2019 -- H 5543 SUBSTITUTE 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:

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

"Office of State Medical Examiners" are 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 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

     (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; and

     (11)(i) For a multi-disciplinary 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

multi-disciplinary 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; 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 the team members (except to

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

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) The provisions of subsection (11)(i) shall sunset and be repealed effective December

31, 2020.

     (12)(i) For a multi-disciplinary 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, health care providers, health care 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 multi-disciplinary 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 health

care 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, health care providers, health care 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

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

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

     23-4-3.1. Immunity.

     No member of the multi-disciplinary teams 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.

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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

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

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

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

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

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

pathologist and maternal fetal medicine specialist.

     This act would take effect upon passage.

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