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HF 660

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/25/2021 07:35pm

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Engrossments
Introduction Posted on 02/04/2021
1st Engrossment Posted on 02/18/2021

Current Version - 1st Engrossment

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A bill for an act
relating to health; establishing the Dignity in Pregnancy and Childbirth Act;
requiring continuing education on anti-racism training and implicit bias; expanding
the maternal death studies conducted by the commissioner of health to include
maternal morbidity; appropriating money; amending Minnesota Statutes 2020,
section 145.901; proposing coding for new law in Minnesota Statutes, chapter
144.

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

Section 1.

new text begin [144.1461] DIGNITY IN PREGNANCY AND CHILDBIRTH.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Dignity in Pregnancy and
Childbirth Act."
new text end

new text begin Subd. 2. new text end

new text begin Continuing education requirement. new text end

new text begin (a) Hospitals with obstetric care and birth
centers must provide continuing education on anti-racism training and implicit bias. The
continuing education must be evidence-based and must include at a minimum the following
criteria:
new text end

new text begin (1) education aimed at identifying personal, interpersonal, institutional, structural, and
cultural barriers to inclusion;
new text end

new text begin (2) identifying and implementing corrective measures to promote anti-racism practices
and decrease implicit bias at the interpersonal and institutional levels, including the
institution's ongoing policies and practices;
new text end

new text begin (3) providing information on the ongoing effects of historical and contemporary exclusion
and oppression of Black and Indigenous communities with the greatest health disparities
related to maternal and infant mortality and morbidity;
new text end

new text begin (4) providing information and discussion of health disparities in the perinatal health care
field including how systemic racism and implicit bias have different impacts on health
outcomes for different racial and ethnic communities; and
new text end

new text begin (5) soliciting perspectives of diverse, local constituency groups and experts on racial,
identity, cultural, and provider-community relationship issues.
new text end

new text begin (b) In addition to the initial continuing educational requirement in paragraph (a), hospitals
with obstetric care and birth centers must provide an annual refresher course that reflects
current trends on race, culture, identity, and anti-racism principles and institutional implicit
bias.
new text end

new text begin (c) Hospitals with obstetric care and birth centers must develop continuing education
materials on anti-racism and implicit bias that must be provided and updated annually for
direct care employees and contractors who routinely care for patients who are pregnant or
postpartum.
new text end

new text begin (d) Hospitals with obstetric care and birth centers shall coordinate with health care
licensing boards to obtain continuing education credits for the trainings and materials
required in this section. The commissioner of health shall monitor compliance with this
section. Initial training for the continuing education requirements in this subdivision must
be completed by December 31, 2022. The commissioner may inspect the training records
or require reports on the continuing education materials in this section from hospitals with
obstetric care and birth centers.
new text end

new text begin (e) A facility described in paragraph (d) must provide a certificate of training completion
to another facility or a training attendee upon request. A facility may accept the training
certificate from another facility for a health care provider that works in more than one
facility.
new text end

new text begin Subd. 3. new text end

new text begin Midwife and doula care. new text end

new text begin In order to improve maternal and infant health as
well as improving birth outcomes in groups with the most significant disparities that include
Black, Indigenous, and other communities of color; rural communities; and people with
low incomes, the commissioner of health in partnership with patient groups and culturally
based community organizations shall:
new text end

new text begin (1) develop procedures and services designed for making midwife and doula services
available to groups with the most maternal and infant mortality and morbidity disparities;
new text end

new text begin (2) propose changes to licensing of midwives in order to allow midwives with nationally
recognized credentials to practice to the full scope of competencies and education the
midwife has attained;
new text end

new text begin (3) promote racial, ethnic, and language diversity in the midwife and doula workforce
that better aligns with the childbearing population in groups with the most significant
maternal and infant mortality and morbidity disparities; and
new text end

new text begin (4) ensure that midwife and doula training and licensing are tailored to the specific needs
of groups with the most significant maternal and infant mortality and morbidity disparities,
including trauma-informed care, maternal mood disorders, intimate partner violence, and
systemic racism.
new text end

Sec. 2.

Minnesota Statutes 2020, section 145.901, is amended to read:


145.901 MATERNALnew text begin MORBIDITY ANDnew text end DEATH STUDIES.

Subdivision 1.

