2018 -- H 7697 SUBSTITUTE A

========

LC004919/SUB A/2

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

____________

A N   A C T

RELATING TO HEALTH AND SAFETY -- OFFICE OF MEDICAL EXAMINERS

     Introduced By: Representatives Bennett, Newberry, McNamara, Shekarchi, and
Marshall

     Date Introduced: February 28, 2018

     Referred To: House Health, Education & Welfare

     (Department of Health)

It is enacted by the General Assembly as follows:

     SECTION 1. Sections 23-4-1 and 23-4-3 of the General Laws in Chapter 23-4 entitled

"Office of State Medical Examiners" are hereby amended to read as follows:

     23-4-1. Definitions.

     (a) "Assistant medical examiner" means a duly licensed doctor of medicine or osteopathy

appointed to assist the office of state medical examiners on a part-time basis.

     (b) "Autopsy" means the dissection of a dead body and the removal and examination of

bone, tissue, organs, and foreign objects for the purpose of determining the condition of the body

and the cause and the manner of the death.

     (c) "Cause of death" means the agent that has directly or indirectly resulted in a death.

     (d) "Inquest" means an official judicial inquiry before a medical examiner and/or medical

examiners jury for the purpose of determining the manner of death.

     (e) "Manner of death" means the means or fatal agency that caused a death.

     (f) "Postmortem examination" means examination after death and includes an

examination of the dead body and surroundings by an agent of the office of state medical

examiners but does not include dissection of the body for any purpose.

     (g) "Work product" means preliminary drafts, notes, impressions, memoranda, working

papers, and similar documents of a governmental entity, whether in electronic or other format.

     23-4-3. Functions.

     The office of state medical examiners shall be responsible for:

     (1) The investigation of deaths within the state that, in its judgment, might reasonably be

expected to involve causes of death enumerated in this chapter;

     (2) For the conduct of inquests when requested by the attorney general;

     (3) For the performance of autopsies, including the retention, examination, and

appropriate disposal of tissue, when appropriate, for deaths that, in its judgment, might

reasonably be expected to involve causes of deaths enumerated in this chapter;

     (4) For the written determination of the causes of death investigated pursuant to this

chapter;

     (5) For the presentation to the courts of Rhode Island of expert testimony relating to the

cause of death;

     (6) For the keeping of complete records, including names, places, circumstances, and

causes of deaths, of deaths investigated and reported, copies of which shall be delivered to the

attorney general and of which written determinations of causes of death shall be made available

for public inspection;

     (7) For the burial of bodies for which there is no other existing legal responsibility to do

so;

     (8) For the development and enforcement of procedures for the pronouncement of death

and for the transplantation of organs from bodies of persons who have died within the state;

     (9) For a multi-disciplinary team review of child fatalities with the goal to decrease the

prevalence of preventable child deaths and report recommendations for community- and systems-

intervention strategies. A child death-review team shall include, but is not limited to,

representation from state agencies, health care, child welfare, and law enforcement; and

     (10) The department shall work with the department of children, youth and families and

the office of the child advocate to develop a process to ensure the timely availability of autopsy

reports on child deaths; and

     (11)(i) For a multi-disciplinary team review of drug-related overdose deaths with the goal

of reducing the prevalence of such deaths by examining emerging trends in overdose, identifying

potential demographic, geographic, and structural points for prevention and other factors. The

multi-disciplinary team for review of drug-related overdose deaths may include, as determined by

the director, representatives from the department of health; the department of the attorney

general; the Rhode Island state police; the department of corrections; the department of

behavioral healthcare, developmental disabilities and hospitals; the Rhode Island Police Chiefs

Association; the Hospital Association of Rhode Island; an emergency department physician; a

primary care physician; an addiction medicine/treatment provider; a mental health clinician; a

LC004919/SUB A/2 - Page 2 of 4

toxicologist; a recovery coach or other representative of the recovery community; and others as

may be determined by the director; and

     (ii) The work product of the multi-disciplinary team for review of drug-related overdose

deaths shall be confidential and protected under all applicable laws, including the federal Health

Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of

health care information act (chapter 37.3 of title 5), and shall be exempt from the provisions of

chapter 2 of title 38, not subject to subpoena, discovery, or introduction into evidence in any civil

or criminal proceeding, and not subject to disclosure beyond such team members (except to

authorized employees of the department of health as necessary to perform official duties of the

department pursuant to § 23-4-3(11)).

     (iii) The multidisciplinary team shall report on or before December 1 of each year to the

governor, the speaker of the house and president of the senate, which report shall summarize the

activities of the team, as well as the team's findings, progress towards reaching its goals, and

recommendations for any needed changes in legislation or otherwise.

     (iv) The provisions of § 23-4-3(11)(i) shall sunset and be repealed effective December

31, 2020.

     SECTION 2. Chapter 23-4 of the General Laws entitled "Office of State Medical

Examiners" is hereby amended by adding thereto the following section:

     23-4-3.1. Immunity.

     No member of the multi-disciplinary team for review of drug-related overdose deaths

shall be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege,

including, but not limited to, civil penalty or disciplinary action by a business, occupational, or

professional licensing board or entity (and, for members who are state employees, termination,

loss of employee or pension benefits), for acting in accordance with § 23-4-3.

     SECTION 3. This act shall take effect upon passage. The provisions amending § 24-4-

3(11)(i) shall be repealed effective December 31, 2020.

========

LC004919/SUB A/2

========

LC004919/SUB A/2 - Page 3 of 4

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- OFFICE OF MEDICAL EXAMINERS

***

     This act would provide that the state medical examiner is to conduct a multi-disciplinary

team review of drug-related overdose deaths. This team would report annually to the governor

and the general assembly on its findings and recommendation. The provisions establishing this

team would be repealed effective December 31, 2020.

     This act would take effect upon passage. The provisions amending § 24-4-3(11)(i) would

be repealed effective December 31, 2020.

========

LC004919/SUB A/2

========

LC004919/SUB A/2 - Page 4 of 4