Mass. Gen. Laws ch. 111, sec. 24O — MA Code / Part I / Title XVI / Chapter 111 / Section 24O
Maternal mortality and morbidity review committee; duties; confidentiality of information, documents and records; committee membership
Status: in_force

Section 24O. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings: ''Maternal morbidity'', any health condition attributed to or aggravated by pregnancy that has negative health outcomes. ''Maternal mortality'', the death of an individual, from any cause, during pregnancy or within 1 year of the end of the pregnancy, regardless of the duration and site of the pregnancy. (b)(i) There shall be within the department a maternal mortality and morbidity review committee to review maternal mortality, study the incidence of pregnancy complications and maternal morbidity and make recommendations to improve maternal outcomes and eliminate preventable maternal deaths. (ii) The committee shall access relevant records and reports pertaining to incidents of maternal mortality or near-death cases under its review. All relevant records and reports shall remain in the possession of committee staff and only de-identified information shall be presented or otherwise shared. (c) The committee shall: (i) conduct case reviews of maternal mortality and maternal morbidity in the commonwealth; (ii) make recommendations to improve access to high-quality, evidence-based health care for pregnant individuals and infants in the commonwealth; (iii) identify gaps in the provision of health care services for pregnant individuals who experience maternal mortality or maternal morbidity, including, but not limited to, disparities in access to: quality care; appropriate health care; transportation; and financial resources. The committee shall identify such gaps by analyzing the pregnant individuals': (1) race, ethnicity and age; (2) geographic region of residence; and (3) socioeconomic status; (iv) review probable cause of death and identify contributing factors in cases reviewed pursuant to clause (i), to the extent possible; (v) determine, to the extent possible, whether the death or health condition presented in cases reviewed pursuant to clause (i) was preventable, and if so, what actions could have been taken to prevent the death or health condition; and (vi) make recommendations to prevent maternal mortality and maternal morbidity and to eliminate disparities in maternal health outcomes. (d)(1) The committee shall maintain all information, documents and records in possession of the committee as confidential and not subject to subpoena or discovery in any civil or criminal proceeding; provided, however, that information, documents and records otherwise available from other sources shall not be exempt from subpoena or discovery solely because such information, documents and records were presented to or reviewed by the committee. (2) A physician, hospital or pharmacy providing the committee access to medical records pursuant to this section shall not be liable for civil damages or be subject to any criminal or disciplinary action for good faith efforts in providing such records. (3) Information, records, reports, statements, notes, memoranda or other data collected pursuant to this section shall not be otherwise admissible as evidence in any action before a court or any other tribunal, board or agency. Such information, records, reports, statements, notes, memoranda or other data shall not be exhibited, and their contents shall not be disclosed in any way, in whole or in part, by any officer or representative of the department or any other person, except as may be necessary to further the review of the committee and as may be allowed by this section. No person participating in such review shall disclose, in any manner, the information so obtained except in conformity with review of the committee. (4) All proceedings and activities of the committee and records obtained, created or maintained pursuant to this section, including records of interviews, written reports and statements procured by the department or any other person, agency or organization acting jointly or under contract with the department in connection with this section shall be confidential. (5) Members of the committee and staff members of the committee shall not be subject to questioning in any civil or criminal proceeding regarding ongoing or completed reviews of the committee; provided, however, that nothing in this section shall be construed to prevent a member of the committee from testifying to information obtained independently of the proceedings of the committee or which is public information. (e)(1) The committee shall consist of the following members: the commissioner, or their designee, who shall serve as chair; the assistant secretary for MassHealth, or their designee, a representative of the department of public health; the executive director of the health policy commission, or their designee; a representative of the Perinatal–Neonatal Quality Improvement Network of Massachusetts; the chief medical examiner, or their designee; the chair of the Massachusetts chapter of the American College of Obstetrics and Gynecology, or their designee; the chair of the Massachusetts chapter of the American College of Nurse Midwives, or their designee; the chair of the Massachusetts chapter of the Association of Women's Health, Obstetric and Neonatal Nurses, or their designee; and the commissioner shall appoint the following members: a medical professional with obstetric and neonatal nursing training; a medical professional with training in cardiology; a medical professional with training in pathology; a medical professional with expertise in substance use prevention and treatment; a psychology, social work or other mental health professional; a representative from academia in a relevant field; a medical professional with formal anesthesiology training; a medical professional with maternal fetal medicine or perinatology training; a medical professional with psychiatric training; a medical professional with family medicine training; the director of a federally-funded Healthy Start program, or their designee; 2 individuals who practice as doulas; 2 community or family members who have been directly affected by a maternal death; a member of a community-based organization; a representative from the department of children and families; and a law enforcement officer. (2) Each member, other than the commissioner, shall serve for a term of 3 years and until their successor is appointed. Nothing in this section shall prohibit the commissioner from appointing a committee member to serve additional terms. The committee shall convene as deemed necessary by the department. The commissioner shall, to the extent feasible, appoint members representing the racial, ethnic and geographic diversity of the commonwealth and shall prioritize appointing members from communities and groups most impacted by maternal mortality and maternal morbidity. (f) Not later than December 31 of each even-numbered year, the committee shall submit to the clerks of the house of representatives and the senate, the house and senate committees on ways and means and the joint committee on public health a report, including, but not limited to: (i) a description of the incidents of maternal mortality and severe maternal morbidity reviewed during the immediately preceding 24 months, provided in a manner that shall not allow for the identification of any person; (ii) a summary of the disparities identified and reviewed; (iii) recommendations to reduce maternal mortality and severe maternal morbidity in the commonwealth; and (iv) recommendations for any legislation or other changes to policy to reduce maternal mortality and severe maternal morbidity or otherwise improve the delivery of health care in the commonwealth. (g) Notwithstanding any general or special law to the contrary, upon the determination of a majority of the committee that the review of any information or record is necessary to carry out the purpose of this section, the committee shall request and the relevant offices and agencies shall provide requested records or information from any agency, department or office of the commonwealth including, but not limited to: (i) the executive office of health and human services and its constituent agencies; (ii) the executive office of public safety and security; (iii) the center for health information and analysis; (iv) the office of patient protection; (v) a health care facility, state comprehensive health planning agency or acute-care hospital as defined in section 25B; and (vi) a health care provider or professional licensed pursuant to chapter 112. The committee may receive and solicit voluntary information, including oral or written statements relating to any case that may come before the committee from any public or private entity and any person including, but not limited to, a patient in a case of maternal morbidity.

