AN ACT TO ENACT THE NORTH CAROLINA MOMNIBUS ACT.
Identical to S 632, filed 4/6/21.
Includes whereas clauses.
Changes the title of Part 5 of Article 1B of GS Chapter 130A to Maternal Health. Enacts GS 130A-33.61 establishing the 17-member Social Determinants of Maternal Health Task Force (Task Force) within the Department of Health and Human Services (DHHS) to develop a strategy to coordinate efforts between State agencies to address social determinants of maternal health with respect to pregnant and postpartum individuals. Defines social determinants of maternal health as nonclinical factors impacting maternal health outcomes, including economic, neighborhood, social and community, household, education access and quality, and health care access factors. Sets out membership requirements, and provides for selecting a chair. Requires a report no later than two years after the act becomes effective, to the Governor and NCGA on the plan to coordinate efforts, recommendations on funding, and on how to leverage services under the State's Medicaid program.
Requires DHHS to establish and operate a Maternal Mortality Prevention Grant Program (grant program) to award grants to eligible entities to establish or expand programs for the prevention of maternal mortality and severe maternal morbidity among black women. Requires applicants to be community-based organizations offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for black women. Requires DHHS, beginning July 1, 2021, to conduct outreach to encourage eligible applicants to apply and provide application assistance. Awards a maximum of five grants with amounts ranging from $10,000 to $50,000. Sets out criteria to be considered when awarding the grants. Sets out the types of technical assistance DHHS must provide. Requires DHHS to report to the specified NCGA committee and division by October 1, 2023, and October 1, 2024; sets out issues to be addressed in those reports. Sets the grant program to expire on June 30, 2023.
Appropriates the following from the General Fund to DHHS, Division of Public Health, for 2021-22: (1) $23,000 in recurring funds to be allocated to the Task Force; (2) $82,000 in recurring funds to establish a Public Health Program Coordinator IV position with responsibilities related to the Task Force and grant program; and (3) $395,500 to be allocated to the grant program, allowing up to 10% of the funds to be used for administrative purposes. Appropriates those same amounts for similar purposes in 2022-23. Authorizes DHHS to hire a Public Health Program Coordinator IV. Effective July 1, 2021.
Effective October 1, 2021, unless otherwise indicated.
Enacts new GS 130A-33.62, providing as follows. Requires DHHS, in collaboration with (1) community-based organizations led by Black women that serve primarily Black birthing people and (2) a historically Black college or university or other institution that primarily serves minority populations to create or identify an evidence-based implicit bias training program (training program) for health care professionals involved in perinatal care (the provision of care during pregnancy, labor, delivery, and postpartum and neonatal periods). Sets out 12 minimum components of the training program, including identification of previous or current unconscious biases and misinformation; identification of personal, interpersonal, institutional, structural, and cultural barriers to inclusion; corrective measures to decrease implicit bias at the interpersonal and institutional levels; and information about how to communicate more effectively across identities. Requires all health care professionals to complete the training program, specifying deadlines for completion depending on whether the individual is licensed before or after January 1, 2022. Requires proof of completion for license/registration/accreditation/certification renewal. Defines a health care professional as a licensed physician or other health care provider licensed, registered, accredited, or certified to perform perinatal care and regulated under the authority of a health care professional licensing authority. Encourages DHHS to seek opportunities to make the training program available to all health care professions and to promote its use among four specified types of providers and programs. Requires DHHS to collect specified information related to maternal mortality to inform ongoing improvements to the training program.
Enacts GS 130A-33.63 specifying that a patient getting care at a perinatal care facility (a hospital, clinic, or birthing center providing perinatal care in the state), has six listed rights, including: to be informed of continuing health care requirements following discharge; to actively participate in decisions regarding the patient's medical care and the right to refuse treatment; and to receive care and treatment free from discrimination on the basis of age, race, ethnicity, color, religion, ancestry, disability, medical condition, genetic information, marital status, sex, gender identity, gender expression, sexual orientation, socioeconomic status, citizenship, nationality, immigration status, primary language, or language proficiency. Requires perinatal care facilities to provide patients upon admission with a written copy of the rights.
Effective October 1, 2021.
Requires DHHS to study five specified issues affecting women serving in the military, including coordinating effectively between veterans' health care facilities and non-veterans health care facilities in the delivery of maternity care and other health care services; facilitating access to community resources to address social determinants of health; and reducing maternal mortality and severe maternal morbidity, with a particular focus on racial and ethnic disparities in maternal health outcomes. Requires DHHS to consult with the Department of Military and Veterans Affairs (DMVA) in conducting the study. Requires DHHS to report to the specified NCGA committees and division by April 1, 2022.
