Bill Text: NJ S3899 | 2022-2023 | Regular Session | Introduced
Bill Title: Requires DOH to establish levels of maternity care at maternity care facilities.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2023-06-01 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S3899 Detail]
Download: New_Jersey-2022-S3899-Introduced.html
Sponsored by:
Senator ROBERT W. SINGER
District 30 (Monmouth and Ocean)
Senator RENEE C. BURGESS
District 28 (Essex)
SYNOPSIS
Requires DOH to establish levels of maternity care at maternity care facilities.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning maternity care and supplementing Title 26 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. As used in this act:
"Antepartum" means the time period before childbirth.
"Intrapartum" means the time period spanning childbirth, from the onset of labor through delivery of the placenta.
"Maternity care facility" means a hospital that provides inpatient maternity services or a birthing center licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.)
"Postpartum" means the time period following childbirth, up to one year after childbirth.
2. a. The Department of Health shall develop a formal, regionalized maternity care classification system that defines the collaborative roles of, and relationships between, all maternity care facilities in the State based on the level of maternity care provided to the patients of such facilities. The purpose of the classification system shall be to ensure the provision of care to pregnant, antepartum, intrapartum, and postpartum patients in the State along an integrated continuum of clinical and social risk-informed care with the goal of reducing the number of adverse maternity care experiences and outcomes and addressing obstetric inequities as a result of preventable safety and quality violations.
b. The levels of maternity care classification system developed pursuant to this section shall be based on the guidelines established pursuant to the American College of Obstetricians and Gynecologists 2023 Obstetric Care Consensus on Levels of Maternity Care and the specific needs and priorities of pregnant, antepartum, intrapartum, and postpartum patients in accordance with the following criteria:
(1) A maternity care facility classified as an accredited birthing center shall be authorized to provide basic maternity care services to patients having a normal to low-risk pregnancy who are expected to have an uncomplicated birth.
(2) A maternity care facility classified as a Level I basic maternity care hospital shall be authorized to provide basic maternity care services to patients having a low to moderate-risk pregnancy which care may include, but not be limited to, the detection, stabilization, and management of unanticipated maternal-fetal or neonatal conditions that occur during the antepartum, intrapartum, or postpartum period until the patient can be transferred to a specialty maternity care hospital or birthing center.
(3) A maternity care facility classified as a Level II specialty maternity care hospital shall be authorized to provide Level I basic maternity care as outlined in paragraph (2) of this subsection and specialty maternity care services to patients who have been assessed as meeting criteria for moderate to high-risk antepartum, intrapartum, or postpartum care.
(4) A maternity care facility classified as a Level III subspecialty maternity care hospital shall be authorized to provide Level II specialty care as outlined in paragraph (3) of this subsection and subspecialty maternity care to patients having more complex maternal medical conditions, obstetric complications, and fetal disorders that occur during the antepartum, intrapartum, or postpartum period.
(5) A maternity care facility classified as a Level IV regional perinatal health care center shall be authorized to provide Level III subspecialty maternity care as outlined in paragraph (4) of this subsection, perinatal care, and on-site medical and surgical care of the most complex maternal conditions, of critically ill pregnant patients, and of critically ill newborns during the antepartum, intrapartum, or postpartum period.
c. Under the maternity care classification system developed pursuant to this section, the physical facility requirements of, and the standards for the hiring, credentialing, and training of professional staff at:
(1) accredited birthing centers shall comply with the standards for accreditation set forth by the American Association of Birth Centers Standards for Birth Centers; and
(2) maternity care hospitals classified as Level I basic, Level II specialty, and Level III subspecialty maternity care hospitals, and Level IV regional perinatal health care centers shall comply with the guidelines established pursuant to the American College of Obstetricians and Gynecologists 2023 Obstetric Care Consensus on Levels of Maternity Care.
