HB 598-FN - AS INTRODUCED
2023 SESSION
23-0630
06/08
HOUSE BILL 598-FN
AN ACT relative to funding maternal mortality reviews.
SPONSORS: Rep. Edwards, Rock. 31; Rep. Roy, Rock. 31; Rep. M. Pearson, Rock. 34
COMMITTEE: Health, Human Services and Elderly Affairs
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ANALYSIS
This bill establishes a dedicated fund for maternal mortality reviews.
This bill redirects a portion of marriage license and marriage officiate fees to fund maternal mortality reviews.
This bill increases the fines from $50 to $250 for domestic violence to increase domestic violence funding.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23-0630
06/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to funding maternal mortality reviews.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; State Treasurer and State Accounts; Application of Receipts; Special Fund for Administration of Maternal Mortality Review. Amend RSA 6:12, I(b) by inserting after subparagraph (387) the following new subparagraph:
(388) Moneys deposited in the special fund for administration of maternal mortality review established in RSA 132:31-a.
2 New Section; Protection for Maternity and Infancy; Special Fund for Administration of Maternal Mortality Review; Established. Amend RSA 132 by inserting after section 31 the following new section:
132:31-a Special Fund for Maternal Mortality Review; Established. There is hereby established a special fund for administration of maternal mortality review. The fund shall be composed of marriage license fees collected by the commissioner in accordance with RSA 457:29 and special marriage officient license fees collected by the commissioner in accordance with RSA 457:32-b and shall be used in whole or in part to carry out the provisions of the maternal mortality review panel established in RSA 132:30 including, but not limited to:
I. Enhanced maternal mortality data abstraction and analysis.
II. Quality improvement efforts at hospitals with birthing facilities to ensure respectful, equitable and supportive care, to improve patient safety, and to optimize coordination of care before, during and after pregnancy.
III. Improving coordination and transition of care for individuals with chronic health conditions before, during and after pregnancy.
IV. Increased access for pregnant and postpartum individuals to substance misuse screening, treatment and recovery programs.
V. Screening for mental health conditions and suicide risk and linkage to appropriate mental health services, treatment and support.
VI. Public outreach and education to raise awareness of urgent maternal health warning signs during and after pregnancy and to improve communication between patients and their healthcare providers.
3 Documentation of Marriages; Marriage License Fee. Amend RSA 457:29 to read as follows:
457:29 Marriage License Fee. The fee for the marriage license shall be $50 to be paid by the parties entering into the marriage. The clerk shall forward $43 from each fee to the department of health and human services for [the purposes of RSA 173-B:15] deposit into the special fund for maternal mortality review established in RSA 132:31-a. The clerk shall retain the remaining $7 as the fee for making the records of notice, issuing the certificate of marriage, and forwarding the $43 portion of the marriage license fee.
4 Solemnization of Marriage; Special Marriage Officiant License. Amend RSA 457:32-b, I to read as follows:
I. The secretary of state may issue a special marriage officiant license, which shall temporarily authorize an individual to solemnize a marriage in this state. Any individual who applies for the special marriage officiant license shall register with the secretary of state, complete the registration form prescribed by the secretary of state, and submit an $85 fee to the department of state. The secretary of state shall forward $80 of the fee to the department of health and human services for deposit in the special fund for maternal mortality [for domestic violence programs, established in] RSA [173-B:15] 132:31-a, and shall retain the remainder of the fee for administrative costs associated with issuance of the license.
5 Assault and Related Offenses; Domestic Violence. Amend RSA 631:2-b, V to read as follows:
V. In addition to any other penalty authorized by law, the court shall levy a fine of [$50] $250 for each conviction under this section. The court shall not reduce or suspend any sentence or the payment of any fine imposed under this section. If the court determines that the defendant is unable to pay the fine on the date imposed, the court may defer payment or order periodic payments thereof. Fines imposed under this section shall not be subject to an additional penalty assessment and shall not be subject to the provisions of RSA 618:8 or 618:9. The clerk shall forward all fines collected under this paragraph to the department of health and human services for the purposes of RSA 173-B:15.
6 Effective Date. This act shall take effect July 1, 2023.
23-0630
Revised 2/8/23
HB 598-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to funding maternal mortality reviews.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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| Estimated Increase / (Decrease) | |||
STATE: | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - | |||
METHODOLOGY:
This bill establishes a special fund for administration of maternal mortality reviews, which will be funded by the state portion of marriage license revenue ($43 per license, established in RSA 457:29) and special marriage officiant license revenue ($80 per license, established in RSA 457:32-b). Currently, these revenues are deposited into a special fund for domestic violence programs. The Department of State notes that in FY22, the state issued 9,213 marriage licenses, resulting in $396,159 deposited into the fund for domestic violence programs. Also in FY22, the State issued 624 special marriage officiant licenses, resulting in $49,920 deposited into the fund for domestic violence programs. Combined, these two revenue sources generated $446,079, which under this bill will now be allocated to the fund for administration of maternal mortality reviews.
To replace the revenue lost from the above changes, the bill raises from $50 to $250 the fine assessed for domestic violence convictions under RSA 631:2-b, V. This revenue is deposited into the fund for domestic violence programs, which is administered by the Department of Health and Human Services. That Department did not provide any information on the fiscal impact of this change. The Department did, however, provide information on the cost of enhancing and/or supplementing activities that are administered by its Division of Public Health Services, Maternal and Child Health Section. These enhanced efforts, which the Department states would be necessary to comply with the terms of the bill, consist of the following:
• Enhanced maternal mortality data abstraction and analysis, to be accomplished by contracting for additional hours (10 percent of a full-time equivalent (FTE) position) with a maternal health epidemiologist.
• Quality improvement efforts at hospitals with birthing facilities. This work is currently being performed through a contract with the Northern New England Perinatal Quality Improvement Network (NNEPQIN). The Department states that additional efforts would require increased funds for NH birthing facilities.
• Improved coordination and transition of care for individuals with chronic health conditions before, during and after pregnancy. This will require additional services to be added to contracts that provide coordination of care referrals for women with chronic health conditions before, during and after pregnancy. The Department states that these measures will come at an indeterminable cost.
• Increased access for pregnant and postpartum individuals to substance misuse screening, treatment and recovery programs.
• Screening for mental health conditions and suicide risk and linkage to appropriate mental health services, treatment and support.
• Public outreach and education to raise awareness of urgent maternal health warning signs during and after pregnancy and to improve communication between patients and their healthcare providers.
These enhanced screening, access and communication efforts would require additional funds be added to the NNEPQIN contracts and health center contracts to increase efforts and expand the scope of service.
The Department estimates a cost of $700,000 per year to conduct the above activities. The Department has provided information relative to the cost of certain positions (for example, approximately $14,000 per year to increase the above-mentioned epidemiology position by 10 percent of an FTE, and approximately $26,000 per year to increase in-house maternal and child health positions by 25 percent of an FTE), but did not provide information on how the various components total $700,000 per year.
AGENCIES CONTACTED:
Departments of State and Health and Human Services