(1) The general assembly finds and declares that: (a) Disparities in maternal and infant health-care access, delivery, and outcomes in Colorado persist, such that birthing people who are American Indian/Alaska Native are nearly three times more likely to die during pregnancy or within one year postpartum than the overall population of those giving birth in Colorado; (b) Birthing people who are Black are nearly two times more likely to die during pregnancy or within one year postpartum than the overall population of those giving birth in Colorado; (c) Birthing people living in frontier counties are more likely to die from pregnancy- related causes than those living in urban counties, and people insured through the medical assistance program are more likely to die during pregnancy or within one year postpartum than those with private insurance; (d) Discrimination contributed to half of all pregnancy-associated deaths in Colorado, and ninety percent of all deaths were deemed preventable by the Colorado maternal mortality review committee; (e) In 2022, the United States' infant mortality rate increased for the first time in two decades. Infants born to Black and Native American birthing people are two times more likely to die compared with their white and Hispanic counterparts. (f) The committee and the maternal health task force established by the department recommend statewide, universal participation in quality improvement initiatives led by the perinatal quality collaborative and the adoption of Alliance for Innovation on Maternal Health patient safety bundles; (g) The National Governors Association, through its maternal and infant health initiative, similarly recommends the adoption of patient safety bundles and increased funding for state maternal mortality review committees and perinatal quality collaboratives; (h) Ninety-six percent of births in Colorado occur in hospitals, and there is a need to provide practical support to hospitals, especially frontier and rural hospitals, for the implementation of clinical quality improvement initiatives; and (i) Participation in state perinatal quality collaboratives has been shown to improve maternal and infant health outcomes through improved access to, and the timeliness of, treatment and through reduced serious pregnancy complications. (2) As used in this section, unless the context otherwise requires: (a) "Engagement program" means the perinatal health quality improvement engagement program created in subsection (5) of this section. (b) "Hospital" means a hospital licensed or certified pursuant to section 25-1.5-103 that provides nonemergent perinatal care services. (c) "Quality improvement program" means the hospital perinatal health quality improvement program created in subsection (4) of this section. (3) (a) The department shall contract with the perinatal quality collaborative to: (I) Track statewide implementation of the committee's recommendations to prevent maternal mortality; (II) Implement hospital quality improvement programs through perinatal care settings to reduce preventable causes of maternal mortality and morbidity; and (III) Address disparate care of and outcomes among American Indian/Alaska Native and Black birthing populations, birthing people insured through the medical assistance program, and birthing people living in rural and frontier counties. (b) In implementing hospital quality improvement programs, the perinatal quality collaborative shall provide quality improvement program support that may include: (I) Clinical quality improvement science education concerning best practices and innovations to support optimal outcomes; (II) Tailored interventions designed to address the needs of priority populations; (III) Individualized program implementation guidance and support; (IV) Data reporting, analysis, and rapid response feedback for assistance in monitoring the sustainability of implemented changes; (V) Provider training in stigma, bias, and trauma-informed and respectful care; and (VI) Public recognition as a maternal and infant care quality champion. (c) The department shall provide vital statistics data to the perinatal quality collaborative for purposes of data analysis and reporting. The perinatal quality collaborative shall develop a data-sharing agreement with the department to identify specific vital statistics data that must be shared. The data-sharing agreement must address the confidentiality of data to ensure that data sharing is protected. (4) Hospital perinatal health quality improvement program. A hospital shall: (a) No later than July 1, 2025, and no later than July 1 each year thereafter, submit to the perinatal quality collaborative, either directly or through a statewide association of hospitals, a minimum data set of key drivers of disparities in perinatal health care and health-care outcomes, maternal mortality and severe maternal morbidity, and infant health care and health-care outcomes, including: (I) Cesarean deliveries; (II) Perinatal hypertension, sepsis, and cardiac conditions; (III) Maternal and neonatal readmissions and length of stay; (IV) Unexpected newborn complications; (V) Perinatal mental health and substance use conditions; (VI) Obstetric hemorrhage; and (VII) Preterm birth; and (b) Beginning December 15, 2025, participate annually in at least one maternal or infant health quality improvement initiative, as determined by the hospital, in collaboration with the perinatal quality collaborative pursuant to subsection (3) of this section, with the goal of: (I) Promoting evidence-based, culturally relevant, safe, equitable, high-quality care; and (II) Preventing maternal and infant mortality and severe morbidity. (5) Perinatal health quality improvement engagement program. (a) No later than July 1, 2025, the department shall create a perinatal health quality improvement engagement program that provides financial support to hospitals and facilities that provide emergent labor and delivery or perinatal care services that do not have sufficient resources to participate in one or more maternal or infant health quality improvement initiatives pursuant to subsection (4) of this section. (b) The department shall select hospitals and facilities that provide emergent labor and delivery or perinatal care services to participate in the engagement program and may contract with the perinatal quality collaborative to administer the engagement program. In order to participate in the engagement program, a hospital or facility must commit to work with the perinatal quality collaborative on the maternal or infant health quality improvement initiatives selected by the hospital or facility. (c) The department shall prioritize financial support for hospitals and facilities that: (I) Are in rural and frontier areas of the state; (II) Qualify for disproportionate share payments under the medical assistance program; or (III) Have lower-acuity maternal or neonatal levels of care designations. (d) Hospitals and facilities receiving financial support pursuant to the engagement program may use the financial support for quality improvement, including dedicated staff time, training costs, travel, continuing education, and data entry and technical assistance. (6) Collaboration with the perinatal quality collaborative. (a) The department shall contract with the perinatal quality collaborative to: (I) Track statewide implementation of the committee's recommendations, developed pursuant to section 25-52-104, to prevent maternal mortality; and (II) No later than July 1, 2026, and no later than July 1 each year thereafter, issue a report to the department concerning: (A) Clinical quality improvement efforts to reduce disparities in perinatal health outcomes and to prevent maternal and infant mortality and morbidity that includes relevant, aggregate hospital maternal and infant health quality metrics and that may be distributed to policymakers, health-care providers, hospitals and other health facilities, public health professionals, and other interested persons to assist the department in promoting data access and facilitating additional efforts to reduce maternal and infant mortality and morbidity; (B) Hospital participation in maternal and infant perinatal quality improvement initiatives pursuant to subsection (4)(b) of this section; (C) Implementation of the federal health resources and services administration maternal and child health bureau's and American College of Obstetricians and Gynecologists' alliance for innovation on maternal health patient safety bundles and related performance metrics, including the status of addressing drivers of perinatal health disparities and maternal and infant mortality and morbidity as described in subsection (4)(a) of this section; and (D) Areas of opportunity for ongoing improvement. (b) In compliance with all applicable state and federal laws relating to the publication of health information and legally binding data use agreements, the perinatal quality collaborative and the department shall make an aggregated and de-identified report prepared pursuant to subsection (6)(a)(II) of this section publicly available on the department's website and on the website of the perinatal quality collaborative. (c) The perinatal quality collaborative shall consult with a statewide association of hospitals and with diverse hospital leadership to support ongoing hospital engagement in quality improvement and to advise practitioners in clinical settings across the state on the advancement of best practices to reduce maternal and infant mortality and morbidity. (d) Data submitted pursuant to subsection (4)(a) of this section is considered confidential and proprietary, contains trade secrets, or is not a public record pursuant to part 2 of article 72 of title 24 and is only reportable in an aggregated and de-identified manner.
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