Appropriates $100,000 for 2021-22 from the General Fund to DHHS for the study.
Effective July 1, 2021.
States the NCGA's intent to support data collection, surveillance, and research on maternal health as a result of the COVID-19 public health emergency. Defines COVID-19 public health emergency as the period beginning on the date that the US Secretary of Health and Human Services declared a public health emergency with respect to COVID-19 under section 319 of the Public Health Service Act (42 U.S.C. § 247d) and ending on the later of the end of such public health emergency or January 1, 2023. Appropriates $529,311 in recurring funds and $3.5 million for 2021-22 and $529,311 in recurring funds for 2022-23 from the General Fund to DHHS to be allocated in the specified amounts to: (1) support the work of the Task Force on Birthing Experience and Safe Maternity Care During a Public Health Emergency (described below); (2) hire five full-time, permanent positions to support DHHS in collecting data about the impact of COVID-19 on pregnant, birthing, and postpartum individuals, including data on COVID-19 testing, infections, hospitalizations, and vaccinations and health outcomes for pregnant, birthing, and postpartum individuals and their infants confirmed or suspected of being infected with COVID-19; and conducting public health education activities as described below; (3) establishment and operation of a one-year competitive grant program to ensure safe maternity care staffing levels at safety net hospitals and health clinics that provide maternity care services, which provides 10 grants in the amount of $150,000, subject to specified program requirements, including reporting requirements; and (4) acquire and distribute personal protective equipment to perinatal workers practicing in noninstitutional settings that provide such equipment to their employees or in communities that are disproportionately affected by COVID-19 and adverse maternal health outcomes. Effective July 1, 2021.
Requires DHHS to partner with and award subgrants to: (1) clinical stakeholders, community-based organizations, and federally recognized Indian tribes, to assist with the collection and analysis of data on the impact of COVID-19 on pregnant and postpartum patients and their newborns, particularly among patients from racial and ethnic minority groups and (2) clinical stakeholders, community-based organizations, and federally recognized Indian tribes, to provide timely, continually updated guidance to families and health care providers on ways to reduce risk to pregnant and postpartum individuals and their newborns and tailor interventions to improve their long-term health. Sets out three criteria to be given special consideration in awarding the grants.
Requires DHHS to give the public information and education about COVID-19 and pregnancy, with a particular focus on pregnant individuals in communities disproportionately affected by maternal mortality and COVID-19. Requires licensed hospitals and health care facilities that provide maternity care services during the COVID-19 public health emergency to give patients information about hospital policies that may affect patient care during pregnancy, labor, delivery, and postpartum, including hospital visitor policies.
Requires licensed hospitals and health care facilities providing maternity care services during the COVID public health emergency to: (1) provide patients with updated and accurate information about hospital policies that may affect patient care during pregnancy, labor, delivery, and postpartum, including visitor policies; (2) allow maternity care patients to have at least one support person with them during labor, delivery, and postpartum recovery; (3) make efforts to safely accommodate the presence of doulas during labor, delivery, and postpartum care and recognize doulas as members of patients' perinatal care teams; (4) implement policies equitably; (5) ensure that institutional policies and practices do not violate patients' rights to reject treatments or birth interventions; and (6) integrate COVID-19 considerations into discussions with patients about the risks and benefits of health care decisions during informed consent processes.
Enacts new GS 130A-33.64 in Part 5 of Article 1B of GS Chapter 130A, as amended above, to establish the 25-member Task Force on Birthing Experience and Safe Maternity Care During a Public Health Emergency (Task Force) within DHHS to develop recommendations on respectful maternity care during the COVID-19 public health emergency and other public health emergencies, with a particular focus on outcomes for individuals from racial and ethnic minority groups and other underserved communities, and to make those recommendations publicly available in multiple languages. Sets out 13 issues the Task Force's recommendations must address, including strategies to increase access to specialized care for individuals with high-risk pregnancies; COVID-19 diagnostic testing for pregnant individuals and individuals in labor; licensing, training, and reimbursement for midwives from racial and ethnic minority groups and underserved communities; and strategies to address hospital capacity issues in communities with an increase in COVID-19 cases, or cases caused by future public health emergencies. Sets out membership requirements, provides for selecting a chair, and requires quarterly meetings. Requires DHHS and the Task Force to report every two years, beginning January 1, 2023, to the Governor and NCGA on its recommendations and on specified additional issues. Effective October 1, 2021.
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