness of the tool on maternal health outcomes.  The DOH may also experience recurring costs for the administration of a three-year pilot program, during which participating facilities selected by DOH will utilize the shared decision-making tool and collect and report information on maternal health outcomes in order for the DOH to gauge the effectiveness of the tool.  This four-year fiscal estimate assumes that the department will need no more than a year to develop the shared decision-making tool prior to the implementation of the three-year pilot program.

      Under the bill, hospitals and birthing centers are not compelled to participate in the three-year pilot program nor are they required to utilize the tool once it is made available Statewide.  However, facilities that volunteer and are selected to participate in the pilot program will be responsible for designing and administering patient questionnaires and using the evaluation process developed by the DOH to evaluate and report on the effectiveness of the tool.  Therefore, the OLS notes that the University Hospital, an independent non-profit legal entity that is an instrumentality of the State located in Newark, may experience an increase in expenditures to fulfill these responsibilities if it participates in the pilot program.  The OLS cannot predict, however, if the hospital will volunteer for the program or be selected for it by the department.

 

 

Section:

Human Services

Analyst:

Sarah Schmidt

Senior Research Analyst

Approved:

Frank W. Haines III

Legislative Budget and Finance Officer

 

 

This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.

 

This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).