The Vermont Statutes Online

Title 18: Health

Chapter 030: Maternal Mortality Review Panel

• § 1551. Definitions

  As used in this chapter:

  (1) “Maternal mortality” or “maternal death” means:

  (A) pregnancy-associated death;

  (B) pregnancy-related death; or

  (C) pregnancy-associated but not pregnancy-related death.

  (2) “Pregnancy-associated death” means the death of a woman while pregnant or within one year following the end of pregnancy, irrespective of cause.

  (3) “Pregnancy-associated, but not pregnancy-related death” means the death of a woman while pregnant or within one year following the end of pregnancy due to a cause unrelated to pregnancy.

  (4) “Pregnancy-related death” means the death of a woman while pregnant or within one year following the end of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by her pregnancy or its management, but not from accidental or incidental causes. (Added 2011, No. 35, § 2, eff. May 18, 2011.)

• § 1552. Maternal Mortality Review Panel established

  (a) There is established the Maternal Mortality Review Panel to conduct comprehensive, multidisciplinary reviews of maternal deaths in Vermont for the purposes of identifying factors associated with the deaths and making recommendations for system changes to improve health care services for women in this State. The Panel shall consider health disparities and social determinants of health, including race and ethnicity in maternal death reviews.

  (b)(1) The members of the Panel shall be appointed by the Commissioner of Health as follows:

  (A) Two members from the Vermont section of the American College of Obstetricians and Gynecologists, one of whom shall be a generalist obstetrician and one of whom shall be a maternal fetal medicine specialist.

  (B) One member from the Vermont chapter of the American Academy of Pediatrics, specializing in neonatology.

  (C) One member from the Vermont chapter of the American College of Nurse-Midwives.

  (D) One member who is a midwife licensed pursuant to 26 V.S.A. chapter 85.

  (E) One member from the Vermont section of the Association of Women’s Health, Obstetric and Neonatal Nurses.

  (F) The Director of the Division of Maternal and Child Health in the Vermont Department of Health or designee.

  (G) An epidemiologist from the Department of Health with experience analyzing perinatal data or designee.

  (H) The Chief Medical Examiner or designee.

  (I) A representative of the community mental health centers.

  (J) A member of the public.

  (2) The Commissioner may appoint any of the following members to one-year terms:

  (A) a licensed clinical provider specializing in substance use disorder;

  (B) an expert in the pharmaceutical management of mental health; and

  (C) a social worker.

  (3) The Panel may consult experts as needed on a case by case basis. An expert consulted pursuant to this subdivision shall be subject to the same restrictions and protections as Panel members with regard to privacy, security, and the disclosure of information.

  (c) The term of each member listed in subdivision (b)(1) of this section shall be three years and the terms shall be staggered. The Commissioner shall appoint the initial Chair of the Panel, who shall call the first meeting of the Panel and serve as Chair for six months, after which time the Panel shall elect its Chair.

  (d) The Commissioner may delegate to the Northern New England Perinatal Quality Improvement Network (NNEPQIN) the functions of collecting, analyzing, and disseminating maternal mortality information; organizing and convening meetings of the Panel; and such other substantive and administrative tasks as may be incident to these activities. The activities of the NNEPQIN and its employees or agents shall be subject to the same confidentiality provisions as apply to members of the Panel.

  (e) The Department may enter into reciprocal agreements with other states that have maternal mortality review panels provided access under such agreements is consistent with privacy, security, and disclosure protections in this chapter.

  (f) The Panel’s review process shall not commence until any criminal prosecution arising out of the maternal mortality is concluded by the Attorney General and a State’s Attorney provides written notice to the Panel that no criminal charges shall be filed.

  (g) Annually, on or before January 15, the Panel shall submit a report with its findings and recommendations to the House Committee on Human Services and to the Senate Committee on Health and Welfare, provided that releasing the information complies with the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-191.

  (h) Members of the Panel shall be entitled to per diem compensation and reimbursement of expenses as permitted under 32 V.S.A. § 1010 for not more than three meetings annually. These payments shall be made from monies appropriated to the Department of Health. (Added 2011, No. 35, § 2, eff. May 18, 2011; amended 2019, No. 142 (Adj. Sess.), § 1.)

• § 1553. Duties

  (a) The Panel, in collaboration with the Commissioner of Health or designee, shall conduct comprehensive, multidisciplinary reviews of maternal mortality in Vermont.

