SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE

 

STATEMENT TO

 

SENATE, No. 3375

 

with committee amendments

 

STATE OF NEW JERSEY

 

DATED:  MARCH 4, 2019

 

      The Senate Health, Human Services and Senior Citizens Committee reports favorably and with committee amendments Senate Bill No. 3375.

      As amended by the committee, this bill requires the Commissioner of Health to develop a shared decision-making tool for use by maternity care hospitals and licensed birthing centers.  Use of the shared decision-making tool will be voluntary.

      The purpose of the shared decision-making tool will 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 to assist the patient in making informed decisions about the maternity care the patient receives; improve patient experiences during, and reduce adverse outcomes related to, or associated with, pregnancy; and encourage maternity care patients to create a birth plan stating the patient’s preferences during the stages of labor, delivery, and postpartum.

      The shared decision-making tool will consist of patient decision aids including, but not limited to: electronic or printed standardized patient questionnaires designed by hospitals and birthing centers, which will be  made available to maternity care patients; 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 maternity care patients about critical maternal conditions and the available treatment options and interventions for such events, along with the advantages, disadvantages, and risks associated with each treatment option and intervention.

      As amended, the bill directs the commissioner to implement a three-year pilot program, under which a select number of maternity care hospitals and birthing centers will utilize and evaluate the shared decision-making tool developed pursuant to the bill.  The commissioner will develop a process for hospitals and birthing centers that are interested in participating in the pilot program to request to participate.  The commissioner will determine the total number of participating hospitals and birthing centers, except that, at a minimum, the commissioner will be required to select at least one hospital or birthing facility from each of the northern, central, and southern regions of the State.

      The hospitals and birthing centers selected by the commissioner to participate in the pilot program will use a standardized, comprehensive evaluation process, to be designed by the commissioner, that will assess 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.  The data to be collected using the evaluation process will include, but will not be limited to, the number and percentage of maternity care patients who: underwent non-medically indicated and medically-indicated labor induction procedures; underwent non-medically indicated and medically-indicated cesarean section procedures; underwent vaginal delivery; delivered at 41 or more weeks of gestation and delivered between 34 and 41 or more weeks of gestation; and created a birth plan.  The evaluation process data will additionally include any other information related to a maternity care patient’s prenatal, postnatal, labor, and delivery care that the commissioner deems necessary.

      As amended, bill requires the hospitals and birthing centers participating in the pilot program to prepare and submit a report to the commissioner, to the Governor, and to the Legislature, within one year after the pilot program established pursuant to the bill expires, 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 improvements to the shared decision-making tool and recommendations regarding Statewide implementation of the shared decision-making tool.

      As amended, the bill provides that it will expire upon the submission of all of the reports required from participant hospitals and birthing centers.

 

COMMITTEE AMENDMENTS

      The committee amendments provide that use of the shared decision-making tool will be voluntary; as introduced, every maternity care hospital and licensed birthing center would have been required to use the tool.

      The committee amendments provide that the Commissioner of Health will determine the total number of hospitals and birthing centers that will participate in the pilot program to evaluate the shared decision-making tool, except that there is to be at least one participant from each of the northern, central, and southern regions of the State.  The commissioner will develop a process for hospitals and birthing centers to request to participate.

      The committee amendments provide that the commissioner will develop the standardized, comprehensive evaluation tool; as introduced, each hospital and birthing center participating in the pilot program would have developed its own evaluation tool.

      The committee amendments revise the reporting requirement to provide that the reports are to be submitted no later than one year after the expiration date of the pilot program, rather than the expiration date of the bill.  Each hospital and birthing facility participating in the pilot program is to submit its own report based on the information collected using the evaluation tool developed by the commissioner.

      The committee amendments revise the effective date to provide that the bill will expire upon submission of all the reports from participant hospitals and birthing centers, rather than three years after the effective date.

      The committee amendments make various technical corrections involving grammar and syntax.