S3375

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 for use by every hospital that provides inpatient maternity services, and every birthing center which is licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.). 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 maternal patient and the patient’s health care provider to assist the patient in making informed decisions about the maternity care they receive;

(3) improve patient experiences during, and reduce adverse outcomes related to, or associated with, pregnancy; and

(4) encourage a maternal patient 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 be limited to:

(1) electronic or printed standardized patient questionnaires designed by hospitals and birthing centers, and made available to a maternal patient;

(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 a maternal patient and the patient’s family, 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 a maternal patient about critical maternal conditions and the available treatment options and interventions for such events, and their associated advantages and disadvantages.

2. a. The Commissioner of Health shall implement a three-year pilot program to evaluate the shared decision-making tool developed pursuant to section 1 of this act. The commissioner shall 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 are interested in participating in the pilot program. The commissioner shall review the proposals and select one hospital or birthing facility from the northern, central, and southern regions of the State.

b. The hospitals or birthing centers that are selected by the commissioner to participate in the pilot program shall design a comprehensive evaluation process that assesses the effectiveness of the shared decision-making tool in improving maternal 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 maternal patients who underwent non-medically indicated labor induction procedures, and the number and percentage of maternal patients who underwent medically indicated induction procedures;

(2) the number and percentage of maternal patients who underwent non-medically indicated cesarean section procedures, and the number and percentage of maternal patients who underwent medically indicated cesarean section procedures;

(3) the number and percentage of maternal patients who underwent vaginal deliveries;

(4) the number and percentage of maternal patients who delivered at 41 or more weeks of gestation;

(5) the number and percentage of maternal patients who delivered after 34 weeks of gestation, but before 41 or more weeks of gestation;

(6) the number and percentage of maternal patients who created a birth plan pursuant to paragraph (4) of subsection a of section 1 of this act; and

(7) any other information related to a maternal patient’s prenatal, postnatal, labor, and delivery care that is deemed necessary.

3. a. Within one year after the expiration date of this act, the hospitals that provide inpatient maternity services and the birthing centers licensed that are selected by the Commissioner of Health to participate in the pilot program established pursuant to section 2 of this act shall prepare, and submit to the commissioner, to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), a report on the effectiveness of the shared-decision making tool developed pursuant to section 1 of this act.

b. The report shall be based on the information collected as part of the evaluation process designed by the hospitals and birthing centers pursuant to subsection b. of section 2 of this act, and shall make recommendations on how the shared decision-making tool can be implemented in hospitals and birthing centers throughout the State.

4. This act shall take effect on the first day of the six month next following the date of enactment, and shall expire three years thereafter. 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.

STATEMENT

This bill requires the Commissioner of Health to develop a shared decision-making tool for use by every hospital that provides inpatient maternity services and every birthing center which is licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

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 maternal patient and the patient’s health care provider to assist the patient in making informed decisions about the maternity care they receive; improve patient experiences during, and reduce adverse outcomes related to, or associated with, pregnancy; and encourage a maternal patient to create a birth plan stating the patient’s preferences during the stages of labor, delivery, and postpartum.

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 and made available to a maternal patient; educational fact sheets providing information on a broad range of maternity care issues, including choosing a caregiver and hospital or birthing center, early labor support techniques, potential maternal and neonatal complications relating to pre-term labor induction, the benefits of carrying pregnancies full term, the benefits of operative vaginal deliveries, and the risks associated with cesarean section procedures; and brochures and other multimedia tools that inform and educate a maternal patient about critical maternal conditions and the available treatment options and interventions for such events, and their associated advantages and disadvantages.

The bill directs the commissioner to implement a three-year pilot program to evaluate the shared decision-making tool developed pursuant to the bill. The commissioner is directed to solicit and review proposals from hospitals and birthing centers that are interested in participating in the pilot program and is to select one hospital or birthing facility from the northern, central, and southern regions of the State.

The hospitals or birthing centers selected by the commissioner to participate in the pilot program would design a comprehensive evaluation process that assesses the effectiveness of the share decision-making tool in improving maternal 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: the number and percentage of maternal patients who underwent non-medically indicated labor induction procedures, and the number and percentage of maternal patients who underwent medically indicated induction procedures; the number and percentage of maternal patients who underwent non-medically indicated cesarean section procedures, the number and percentage of maternal patients who underwent vaginal deliveries; the number and percentage of maternal patients who underwent medically indicated cesarean section procedures; the number and percentage of maternal patients who delivered between 34 and 41 or more weeks of gestation; the number and percentage of maternal patients who created a birth plan pursuant to the bill; and any other information related to a maternal patient’s prenatal, postnatal, labor, and delivery care that is deemed necessary.

The bill requires the hospitals and birthing centers selected by the commissioner, within one year of the expiration of the bill, to prepare, and submit a report to the commissioner, to the Governor, and to the Legislature on the effectiveness of the shared decision-making tool developed pursuant to the bill. The report would be based on the information collected as part of the evaluation process designed as part of the pilot program, and would make recommendations on how the shared decision-making tool can be implemented in hospitals and birthing centers throughout the State.