  (b) Each member of the Panel shall be responsible for disseminating Panel recommendations to his or her respective institution and professional organization, as applicable. All such information shall be disseminated through the institution’s or organization’s quality assurance program in order to protect the confidentiality of all participants and patients involved in any incident.

  (c) [Repealed.]

  (d) The Panel shall not:

  (1) call witnesses or take testimony from any individual involved in the investigation of a maternal death;

  (2) enforce any public health standard or criminal law or otherwise participate in any legal proceeding, except to the extent that a member of the Panel is involved in the investigation of a maternal death or resulting prosecution and must participate in a legal proceeding in the course of performing his or her duties outside the Panel. (Added 2011, No. 35, § 2, eff. May 18, 2011; amended 2015, No. 131 (Adj. Sess.), § 11.)

• § 1554. Confidentiality

  (a) The Panel’s meetings are confidential and shall be exempt from the Open Meeting Law, 1 V.S.A. chapter 5, subchapter 2. The records produced or acquired by the Panel are exempt from public inspection and copying under the Public Records Act and shall be kept confidential. The records of the Panel are not subject to discovery, subpoena, or introduction into evidence in any civil or criminal proceeding; provided, however, that nothing in this subsection shall be construed to limit or restrict the right to discover or use in any civil or criminal proceeding anything that is available from another source and entirely independent of the Panel’s proceedings.

  (b) Members of the Panel shall not be questioned in any civil or criminal proceeding regarding the information presented in or opinions formed as a result of a meeting of the Panel; provided, however, that nothing in this subsection shall be construed to prevent a member of the Panel from testifying to information obtained independently of the Panel or that is public information. (Added 2011, No. 35, § 2, eff. May 18, 2011; amended 2019, No. 142 (Adj. Sess.), § 2.)

• § 1555. Information related to maternal mortality

  (a)(1) Health care providers; health care facilities; clinics; laboratories; medical records departments; and State offices, agencies, and departments shall report all maternal mortality deaths to the Chair of the Maternal Mortality Review Panel and to the Commissioner of Health or designee.

  (2) The Commissioner and the Chair may acquire the information described in subdivision (1) of this subsection from health care facilities, maternal mortality review programs, and other sources in other states to ensure that the Panel’s records of Vermont maternal mortality cases are accurate and complete.

  (b)(1) In any case under review by the Panel, upon written request of the Commissioner or designee, a person who possesses information or records that are necessary and relevant to the review of a maternal mortality shall, as soon as practicable, provide the Panel with the information and records. All requests for information or records by the Commissioner or designee related to a case under review shall be provided by the person possessing the information or records to the Panel at no cost.

  (2) The Commissioner or designee may retain identifiable information regarding facilities where maternal deaths occur and geographic information on each case solely for the purposes of trending and analysis over time. In accordance with the rules adopted pursuant to subdivision 1556(4) of this title, all individually identifiable information on individuals and identifiable information on facilities shall be removed prior to any case review by the Panel.

  (3) The Chair shall not acquire or retain any individually identifiable information.

  (4) As used in this subsection, “individually identifiable information” includes vital records; hospital discharge data; prenatal, fetal, pediatric, or infant medical records; hospital or clinic records; laboratory reports; records of fetal deaths or induced terminations of pregnancies; and autopsy reports.

  (c) If a root cause analysis of a maternal mortality event has been completed, the findings of such analysis shall be included in the records supplied to the review Panel. (Added 2011, No. 35, § 2, eff. May 18, 2011; amended 2019, No. 142 (Adj. Sess.), § 3.)

• § 1556. Rulemaking

  The Commissioner of Health, with the advice and recommendation of a majority of the members of the Panel, shall adopt rules pursuant to 3 V.S.A. chapter 25 related to the following:

  (1) The system for identifying and reporting maternal deaths to the Commissioner or designee.

  (2) The form and manner through which the Panel may acquire information under section 1555 of this title.

  (3) The protocol to be used in carefully and sensitively contacting a family member of the deceased woman for a discussion of the events surrounding the death, including allowing grieving family members to delay or refuse such an interview.

  (4) Ensuring de-identification of all individuals and facilities involved in the Panel’s review of cases. (Added 2011, No. 35, § 2, eff. May 18, 2011.)