(1) The Colorado maternal mortality review committee is hereby created in the department for the purposes of: (a) Reviewing specific cases of maternal death that occur in Colorado; (b) Identifying the causes of maternal mortality; and (c) Developing recommendations to address preventable maternal deaths, including legislation, policies, rules, training, and best practices that will support the health and safety of the pregnant and postpartum population in Colorado and prevent maternal deaths. (2) (a) By October 1, 2019, the executive director of the department shall appoint at least eleven members to serve on the committee. The term of appointment is three years; except that the term of the first six members appointed is two years. Members may serve up to three terms. The executive director may fill any vacancies on the committee. (b) In appointing members to the committee, the executive director shall: (I) Follow best practices as outlined by the centers for disease control and prevention in the federal department of health and human services; (II) Ensure that committee members represent diverse communities and a variety of clinical, forensic, and psychosocial specializations and community perspectives, including community-based midwifery; and (III) Make an effort to include committee members working in and representing communities that are: (A) Diverse with regard to race, ethnicity, immigration status, English proficiency, income, wealth, and geographic region of the state, including both urban and rural areas; and (B) Affected by higher rates of maternal mortality and by a lack of access to the full scope of maternity care health services. (c) The members of the committee who reside more than fifty miles from the location of a committee hearing are entitled to receive the same per diem compensation and reimbursement of expenses as those provided for members of boards and commissions pursuant to section 12- 20-103 (6), and for expenses incurred in traveling to and from the meetings of the committee, including any required dependent or attendant travel, food, and lodging. Members of the committee are also entitled to reimbursement for any expenses necessary to support the members' participation at a committee hearing, including any dependent or attendant care. (3) The committee may form special ad hoc panels to further investigate cases of maternal death resulting from specific causes when the need arises. (4) The committee shall: (a) Review each death in Colorado that is a maternal death; (b) Review medical records and other relevant data related to each maternal death; (c) Take steps to improve the quality and scope of data obtained through investigations and review of maternal deaths; (d) Identify the causes of maternal mortality, including any trends and patterns across racial, geographic, and other groups; (e) Develop recommendations for the prevention of maternal mortality and deliver the recommendations to the department; (f) Perform any other functions as resources allow to enhance the capability of the state to reduce and prevent maternal mortality; and (g) Advise the department in the department's work on decreasing maternal mortality. (5) The department shall: (a) Compile reports of aggregated, nonindividually identifiable data on a routine basis for distribution in an effort to further study the causes and problems associated with maternal mortality that may be distributed to policymakers, health-care providers, health facilities, behavioral health providers, public health professionals, the health equity commission created in section 25-4-2206, and others necessary to reduce the maternal mortality rate; (b) Serve as a link with maternal mortality review teams throughout the country and participate in regional or national maternal mortality review team activities; (c) Incorporate input and feedback from: (I) Interested and affected stakeholders, with a focus on persons who are pregnant or in the postpartum period and their family members; (II) Multidisciplinary, nonprofit organizations representing persons who are pregnant or in the postpartum period, with a focus on persons from racial and ethnic minority groups; and (III) Multidisciplinary, community-based organizations that provide support or advocacy for persons who are pregnant or in the postpartum period, with a focus on persons from racial and ethnic minority groups; (d) Make recommendations to improve the collection and public reporting of maternal health data from hospitals, health systems, insurers, maternal care providers, pharmacies, local and state law enforcement offices, behavioral health treatment facilities, and substance use disorder treatment facilities, including: (I) Data on race and ethnicity correlated with conditions and outcomes; disability correlated with conditions and outcomes; uptake of trainings on bias, racism, or discrimination; and incidents of disrespect or mistreatment of a pregnant person; and (II) Data collected through stories from pregnant and postpartum persons and their family members, with a focus on the experiences of marginalized groups including persons of racial and ethnic minority groups; and (e) Study the use of research evidence in policies related to the perinatal period in Colorado and, no later than September 1, 2023, report to the senate committee on health and human services and the house of representatives committee on health and insurance, or their successor committees, on the use of research evidence in policies related to the perinatal period in the state, including public and private payment systems and malpractice insurance policies, using the implementation science framework. To fulfill the requirements of this subsection (5)(e), the department may contract with a third party and request information from insurers offering medical malpractice policies in the state regarding the insurer's policies related to labor and delivery services. (5.5) The department may contract with an independent third-party evaluator to: (a) Study closures, consolidations, and acquisitions related to perinatal health-care practices and facilities and perinatal state-designated health professional shortage areas, as defined in section 25-1.5-402 (11), and assets and deficits related to perinatal health and health- care services across the state, not limited to obstetric providers; (b) Identify major outcome categories at the clinical, family, community, and provider levels that the department should track over time and identify risks and opportunities related to closures, consolidations, and acquisitions of perinatal health-care practices and facilities; (c) Explore the effects of practice and facility closures on maternal and infant health outcomes and experiences, to illustrate structural needs around closures, when applicable; (d) Identify recommendations during practice and facility closures and resultant transfers of care. The department or third-party evaluator may use both primary and secondary data in making the recommendations. The department or third-party evaluator shall use the map created pursuant to subsection (5.5)(f) of this section in developing the recommendations. The recommendations must: (I) Include solutions at the facility level, the practice level, the workforce level, the community level, and the patient level; (II) Include minimum requirements for reporting on closures, including metrics on timelines and geographic area, including whether the timeline created in section 25-3-131 is appropriate; (III) Develop recommendations on primary and secondary data collection related to closures and resultant transfers of care. (e) Identify best practice guidelines during practice and facility closures and resultant transfers of care. The third-party evaluator may use both primary and secondary data in identifying the best practice guidelines. The third-party evaluator shall use the map created pursuant to subsection (5.5)(f) of this section in developing the guidelines. The guidelines must consider the following areas: Risks and opportunities; transfers of care; community notice needs and opportunities; notification to the department; closure timeline; and resources needed by facilities, providers, and families. (f) Create a health professional shortage area and perinatal health services assets and deficits asset map that identifies by perinatal service area: (I) Primary health-care providers, including physicians and midwives of all credential types who provide or could be providing perinatal health care; (II) The type and location of perinatal health care offered by the providers listed pursuant to subsection (5.5)(f)(I) of this section; (III) Community-based perinatal health-care workers, such as doulas, childbirth educators, and lactation support consultants; and (IV) Resources such as community advocates, gathering places, and educational hubs; (g) By July 1, 2026, deliver the best practices and recommendations created pursuant to this subsection (5.5) to the house of representatives health and human services committee and the senate health and human services committee, or their successor committees. (6) (a) No later than July 1, 2020, and July 1 every three years thereafter, the department shall submit a report to the house of representatives committees on public and behavioral health and human services and health and insurance and the senate committee on health and human services, or their successor committees. The report must include: (I) In consultation with health equity experts, recommendations to achieve equity in maternal health outcomes in Colorado; (II) Recommendations to reduce the incidence of preventable maternal mortality and related morbidity; (III) A prioritization of a limited number of causes of maternal mortality that are identified as having the greatest impact on the pregnant and postpartum population in Colorado and as most preventable; (IV) In consultation with the designated state perinatal care quality collaborative, recommendations for clinical quality improvement approaches that could reduce the incidence of pregnancy-related deaths or maternal mortality or morbidity in prenatal, perinatal, and postnatal clinical settings and recommendations for how to spread best practices to clinical settings across the state; and (V) Repealed. (b) The department shall post the report prepared in accordance with this subsection (6) on its website. (c) Notwithstanding section 24-1-136 (11)(a)(I), the reporting required by this subsection (6) continues indefinitely.
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