2019 -- H 5543 SUBSTITUTE B

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LC001829/SUB B

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY - OFFICE OF STATE MEDICAL EXAMINERS

     

     Introduced By: Representatives Williams, Alzate, Shanley, Diaz, and Almeida

     Date Introduced: February 27, 2019

     Referred To: House Health, Education & Welfare

     (Dept. of Health)

It is enacted by the General Assembly as follows:

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     SECTION 1. Sections 23-4-3 and 23-4-3.1 of the General Laws in Chapter 23-4 entitled

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

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     23-4-3. Functions.

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     The office of state medical examiners shall be responsible for:

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

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expected to involve causes of death enumerated in this chapter;

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

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

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

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

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

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chapter;

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

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cause of death;

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

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

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

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for public inspection;

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

 

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so;

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

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

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

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

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

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

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     (ii) The work product of the child death review team shall be confidential and protected

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under all applicable laws, including the federal Health Insurance Portability and Accountability

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Act of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of

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title 5) and shall be exempt from the provisions of chapter 2 of title 38 and shall be deemed

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privileged pursuant to § 23-17.21-8.

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

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

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of autopsy reports on child deaths; and

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

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

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

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

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

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

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the department of behavioral healthcare, developmental disabilities and hospitals; the Rhode

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Island Police Chiefs Association; the Hospital Association of Rhode Island; an emergency

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department physician; a primary care physician; an addiction medicine/treatment provider; a

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mental health clinician; a toxicologist; a recovery coach or other representative of the recovery

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community; and others as may be determined by the director of the department of health; and

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

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

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

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

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

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

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

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department pursuant to this subsection (11).;

 

LC001829/SUB B - Page 2 of 5

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

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

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

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recommendations for any needed changes in legislation or otherwise.; and

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     (iv) The provisions of subsection (11)(i) shall sunset and be repealed effective December

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31, 2020.

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     (12)(i) For a multi-disciplinary maternal mortality review committee for review of

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maternal deaths of women that occur during pregnancy, delivery, or within one year of the end of

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pregnancy with the goal of reducing the prevalence of such deaths by examining emerging trends

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in such deaths, identifying potential demographic, geographic, and structural points for

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prevention and other factors. This committee has the authority to request and receive data from

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vital records, health care providers, health care facilities, pharmacy records, and any other

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agencies or officials having information that is necessary for the committee to carry out its duties

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under this section. The multi-disciplinary maternal mortality review committee shall include, but

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not be limited to, as determined by the director of the department of health, representation from

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state agencies, an obstetric provider from each hospital that delivers obstetrical care, a neonatal

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specialist, individuals or organizations that represent the populations that are most affected by

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pregnancy-related deaths or pregnancy-associated deaths and lack of access to maternal health

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care services, a perinatal pathologist and a maternal fetal medicine specialist. This committee

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shall develop recommendations for the prevention of maternal deaths and disseminate findings

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and recommendations to policy makers, health care providers, health care facilities, and the

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general public.

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     (ii) The work product of the maternal mortality review committee shall be confidential

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and protected under all applicable laws, including the federal Health Insurance Portability and

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Accountability Act of 1996 and the Rhode Island confidentiality of health care information act

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(chapter 37.3 of title 5) and shall be exempt from the provisions of chapter 2 of title 38and shall

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be deemed privileged pursuant to § 23-17.21-8.

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     23-4-3.1. Immunity.

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

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

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

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

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employees, termination, loss of employee or pension benefits), for acting in accordance with §

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23-4-3.

 

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - OFFICE OF STATE MEDICAL EXAMINERS

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     This act would provide that the multi-disciplinary maternal mortality review committee

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be placed under the review of the office of state medical examiners and would provide that the

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work product of the multi-disciplinary maternal mortality review committee and the child death

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review team be considered confidential and would extend the immunity's for criminal and civil

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action to all multi-disciplinary teams. It would also provide that the committee would include

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representation from state agencies, an obstetric provider, a neonatal specialist, perinatal

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pathologist and maternal fetal medicine specialist.

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     This act would take effect upon passage.

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