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Initiative: State Prematurity Task Force

Model Legislative Language for Prematurity Task Force

Notes:

  1. Text in blue must be customized for your state. See endnotes for sources.
  2. Section 3 & 4 contains optional language relating to RSV access. Please determine the appropriateness of this language for the specific state.

SECTION 1. Findings.

The General Assembly finds that:

  1. Infants born premature at less than 37 weeks gestational age have greater morbidity and mortality than full-term infants.
  2. In 2006, 12.8 percent of all births in the United States were premature, accounting for more than 542,000 infants.
  3. In [state], [1] in [8] babies were born premature in 2006, or [13.3]% of live births, accounting for [23,955] premature births.1
  4. Between 1996 and 2006, the rate of infants born premature in [state] increased nearly [15]%.2
  5. The rate of premature birth in [state] is highest in African American infants (19.3%), followed by Native Americans (15.6%), Hispanics (12.1%) and Caucasians (11.9%).3
  6. Approximately 70% of premature births occur in the late preterm period between 34 and 36 completed weeks of gestation, and late-preterm babies have significant differences in clinical outcomes than full-term infants including greater risk for temperature instability, hypoglycemia, respiratory distress, and jaundice.
  7. In 2005, preterm birth cost the United States at least $26.2 billion, or $51,600 for every infant born prematurely.
  8. Medical costs for premature babies are greater than they are for healthy newborns. In 2007, the average medical costs for a preterm baby were more than 10 times as high as they were for a healthy full-term baby. The costs for a healthy baby from birth to his first birthday were $4,551. For a preterm baby, the costs were $49,033.
  9. The direct healthcare costs to employers for premature infants during their first year of life are 15 times greater and average $41,610 compared to $2,830 for babies born healthy and full-term.
  10. The costs of premature birth to [state] may be significant because the state Medicaid program paid for [40]% of all births in 2003.4
  11. Premature infant standard of care practices of clinicians and hospitals may vary across the state, particularly for late preterm births.
  12. There are no standardized procedures for hospital discharge and follow-up care of premature infants, and as a result, babies born premature may leave the hospital after birth without adequate discharge and follow-up care plans in place to ensure they receive appropriate care to address their special health needs once they are home in their community.
  13. Without organized discharge care plans, premature babies are more likely to experience gaps in healthcare and medical complications including re-hospitalization.
  14. The most frequent causes of re-hospitalization for premature infants are RSV bronchiolitis, bronchiolitis (cause unspecified), pneumonia (cause unspecified), esophageal reflux and vascular implant complications.
  15. Because all premature infants, and especially late-preterm infants born at 34 through 36 weeks gestational age, have higher risks for medical complications and re-hospitalizations compared to full-term infants, the state should develop standards of care for premature infants and measurably improve the quality of healthcare for premature infants within their first year of life.

SECTION 2. [State] Task Force on Prematurity

  1. There is created the [State] Task Force on Prematurity to consist of [x] members, appointed as follows:
    1. list the number of members; the legislative body, agency or organization of the appointee; and whom appoints5
  2. The members of the task force shall be appointed by [date].
  3. Members shall serve at the pleasure of the appointing authority.
  4. A majority of a quorum from among the task force membership shall elect co-chairs of the task force.
  5. A majority vote of a quorum of the task force is required for any action.
  6. The task force shall meet and conduct business at least quarterly or as called either by the co-chairs or a majority of a quorum. All meetings of the task force, including meetings of committees, shall be open to the public with opportunities for public comments on a regular basis.
  7. The task force may establish committees that will be responsible for conducting specific projects.
  8. The [Bureau of Legislative Research; Department of Health; Maternal & Child Health Bureau, etc.] shall provide staff support to the task force as necessary to assist the task force in the performance of its duties.
  9. Members of the task force who are not legislators, state officials or state employees may be reimbursed for mileage and actual expenses incurred in the performance of their duties if funds are available for this purpose. Legislative members attending task force meetings may be reimbursed for expenses from the same source as provided by law for members of the General Assembly attending meetings of interim committees.
  10. Vacancies on the task force shall be filled as soon as possible by the appointing authority.

SECTION 3. Goal.

  1. 1) The goal of the [State] Task Force on Prematurity is:
    1. Develop standards of care for premature infants born less than 37 weeks gestational age to help improve their access to and quality of care in their first year of life.
    2. Examine and make recommendations to improve hospital discharge and follow-up care procedures to promote coordinated processes as premature infants leave the hospital from either a Level 1 (well baby nursery), Level 2 (step down or transitional nursery) or Level 3 (neonatal intensive care unit) unit and transition to follow-up care by a healthcare provider in the community.
    3. Urge hospitals serving infants eligible for medical assistance and child health assistance to report to the state the causes and incidence of all re-hospitalizations of infants born premature at less than 37 weeks gestational age within their first six months of life.
    4. Develop recommendations for quality measures to assess healthcare outcomes of premature infants.
    5. Develop recommendations to ensure access to preventive healthcare therapies to protect premature infants from common infectious diseases, including respiratory syncytial virus.
    6. Measurably improve the quality of care for premature infants through advocacy of evidenced-based approaches and proposals for legislation, regulation, and public policy change.

SECTION 4. Duties.

  1. The [State] Task Force on Prematurity shall collaborate with and make recommendations to the [state] General Assembly through the [list relevant legislative committees] to improve premature infant healthcare in the State of [state].
  2. The task force shall:
    1. Review relevant evidence-based research regarding premature infant healthcare and seek input from public and private entities currently associated with treatment of prematurity.
    2. Develop recommendations and strategies to improve healthcare for premature infants by:
      1. Developing standards of care for premature infants born less than 37 weeks gestational age pursuant to section 3 of this act.
      2. Coordinating information among appropriate professional and advocacy organizations on measures to improve healthcare for infants born premature; and
      3. Issuing findings of goals, objectives, strategies and tactics to improve premature infant healthcare in [state].

SECTION 5. Expiration.

The [State] Task force on Prematurity shall expire on [insert date].

Pull-through deliverables:

  1. Establish a state Prematurity Task Force with membership (i.e., legislative supporters, advocates) that is favorable to MedImmune’s common goals.
  2. Work with Task Force to implement recommendations and standards that support appropriate access to Synagis, including (a) access to preventive therapies to protect against infectious disease, including RSV; (b) standards for hospital discharge and follow-up care that support tracking and compliance with RSV prophylaxis; (c) reporting of premature infant re-hospitalization rates and causes.
  1. Find data for your state at: http://www.marchofdimes.com/peristats/
  2. Find data for your state at: http://statehealthfacts.org/comparetable.jsp?ind=223&cat=4&sub=57&yr=58&typ=2&sort=a
  3. See examples from Arkansas and Mississippi