d. In developing the levels of maternity care classification system pursuant to this section, the department shall:
(1) introduce uniform designations for levels of maternity care that are complimentary but distinct from the levels of neonatal care;
(2) designate and delineate any county, zip code, or group of zip codes in the State as a prospective service region for a maternity care hospital classified as a regional perinatal health care center pursuant to paragraph (5) of subsection b. of this section;
(3) establish uniform criteria for the designation of maternity care facilities that are integrated with existing State, county, and local emergency response systems to help ensure that the appropriate personnel, physical space, equipment, training, technology, and resources are available to achieve optimal outcomes and equitable experiences when providing clinical and social risk-informed maternity care;
(4) require that maternity care facilities maintain pregnant, antepartum, intrapartum, and postpartum patient transfer criteria, transfer agreements, and admission protocols, which criteria, agreements, and protocols shall provide for the effective and efficient transfer and admission of such patients between maternity care facilities classified as accredited birthing centers, Level I basic, Level II specialty, and Level III subspecialty maternity care hospitals, and Level IV regional perinatal health care centers;
(5) require maternity care facilities classified as accredited birthing centers and maternity care hospitals classified as Level I basic, Level II specialty, and Level III subspecialty maternity care hospitals, and Level IV regional perinatal health care centers to enter into a written agreement with the department to participate in the Maternal Data Center pursuant to section 14 of P.L.2019, c.75 (C.26:6C-14) in order for the department to:
(a) analyze the data collected from the Maternal Data Center to assess the efficacy of the levels of maternity care classification system in reducing the rates of maternal morbidity and mortality and maternal health inequities; and
(b) achieve continuous quality improvement in patient safety achieved through, and the quality of care provided under, the levels of maternity care classification system;
(6) establish a multi-disciplinary, multigenerational, multiracial, and multicultural team with expertise in clinical and social risk-informed maternity care to study actions that can be undertaken by the department to adopt the classification system for levels of maternity care at all maternity care facilities; and
(7) establish a public awareness campaign, in collaboration with community-based organizations that provide services to communities most unfairly and disproportionally impacted by maternal morbidity, maternal mortality, and maternal health inequities, to inform the general public about the levels of maternity care classification system and the importance of the system in improving prenatal care and maternal health throughout the State.
3. a. The Department of Health shall designate maternity care facilities that meet the criteria set forth in subsection b. of section 1 of this act as accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, or Level IV regional perinatal health care centers.
b. Each maternity care facility shall apply to the department, on a form and in a manner approved by the department, for designation under the levels of maternity care classification system developed pursuant to section 2 of this act and shall demonstrate the ability to consistently provide the level of care associated with the facility's designation under the classification system. A maternity care facility, may, at any time, apply to the department for re-designation at a different classification level, which application shall be approved if the maternity care facility meets the requirements for classification at the new classification level.
c. The department shall designate as many maternity care facilities as accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, and Level IV regional perinatal health care centers as apply pursuant to subsection b. of this section and as meet the requirements for that classification.
d. The department may suspend or revoke a maternal care facility's designation as an accredited birthing center, Level I basic, Level II specialty, Level III subspecialty, or Level IV regional perinatal health care center, after notice and hearing, if the department determines that the facility is not in compliance with the requirements of this act.
e. The department shall prepare, maintain, and make available on the department's website a list of maternity care facilities designated accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, or Level IV regional perinatal health care centers. The department shall update the list whenever the department newly designates a maternity care facility as an accredited birthing center, Level I basic, Level II specialty, Level III subspecialty, or Level IV regional perinatal health care center, as well as whenever the department approves a change in classification to a maternity care facility's classification level.
4. The Department of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.
5. This act shall take effect on the first day of the sixth month next following the date of enactment, except that the Commissioner of Health may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.
STATEMENT
This bill requires the Department of Health (DOH) to develop a formal, regionalized classification system that defines the roles of all State maternity care facilities based on the level of maternity care provided to the patients of such facilities, to ensure the provision of care to pregnant, antepartum, intrapartum, and postpartum patients in the State along an integrated continuum of care, and to reduce the number of adverse maternity care experiences and outcomes and address obstetric inequities. The system, based on the specific needs and priorities of pregnant, antepartum, intrapartum, and postpartum patients, would designate maternity care facilities as accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, or Level IV regional perinatal health care centers in accordance with criteria outlined in the bill.
In developing the classification system, the DOH is to: (1) introduce uniform designations for levels of maternity care complimentary to, but distinct from, the levels of neonatal care; (2) designate a prospective service region for a regional perinatal health care center; (3) establish uniform criteria for the designation of maternity care facilities integrated with emergency response systems; (4) require that accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty maternity care hospitals, and Level IV regional perinatal care centers maintain patient and newborn transfer criteria, transfer agreements, and admission protocols governing transfers between such birthing centers and hospitals; (5) require accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, and Level IV regional perinatal health care centers to participate in the Maternal Data Center; (6) establish an multi-disciplinary team to study actions that the DOH may take to adopt the levels of maternity care at all maternity care facilities; (7) establish a public awareness campaign to inform the public about the classification system; and (8) develop policies and procedures allowing patients receiving services at accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, and Level IV regional perinatal health care centers to pursue legal recourse against such birthing centers and hospitals based on acts of obstetric violence or obstetric racism.
The DOH is to designate as many maternity care facilities as accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, and Level IV regional perinatal health care centers as apply for designation and demonstrate the ability to provide the level of care associated with the designation, and may revoke or suspend such designation if the requirements of the bill are not met. The DOH is also required to prepare, maintain, make available on its website, and update as necessary, a list of accredited birthing centers, Level I basic, Level II specialty, Level III subspecialty, and Level IV regional perinatal health care centers.
