HOUSE OF REPRESENTATIVES

H.B. NO.

2300

TWENTY-SEVENTH LEGISLATURE, 2014

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO INFANT MORTALITY.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  Infant mortality, deaths to infants during the first year of life (measured as the rate of infant deaths per 1000 live births), has long been understood to be a reflection of how well society takes care of its most vulnerable citizens.  Infant mortality is a multi-factorial phenomenon, with rates reflecting a society’s commitment to the provision of:  high quality health care, adequate food and good nutrition, safe and stable housing, a healthy psychosocial and physical environment, and sufficient income to prevent impoverishment.  As such, the ability to prevent infant deaths and to address long-standing disparities in infant mortality rates between population groups is a barometer of society’s commitment to the health and well-being of all women, children and families.

     Because of its multifactorial nature, risk factors for infant mortality include those related to women’s health one year prior to conception and pregnancy,  those related to the pregnancy experience, those associated with the birth and newborn experience and those associated with the child’s health and well-being in the first year of life. Thus, many points of intervention and approaches for reducing infant mortality exist.  Approaches are as disparate as expanding access to: primary care or family planning prior to pregnancy; perinatal support services for screening and interventions to prevent substance abuse; high quality prenatal care, including Centering Pregnancy, a multifaceted model of care; specialty treatments for preterm or sick infants, including neonatal resuscitation training and services for Fetal Alcohol Syndrome Disorder; parent/family support services including home visitation and safe sleep resources, breastfeeding support; immunizations and safe housing and healthy neighborhoods.

     Reducing the rate of infant mortality has received significant national attention in recent years.  The infant mortality rate has remained relatively constant since 2000 despite declines in prior years.  Hawaii's infant mortality rate in 2009 was 5.9 deaths per 1,000 births, well behind many other industrialized nations.  Significant disparities persist between populations.  Preterm births and infant losses have enormous costs to families, health care systems, schools, and national prosperity, The Institute of Medicine estimates that preterm birth in the U.S., had an annual societal economic cost of at least $26.2 billion in 2005.

     A comprehensive public policy to address infant mortality and eliminate disparities is a public health priority; therefore the department of health is proposing a new comprehensive maternal and child health quality improvement program.

     SECTION  2.  Chapter 321, Hawaii Revised Statutes, is amended by adding to part XXV three new sections to be appropriately designated and to read as follows:

     "§321-     Comprehensive maternal and child health quality improvement program; established.  (a)  The department of health shall establish, administer, and maintain a statewide, comprehensive maternal and child health quality improvement program.

     (b)  The goals of the comprehensive maternal and child health quality improvement program shall be to:

     (1)  Improve statewide coordination of infant mortality reduction planning and oversight;

     (2)  Oversee the implementation of evidence-based practices; and

     (3)  Generally and comprehensively address social determinants of health and other demonstrated factors that contribute reducing infant mortality.

     §321-     Hawaii maternal and child health quality improvement collaborative, established.  (a)  There is established within the department of health for administrative purposes the Hawaii maternal and child health quality improvement collaborative.  The department shall convene entities and agencies, public and private, involved in the reduction of infant mortality.  The collaborative shall consist of interested parties to include thirteen members to be appointed by the governor.  In addition to the thirteen members appointed by the governor, the director of health or designee and the director of human services or designee shall serve as ex-officio, voting members of the collaborative.

     (b)  The membership of the collaborative shall reflect geographic diversity and the diverse interests of stakeholders, including consumers, employers, insurers, and health care providers.

     (c)  The collaborative shall be responsible for:

     (1)  Approving the maternal and child health quality improvement strategic plan to reduce infant mortality;

     (2)  Advising the maternal and child health quality improvement program on how best to meet the goals and objectives of the strategic plan;

     (3)  Providing recommendations to the department on improving the quality, availability, and coordination of services of the maternal and child health quality improvement program; and

     (4)  Promoting collaboration among public agencies and private stakeholders to reduce infant mortality in the State.

     (d)  Members shall serve without compensation but shall be reimbursed for expenses, including travel expenses, necessary for the performance of their duties.

     §321-     Maternal and child health quality improvement strategic plan; social determinants of health focus.  (a)  The department shall develop and publish a statewide, comprehensive maternal and child health quality improvement strategic plan to reduce infant mortality in the State.  The department shall publish the initial strategic plan no later than January 1, 2016.

     (b)  The plan shall include strategies to address social determinants of health as they relate to reducing infant mortality.

     (c)  Perinatal core measure set data gathered and analyzed in §321-    shall inform policy recommendations.

     (d)  The department shall present the strategic plan to the Hawaii maternal and child health quality improvement collaborative for its approval.  Upon approval, the strategic plan shall guide policy development related to infant mortality reduction in Hawaii."

     SECTION 3.  Chapter 321, Hawaii Revised Statutes, is amended by adding to part XXVI two new sections to be appropriately designated and to read as follows:

     "§321-     Provider responsibilities.  (a)  Each hospital within the State shall establish written policies regarding inductions of newborn deliveries or cesarean sections that are not medically indicated prior to thirty-nine weeks of gestation following guidelines adopted by the American College of Obstetricians and Gynecologists.

     "§321-     Reporting requirements; health care providers.  Each licensed birthing facility in the State shall report to the department, in a manner and at intervals determined by the department, the perinatal core measure set data that is required to be submitted to the U.S. Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Hospital Organizations, or both.

     SECTION 4.  Section 321-323, Hawaii Revised Statutes is amended by adding a new definition to be appropriately inserted and to read as follows:

     "Social determinants of health" means the conditions in which people are born, grow, live, work, and age, including the health system, provided that these conditions are attributable, in large part, to health inequities and avoidable differences in health status among demographic groups."

     SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $215,000, or so much thereof as may be necessary, for fiscal year 2014-2015 to carry out the purposes of this Act, including the hiring of necessary staff.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 7.  New statutory material is underscored.

     SECTION 8.  This Act, upon its approval, shall take effect on July 1, 2014.

 

INTRODUCED BY:

_____________________________

 

BY REQUEST


 


 

Report Title:

Infant Mortality

 

Description:

Clarifies the role of the Department of Health in reducing infant mortality rates; establishes the Hawaii maternal and child health quality improvement collaborative; requires birthing facility reporting; and appropriates funds for operations.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.