A3769

An Act concerning fetal death certification and reporting, amending R.S.26:6-11 and P.L.2013, c.217, and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. (New section) No later than 90 days after the effective date of this act, the Commissioner of Health shall adopt rules and regulations, or revise or repeal its existing rules and regulations, as appropriate, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), to ensure that the regulatory requirements and guidelines applicable to fetal death certification and fetal death reporting are consistent with revised standards adopted in 2003 by the federal Centers for Disease Control and Prevention (CDC). On a biennial basis thereafter, the commissioner shall review the rules and regulations pertaining to fetal death certification and fetal death reporting, and shall revise or repeal those rules or regulations as may be necessary to ensure that they remain consistent with the most recent CDC standards and guidelines in this area.

2. R.S.26:6-11 is amended to read as follows:

26:6-11. A certificate of fetal death containing such items as shall be listed on fetal death certificate forms provided or approved by the department under the authority of [section 26:8-24(c) of the Revised Statutes] subsection c. of R.S.26:8-24, and a burial or removal permit , shall be required for every fetal death; provided [,] that 20 or more weeks of gestation has elapsed before the delivery.

No midwife shall sign a certificate for a fetal death; but any fetal death occurring without attendance of a physician shall be treated as a death without medical attendance, as provided in [section] R.S.26:6-9 [of this Title].

In accordance with the provisions of section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill), the department shall take appropriate action to ensure that any certificate of fetal death required by this section is prepared in accordance with, and contains information that satisfies, the current standards for fetal death certification and fetal death reporting that have been adopted by the federal Centers for Disease Control and Prevention.

(cf: P.L.1965, c.78, s.8)

3. Section 3 of P.L.2013, c.217 (C.26:8-40.29) is amended to read as follows:

3. The Department of Health shall establish a fetal death evaluation protocol, which a hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall follow in collecting data relevant to each stillbirth. In accordance with the provisions of section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill), the department shall take appropriate action to ensure that the fetal death evaluation protocol established under this section is consistent with the current standards for fetal death certification and fetal death reporting that have been adopted by the federal Centers for Disease Control and Prevention. The information [required] to be collected under the fetal death evaluation protocol shall include, but not be limited to:

a. the race, age of the mother, maternal and paternal family history, comorbidities, prenatal care history, antepartum findings, history of past obstetric complications, exposure to viral infections, smoking, drug and alcohol use, fetal growth restriction, placental abruption, chromosomal and genetic abnormalities obtained pre-delivery, infection in premature fetus, cord accident, including evidence of obstruction or circulatory compromise, history of thromboembolism, and whether the mother gave birth before; [and] b. documentation of the evaluation of a stillborn child, placenta, and cytologic specimen that conform to the standards established by the American College of Obstetricians and Gynecologists and meet any other requirements deemed by the Commissioner of Health as necessary, including, but not limited to, the following components:

(1) if the parents consent to a complete autopsy: the weight of the stillborn child and placenta, head circumference, length of stillborn child, foot length if stillbirth occurred before 23 weeks of gestation, and notation of any dysmorphic feature; photograph of the whole body, frontal and profile of face, extremities and palms, close-up of any specific abnormalities; examination of the placenta and umbilical cord; and gross and microscopic examination of membranes and umbilical cord; or

(2) if the parents do not consent to a complete autopsy, an evaluation of a stillborn child as set forth in paragraph (1) of this subsection, and appropriate alternatives to a complete autopsy, including a placental examination, external examination, selected biopsies, X-rays, MRI, and ultrasound ; and

c. any other relevant information, which is consistent with the current standards for fetal death certification and fetal death reporting that have been adopted by the federal Centers for Disease Control and Prevention.

(cf: P.L.2013, c.217, s.3)

4. This act shall take effect immediately.

STATEMENT

This bill would require the Commissioner of Health to adopt, revise, or repeal rules and regulations related to fetal death certification and fetal death reporting, in order to ensure that such rules and regulations are consistent with current federal standards.

Although the federal Centers for Disease Control and Prevention (CDC) revised the federal standards applicable to fetal death certification and fetal death reporting in 2003, it does not appear that the Department of Health has formally updated its fetal death protocols to comport with the revised federal guidelines in this area. This bill would, therefore, require the commissioner, within 90 days after the bill’s effective date, to update the department’s rules and regulations on fetal death, in order to make them consistent with the revised federal standards adopted in 2003, and it would additionally require the commissioner to make regular, biennial updates to the rules and regulations, as may be necessary to ensure that they continue to comport with the most current federal standards applicable to fetal death.