Comprehensive authority and protections codified in state legislation, regulation, or other public health rules are the bedrock of the Maternal Mortality Review Committee (MMRC). Without them, MMRCs cannot carry out key functions of the public health surveillance process.
Efforts to establish or strengthen a MMRC should include a review of the state’s laws and regulations to determine which protections and authorities are already in place for the MMRC to operate. Public health attorneys in your state health department can be instrumental in this review and understanding the implications of existing laws and regulations.
Authority and protections for MMRCs must protect the intent of the public health surveillance process. The purpose of the MMRC is not to find fault or assign blame to individual providers or hospitals but to look for opportunities to prevent maternal deaths within and across cases for population level action. It is distinct from and not a substitute for hospital peer review committees, root cause analysis, or complaint investigations.
To assist emerging or established MMRCs in evaluating their authority and protections, the following six key components of authority and protections for MMRCs should be in place. To see examples of each of the components as written in state legislation, read the Key Components of MMRC Authorities and Protections resource, linked below.
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COMMUNICATION METHOD
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RATIONALE & OBJECTIVE
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Authority to Access Data
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Case abstractors should be able to collect at a minimum vital records, hospitalization and prenatal care records, and autopsy reports. Other desirable data sources include interviews with family members or police reports. Pointing to clear authority in legislation can facilitate compliance with data requests. |
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Confidentiality and Protection of Collected Data, Proceedings and Activities
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Confidentiality for MMRCs refers to the legal protection of information collected as part of the review process and the protection of the MMRC’s discussions and findings from discovery or subpoena. Strong confidentiality protections can facilitate participation in reviews and the sharing of data and information. |
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Immunity for Committee Members
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Immunity protects MMRC members as well as any witnesses or others providing information from personal liability based on activities during the review process. Immunity facilitates full participation in the review process. |
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Regular Reporting and Dissemination of Findings
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Specifying how often and to whom/to what entity the MMRC will report its findings and recommendations helps keep the MMRC as a public health priority for the state and facilitates dissemination of best practices. |
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Multidisciplinary Committee With Local Input
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The MMRC members should represent a variety of clinical and psychosocial specializations and members working in and representing diverse communities and from different geographic regions in the state. Specifying representation can facilitate diversity and inclusion of key stakeholder groups. |
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Ability to Share De-identified Data and Findings Locally and Regionally
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Flexible authority for limited access to MMRC data for research and to collaborate with other jurisdictions helps MMRCs overcome challenges presented by the identification of trends from small caseloads or cases where the place of residence and place of death are in different states; it also enables the MMRC to participate in activities to advance regional or national priorities in maternal mortality prevention. |
Key Components of MMRC Authorities and Protections