                                 CODE OF VIRGINIA

MATERNAL MORTALITY REVIEW TEAM; DUTIES; MEMBERSHIP; CONFIDENTIALITY; PENALTIES;
REPORT; ETC (§ 32.1-283.8)

A. As used in this section, &#8220;maternal death&#8221; means the death of a
woman who was pregnant at the time of death or within one year prior to the time
of death, regardless of the outcome of the pregnancy, including any death
determined to be a natural death, unnatural death, or violent death or for which
no cause of death was determined.

B. There is hereby created the Maternal Mortality Review Team (the Team), which
shall develop and implement procedures to ensure that certain maternal deaths
occurring in the Commonwealth are analyzed in a systematic way. The Team shall
review every maternal death in the Commonwealth. The Team shall not initiate a
maternal death review until the conclusion of any law-enforcement investigation
or criminal prosecution. The Team shall (i) develop and revise as necessary
operating procedures for maternal death reviews, including identification of
cases to be reviewed and procedures for coordinating among the agencies and
professionals involved; (ii) improve the identification of and data collection
and record keeping related to causes of maternal deaths; (iii) recommend
components of programs to increase awareness and prevention of and education
about maternal deaths; and (iv) recommend training to improve the review of
maternal deaths. Such operating procedures shall be exempt from the
Administrative Process Act (&#xA7; 2.2-4000 et seq.) pursuant to subdivision B
17 of &#xA7; 2.2-4002.

C. The Team shall consist of the following persons or their designees: the Chief
Medical Examiner, the Director of the Office of Family Health of the Department
of Health, the State Registrar of Vital Records, and the Commissioner of
Behavioral Health and Developmental Services. In addition, the Governor shall
appoint one representative of each of the following entities: local law
enforcement, local fire departments, local emergency medical services providers,
local departments of social services, community services boards, attorneys for
the Commonwealth, the Medical Society of Virginia, the Virginia Hospital and
Healthcare Association, the Virginia College of Emergency Physicians, the
Virginia Section of the American College of Obstetricians and Gynecologists, the
Virginia Affiliate of the American College of Nurse-Midwives, the Virginia
Chapter of the Association of Women&#8217;s Health, Obstetric and Neonatal
Nurses, the Virginia Neonatal Perinatal Collaborative, the Virginia Midwives
Alliance, the Virginia Academy of Nutrition and Dietetics, the Department of
Corrections, and the State Board of Local and Regional Jails. The Chief Medical
Examiner and the Director of the Office of Family Health of the Department of
Health shall serve as co-chairs of the Team and may appoint additional members
of the Team as may be needed to complete maternal death reviews pursuant to this
section.
			After the initial staggering of terms, members other than the Chief Medical
Examiner, the Director of the Office of Family Health of the Department of
Health, the State Registrar of Vital Records, the Commissioner of Behavioral
Health and Developmental Services, and the Director of the Department of
Criminal Justice Services shall be appointed for a term of three years.
Appointments to fill vacancies, other than by expiration of a term, shall be for
the unexpired terms. Vacancies shall be filled in the same manner as the
original appointments. All members may be reappointed. The Chief Medical
Examiner, the Director of the Office of Family Health of the Department of
Health, the State Registrar of Vital Records, the Commissioner of Behavioral
Health and Developmental Services, and the Director of the Department of
Criminal Justice Services shall serve terms coincident with their terms of
office.

D. Upon the request of the Chief Medical Examiner in his capacity as a co-chair
of the Team, made after the conclusion of any law-enforcement investigation or
prosecution, the Chief Medical Examiner or his designee may inspect and copy
information and records regarding a maternal death, including (i) any report of
the circumstances of the maternal death maintained by any state or local
law-enforcement agency or medical examiner, and (ii) information or records
about the woman maintained by any social services agency or court. Information,
records, or reports maintained by any attorney for the Commonwealth shall be
made available for inspection and copying by the Chief Medical Examiner or his
designee pursuant to procedures that shall be developed by the Chief Medical
Examiner and the Commonwealth&#8217;s Attorneys&#8217; Services Council
established by &#xA7; 2.2-2617. Any presentence report prepared pursuant to
&#xA7; 19.2-299 for any person convicted of a crime that led to the death of the
woman shall be made available for inspection and copying by the Chief Medical
Examiner or his designee. In addition, the Chief Medical Examiner or his
designee may inspect and copy from any health care provider in the Commonwealth,
on behalf of the Team, (a) without obtaining consent, subject to any limitations
on disclosure under applicable federal and state law, the health and mental
health records of the woman and those prenatal medical records relating to any
child born to the woman and (b) upon obtaining consent, from each adult
regarding his records.

E. All information and records obtained or created by the Team or on behalf of
the Team regarding a review shall be confidential and excluded from the Virginia
Freedom of Information Act (&#xA7; 2.2-3700 et seq.) pursuant to subdivision 7
of &#xA7; 2.2-3705.5. All such information and records shall be used by the Team
only in the exercise of its proper purpose and function and shall not be
disclosed. In preparing information and records for review by the Team, the
Department shall remove any individually identifiable information or information
identifying a health care provider, as those terms are defined in 45 C.F.R.
&#xA7; 160.103. Such information shall not be subject to subpoena, subpoena
duces tecum, or discovery, be admissible in any civil or criminal proceeding, or
be used as evidence in any disciplinary proceeding or regulatory or licensure
action of the Department of Health Professions or any health regulatory board.
If available from other sources, however, such information and records shall not
be immune from subpoena, discovery, or introduction into evidence when obtained
through such other sources solely because the information and records were
presented to the Team during a maternal death review. The findings of the Team
may be disclosed or published in statistical or other form, but shall not
identify any individual. Upon conclusion of the maternal death review, all
information and records concerning the woman and the woman&#8217;s family shall
be shredded or otherwise destroyed by the Office of the Chief Medical Examiner
in order to ensure confidentiality.
			The portions of meetings in which individual maternal deaths are discussed by
the Team shall be closed pursuant to subdivision A 21 of &#xA7; 2.2-3711. In
addition to the requirements of &#xA7; 2.2-3712, all Team members and other
persons attending closed Team meetings, including any persons presenting
information or records on specific maternal deaths to the Team during closed
meetings, shall execute a sworn statement to (i) honor the confidentiality of
the information, records, discussions, and opinions disclosed during meetings at
which the Team reviews a specific maternal death and (ii) not use any such
information, records, discussions, or opinions disclosed during meetings at
which the Team reviews a specific maternal death for any purpose other than the
exercise of the proper purpose and function of the Team. Violations of this
subsection are punishable as a Class 3 misdemeanor.

F. Upon notification of a maternal death, any state or local government agency
maintaining records on the woman or the woman&#8217;s family that are
periodically purged shall retain such records for the longer of 12 months or
until such time as the Team has completed its review of the case.

G. The Team shall compile annual statistical data, which shall be made available
to the Governor and the General Assembly. Any statistical compilations prepared
by the Team shall be public record and shall not contain any personal
identifying information.

H. Members of the Team, as well as their agents and employees, shall be immune
from civil liability for any act or omission made in connection with
participation in a review by the Team, unless such act or omission was the
result of gross negligence or willful misconduct. Any organization, institution,
or person furnishing information, data, testimony, reports, or records to the
Team as part of such review shall be immune from civil liability for any act or
omission in furnishing such information, unless such act or omission was the
result of gross negligence or willful misconduct.

HISTORY: 2019, c. 834; 2023, c. 369; 2024, c. 376.