Purpose.

new text begin (a) new text endThe commissioner of health may conduct maternal new text beginmorbidity
and
new text enddeath studies to assist the planning, implementation, and evaluation of medical, health,
and welfare service systems and to reduce the numbers of preventablenew text begin adversenew text end maternal
new text begin outcomes and new text enddeaths in Minnesota.

new text begin (b) For purposes of this section, "maternal morbidity" has the meaning given to severe
maternal morbidity by the Centers for Disease Control and Prevention, and includes an
unexpected outcome of labor or delivery that results in significant short- or long-term
consequences to a woman's health.
new text end

Subd. 2.

Access to data.

(a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records new text beginas defined in section 144.291, subdivision
2, paragraph (c),
new text end created, maintained, or stored by providers deleted text beginas defined in section deleted text enddeleted text begin144.291,
subdivision 2
deleted text end
deleted text begin, paragraph (i),deleted text end without the consent of the subject of the data, and without the
consent of the parent, spouse, other guardian, or legal representative of the subject of the
data, when the subject of the data is a woman who diednew text begin or experienced morbiditiesnew text end during
a pregnancy or within 12 months of a fetal death, a live birth, or other termination of a
pregnancy.

The commissioner has access only to medical data and health records related to new text beginmaternal
morbidities and
new text enddeaths that occur on or after July 1, 2000new text begin, including the names of the
providers and clinics where care was received before, during, or related to the pregnancy
or death. The commissioner has access to records maintained by family home visiting
programs; the women, infants, and children (WIC) program; the prescription monitoring
program; behavioral health services programs; substance use treatment facilities; law
enforcement; the medical examiner; coroner; or hospitals for the purpose of providing the
name and location of any pre-pregnancy or prenatal care received by the subject of the data
or of any postpartum care received up to one year following the end of pregnancy by the
subject of the data
new text end.

(b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.

(c) The commissioner shall make a good faith reasonable effort to notify thenew text begin subject of
the data, or the subject's
new text end parent, spouse, deleted text beginotherdeleted text end guardian, or legal representative deleted text beginof the subject
of the data
deleted text end before collecting data on the subject. For purposes of this paragraph, "reasonable
effort" means one notice is sent by certified mail to the last known address of the new text beginsubject
of the data, or the subject's
new text endparent, spouse, guardian, or legal representative informing the
recipient of the data collection and offering a public health nurse support visit if desired.

(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.

new text begin (e) The commissioner may request and receive from a coroner or medical examiner the
name of the health care provider that provided prenatal, postpartum, and other health services
to the subject of the data.
new text end

new text begin (f) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems to reduce preventable
maternal deaths.
new text end

new text begin (g) The commissioner may request and receive from a law enforcement agency law
enforcement reports or incident reports related to the subject of the data.
new text end

Subd. 3.

Management of records.

After the commissioner has collected all data about
a subject of a maternal new text beginmorbidity or new text enddeath study needed to perform the study, the data from
source records obtained under subdivision 2, other than data identifying the subject, must
be transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data have been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.

Subd. 4.

Classification of data.

(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternalnew text begin morbidity andnew text end death studies, are classified as confidential
data on individuals or confidential data on decedents, as defined in sections 13.02, subdivision
3
, and 13.10, subdivision 1, paragraph (a).

(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out maternalnew text begin morbidity andnew text end death studies.

(c) Summary data on maternal new text beginmorbidity and new text enddeath studies created by the commissioner,
which does not identify individual data subjects or individual providers, shall be public in
accordance with section 13.05, subdivision 7.

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

Sec. 3. new text beginAPPROPRIATION; ANTI-RACISM AND IMPLICIT BIAS TRAINING;
MATERNAL MORBIDITY AND DEATH STUDIES.
new text end

new text begin (a) $....... in fiscal year 2022 is appropriated from the general fund to the commissioner
of health to be used for grants for anti-racism and implicit bias training in accredited medical,
nursing, midwifery, and doula education curricula in obstetric clinical practice.
new text end

new text begin (b) $....... in fiscal year 2022 and $....... in fiscal year 2023 are appropriated from the
general fund to the commissioner of health for purposes of Minnesota Statutes, section
145.901.
new text end