STATE OF NEW YORK ________________________________________________________________________ 7204 2023-2024 Regular Sessions IN ASSEMBLY May 12, 2023 ___________ Introduced by M. of A. BICHOTTE HERMELYN, ANDERSON, WALKER -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to establishing protocols for the handling of stillbirths by healthcare facilities and establishing a stillbirth research database The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act shall be known and may be cited as the "Kennedy 2 Grey Law". 3 § 2. Section 206 of the public health law is amended by adding a new 4 subdivision 32 to read as follows: 5 32. (a) The commissioner, in consultation with the state board of 6 medical examiners, the New York board of nursing, the state board for 7 psychology, and the state board for social work, shall develop and 8 prescribe by regulation comprehensive policies and procedures to be 9 followed by health care facilities that provide birthing and newborn 10 care services in the state when a stillbirth occurs. 11 (b) The commissioner shall require as a condition of licensure that 12 each health care facility in the state that provides birthing and 13 newborn care services adhere to the policies and procedures prescribed 14 in this subdivision. The policies and procedures shall include, at a 15 minimum: 16 (i) protocols for assigning primary responsibility to one physician, 17 who shall communicate the condition of the fetus to the mother and fami- 18 ly, and inform and coordinate staff to assist with labor, delivery, and 19 postmortem procedures; 20 (ii) guidelines to assess a family's level of awareness and knowledge 21 regarding the stillbirth; 22 (iii) the establishment of a bereavement checklist, and an informa- 23 tional pamphlet to be given to a family experiencing a stillbirth that 24 includes information about funeral and cremation options; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01157-03-3A. 7204 2 1 (iv) provision of one-on-one nursing care for the duration of the 2 mother's stay at the facility; 3 (v) training of physicians, nurses, psychologists, and social workers 4 to ensure that information is provided to the mother and family experi- 5 encing a stillbirth in a sensitive manner, including information about 6 what to expect, the availability of grief counseling, the opportunity to 7 develop a plan of care that meets the family's social, religious, and 8 cultural needs, and the importance of an autopsy and thorough evaluation 9 of the fetus; 10 (vi) best practices to provide psychological and emotional support to 11 the mother and family following a stillbirth, including referring to the 12 fetus by name, and offering the family the opportunity to cut the umbil- 13 ical cord, hold the baby with privacy and without time restrictions, and 14 prepare a memory box with keepsakes, such as a handprint, footprint, 15 blanket, bracelet, lock of hair, and photographs, and provisions for 16 retaining the keepsakes for one year if the family chooses not to take 17 them at discharge; 18 (vii) protocols to ensure that the physician assigned primary respon- 19 sibility for communicating with the family discusses the importance of 20 an autopsy for the family, including the significance of autopsy find- 21 ings on future pregnancies and the significance that data from the 22 autopsy may have for other families; 23 (viii) protocols to ensure coordinated visits to the family by a 24 hospital staff trained to address the psychosocial needs of a family 25 experiencing a stillbirth, provide guidance in the bereavement process, 26 assist with completing any forms required in connection with the still- 27 birth and autopsy, and offer the family the opportunity to meet with the 28 hospital chaplain or other individual from the family's religious commu- 29 nity; and 30 (ix) guidelines for educating health care professionals and hospital 31 staff on caring for families after stillbirth. 32 § 3. Subdivision 1 of section 201 of the public health law is amended 33 by adding three new paragraphs (z), (aa) and (bb) to read as follows: 34 (z) establish a fetal death evaluation protocol, which a licensed 35 hospital shall follow in collecting data relevant to each stillbirth. 36 The information required to be collected shall include, but not be 37 limited to: 38 (i) the race, age of the mother, maternal and paternal family history, 39 comorbidities, prenatal care history, antepartum findings, history of 40 past obstetric complications, exposure to viral infections, smoking, 41 drug and alcohol use, fetal growth restriction, placental abruption, 42 chromosomal and genetic abnormalities obtained pre-delivery, infection 43 in premature fetus, cord accident, including evidence of obstruction or 44 circulatory compromise, history of thromboembolism, and whether the 45 mother gave birth before; and 46 (ii) documentation of the evaluation of a stillborn fetus, placenta, 47 and cytologic specimen that conform to the standards established by the 48 American College of Obstetricians and Gynecologists and meet any other 49 requirements deemed by the commissioner as necessary, including, but not 50 limited to, the following components: 51 (A) if the parents consent to a complete autopsy: the weight of the 52 fetus and placenta, head circumference, length of fetus, foot length if 53 stillbirth occurred before twenty-three weeks of gestation, and notation 54 of any dysmorphic feature; photograph of the whole body, frontal and 55 profile of face, extremities and palms, close-up of any specific abnor-A. 7204 3 1 malities; examination of the placenta and umbilical cord; and gross and 2 microscopic examination of membranes and umbilical cord; or 3 (B) if the parents do not consent to a complete autopsy, an evaluation 4 of a fetus as set forth in clause (A) of this subparagraph, and appro- 5 priate alternatives to a complete autopsy, including a placental exam- 6 ination, external examination, selected biopsies, X-rays, MRI, and 7 ultrasound. 8 (aa) shall establish and maintain a database that contains a confiden- 9 tial record of all data obtained pursuant to paragraph (z) of this 10 subdivision. The data shall be made available to the public through the 11 department website, except that no data shall identify any person to 12 whom the data relate. 13 (bb) shall evaluate the data obtained pursuant to paragraph (z) of 14 this subdivision for purposes of identifying the causes of, and ways to 15 prevent, stillbirths, and may contract with a third party, including, 16 but not limited to, a public institution of higher education in the 17 state or a foundation, to undertake the evaluation. 18 § 4. This act shall take effect sixty days after it shall have become 19 a law; provided, however, that no later than five years after the effec- 20 tive date of this act, the commissioner of health shall report to the 21 governor, and to the legislature, on the findings of the evaluation 22 required pursuant to section three of this act, and shall include in the 23 report any recommendations for legislative action that the commissioner 24 deems appropriate. Effective immediately the addition, amendment and/or 25 repeal of any rule or regulation necessary for the implementation of 26 this act on its effective date are authorized to be made and completed 27 on or before such date.