Section 24O. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:

''Maternal morbidity'', any health condition attributed to or aggravated by pregnancy that has negative health outcomes.

''Maternal mortality'', the death of an individual, from any cause, during pregnancy or within 1 year of the end of the pregnancy, regardless of the duration and site of the pregnancy.

(b)(i) There shall be within the department a maternal mortality and morbidity review committee to review maternal mortality, study the incidence of pregnancy complications and maternal morbidity and make recommendations to improve maternal outcomes and eliminate preventable maternal deaths.

(ii) The committee shall access relevant records and reports pertaining to incidents of maternal mortality or near-death cases under its review. All relevant records and reports shall remain in the possession of committee staff and only de-identified information shall be presented or otherwise shared.

(c) The committee shall:

(i) conduct case reviews of maternal mortality and maternal morbidity in the commonwealth;

(ii) make recommendations to improve access to high-quality, evidence-based health care for pregnant individuals and infants in the commonwealth;

(iii) identify gaps in the provision of health care services for pregnant individuals who experience maternal mortality or maternal morbidity, including, but not limited to, disparities in access to: quality care; appropriate health care; transportation; and financial resources. The committee shall identify such gaps by analyzing the pregnant individuals':

(1) race, ethnicity and age;

(2) geographic region of residence; and

(3) socioeconomic status;

(iv) review probable cause of death and identify contributing factors in cases reviewed pursuant to clause (i), to the extent possible;

(v) determine, to the extent possible, whether the death or health condition presented in cases reviewed pursuant to clause (i) was preventable, and if so, what actions could have been taken to prevent the death or health condition; and

(vi) make recommendations to prevent maternal mortality and maternal morbidity and to eliminate disparities in maternal health outcomes.

(d)(1) The committee shall maintain all information, documents and records in possession of the committee as confidential and not subject to subpoena or discovery in any civil or criminal proceeding; provided, however, that information, documents and records otherwise available from other sources shall not be exempt from subpoena or discovery solely because such information, documents and records were presented to or reviewed by the committee.

