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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HEALTH AND SAFETY -- OFFICE OF STATE MEDICAL EXAMINERS

     Introduced By: Senator Joshua Miller

     Date Introduced: March 22, 2023

     Referred To: Senate Health & Human Services

     (Dept. of Health)

It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-4-3 of the General Laws in Chapter 23-4 entitled "Office of State

Medical Examiners" is hereby amended to read as follows:

     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)(i) For a multidisciplinary 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

     (ii) The work product of the child death-review team 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 and shall be deemed privileged

pursuant to § 23-17.21-8;

     (10) The department of health 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;

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

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

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

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

the director of the department of health, 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 toxicologist; a recovery coach or other representative of the recovery community; and

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

     (ii) The work product of the multidisciplinary 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 the team members (except to authorized

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

subsection (11));

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     (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; and

     (iv) [Deleted by P.L. 2021, ch. 21, § 1 and P.L. 2021, ch. 22, § 1.]

     (v) The multidisciplinary team, or Rhode Island department of health state employees

appointed by the director of the department of health shall, as relatives of the deceased are willing,

be empowered to gather information from such consenting relatives regarding the circumstances of

the decedent's death. The information gathered shall remain confidential and publicly released as

aggregate de-identified information. The information gathered will be utilized to help identify

specific prevention and intervention strategies to prevent further deaths. The information gathered

shall not be subject to subpoena, discovery, or introduction into evidence in any civil or criminal

proceeding, and shall not be subject to disclosure beyond the team members except to authorized

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

subsection (11) of this section, and except as aggregate de-identified information.

     (12)(i) For a multidisciplinary maternal mortality review committee for review of maternal

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

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

deaths, identifying potential demographic, geographic, and structural points for prevention, and

other factors. This committee has the authority to request and receive data from vital records,

healthcare providers, healthcare facilities, pharmacy records, and any other agencies or officials

having information that is necessary for the committee to carry out its duties under this section.

The multidisciplinary maternal mortality review committee shall include, but not be limited to, as

determined by the director of the department of health, representation from state agencies; an

obstetric provider from each hospital that delivers obstetrical care; a neonatal specialist; individuals

or organizations that represent the populations that are most affected by pregnancy-related deaths

or pregnancy-associated deaths and lack of access to maternal healthcare services; a perinatal

pathologist; and a maternal fetal medicine specialist. This committee shall develop

recommendations for the prevention of maternal deaths and disseminate findings and

recommendations to policy makers, healthcare providers, healthcare facilities, and the general

public.

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

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

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

     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

***

     This act would provide that the multidisciplinary team for review of drug overdose deaths

or the department of health employees may gather information on the circumstances of a decedent's

death when the relatives of the deceased are willing to provide the information to be utilized to help

identify prevention and intervention strategies.

     This act would take effect upon passage.

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