(2) A physician, hospital or pharmacy providing the committee access to medical records pursuant to this section shall not be liable for civil damages or be subject to any criminal or disciplinary action for good faith efforts in providing such records.

(3) Information, records, reports, statements, notes, memoranda or other data collected pursuant to this section shall not be otherwise admissible as evidence in any action before a court or any other tribunal, board or agency. Such information, records, reports, statements, notes, memoranda or other data shall not be exhibited, and their contents shall not be disclosed in any way, in whole or in part, by any officer or representative of the department or any other person, except as may be necessary to further the review of the committee and as may be allowed by this section. No person participating in such review shall disclose, in any manner, the information so obtained except in conformity with review of the committee.

(4) All proceedings and activities of the committee and records obtained, created or maintained pursuant to this section, including records of interviews, written reports and statements procured by the department or any other person, agency or organization acting jointly or under contract with the department in connection with this section shall be confidential.

(5) Members of the committee and staff members of the committee shall not be subject to questioning in any civil or criminal proceeding regarding ongoing or completed reviews of the committee; provided, however, that nothing in this section shall be construed to prevent a member of the committee from testifying to information obtained independently of the proceedings of the committee or which is public information.

(e)(1) The committee shall consist of the following members: the commissioner, or their designee, who shall serve as chair; the assistant secretary for MassHealth, or their designee, a representative of the department of public health; the executive director of the health policy commission, or their designee; a representative of the Perinatal–Neonatal Quality Improvement Network of Massachusetts; the chief medical examiner, or their designee; the chair of the Massachusetts chapter of the American College of Obstetrics and Gynecology, or their designee; the chair of the Massachusetts chapter of the American College of Nurse Midwives, or their designee; the chair of the Massachusetts chapter of the Association of Women's Health, Obstetric and Neonatal Nurses, or their designee; and the commissioner shall appoint the following members: a medical professional with obstetric and neonatal nursing training; a medical professional with training in cardiology; a medical professional with training in pathology; a medical professional with expertise in substance use prevention and treatment; a psychology, social work or other mental health professional; a representative from academia in a relevant field; a medical professional with formal anesthesiology training; a medical professional with maternal fetal medicine or perinatology training; a medical professional with psychiatric training; a medical professional with family medicine training; the director of a federally-funded Healthy Start program, or their designee; 2 individuals who practice as doulas; 2 community or family members who have been directly affected by a maternal death; a member of a community-based organization; a representative from the department of children and families; and a law enforcement officer.

(2) Each member, other than the commissioner, shall serve for a term of 3 years and until their successor is appointed. Nothing in this section shall prohibit the commissioner from appointing a committee member to serve additional terms. The committee shall convene as deemed necessary by the department. The commissioner shall, to the extent feasible, appoint members representing the racial, ethnic and geographic diversity of the commonwealth and shall prioritize appointing members from communities and groups most impacted by maternal mortality and maternal morbidity.

(f) Not later than December 31 of each even-numbered year, the committee shall submit to the clerks of the house of representatives and the senate, the house and senate committees on ways and means and the joint committee on public health a report, including, but not limited to:

(i) a description of the incidents of maternal mortality and severe maternal morbidity reviewed during the immediately preceding 24 months, provided in a manner that shall not allow for the identification of any person;

(ii) a summary of the disparities identified and reviewed;

(iii) recommendations to reduce maternal mortality and severe maternal morbidity in the commonwealth; and

(iv) recommendations for any legislation or other changes to policy to reduce maternal mortality and severe maternal morbidity or otherwise improve the delivery of health care in the commonwealth.

(g) Notwithstanding any general or special law to the contrary, upon the determination of a majority of the committee that the review of any information or record is necessary to carry out the purpose of this section, the committee shall request and the relevant offices and agencies shall provide requested records or information from any agency, department or office of the commonwealth including, but not limited to: (i) the executive office of health and human services and its constituent agencies; (ii) the executive office of public safety and security; (iii) the center for health information and analysis; (iv) the office of patient protection; (v) a health care facility, state comprehensive health planning agency or acute-care hospital as defined in section 25B; and (vi) a health care provider or professional licensed pursuant to chapter 112. The committee may receive and solicit voluntary information, including oral or written statements relating to any case that may come before the committee from any public or private entity and any person including, but not limited to, a patient in a case of maternal morbidity.