Virginia Law

Article 25. Severe Maternal Morbidity Surveillance and Review Program.

A. For the purposes of this section:

"Severe maternal morbidity" means unintended outcomes of the process of labor and delivery that result in significant short-term or long-term consequences to a woman's health.

"SMM Program" means the Severe Maternal Morbidity Surveillance and Review Program established pursuant to this article.

B. The Department shall:

1. Establish the Severe Maternal Morbidity Surveillance and Review Program for the purpose of identifying, analyzing, and reviewing instances of severe maternal morbidity;

2. Develop a reporting system for hospitals and freestanding birthing centers to report findings and recommendations;

3. Develop a severe maternal morbidity surveillance case definition aligned with evidence-based practice and reflecting stakeholder subject matter expertise; and

4. Develop a model protocol for the development and implementation of severe maternal mortality advisory boards established pursuant to subsection C. Such model protocol shall include relevant procedures for conducting reviews of severe maternal morbidity.

C. Each hospital and freestanding birthing center shall participate in the SMM Program and shall:

1. Establish an advisory board to review severe maternal morbidity cases. Such advisory board shall consist of a multidisciplinary group of health care providers, experts in maternal care, and community members, including:

a. At least one representative from a community-based organization primarily serving minority populations with high rates of maternal mortality or morbidity;

b. At least one community-based doula or midwife with experience in providing perinatal support; and

c. Other relevant community members, as deemed appropriate by the hospital or freestanding birth center.

2. Review all severe maternal morbidity events using the severe maternal morbidity surveillance case definition;

3. Identify the drivers, risk factors, and causes of severe maternal morbidity;

4. Engage in quality improvement efforts regarding severe maternal morbidity based on the reviews;

5. Determine whether severe maternal morbidity events were potentially preventable;

6. Make recommendations to reduce the prevalence of severe maternal morbidity in the Commonwealth; and

7. Report its findings and recommendations to the Department on an annual basis at a time and through a reporting system specified by the Department.

D. The Department shall analyze reports submitted pursuant to subdivision C 7 and incorporate recommendations as part of the annual report released by the SMM Program. The SMM Program shall also work collaboratively with the Maternal Mortality Review Team established pursuant to § 32.1-283.8 to address shared risk and protective factors for both severe maternal morbidity and maternal mortality.

E. The Department shall annually compile statewide trends of severe maternal morbidity and publish such trends on its website. Any statistical compilations relating to severe maternal morbidity shall comply with the provisions of § 32.1-127.1:03 and the federal Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. § 1320d et seq.) and shall not contain any personal identifying information.

F. Upon the request of the Department, made after the conclusion of any law-enforcement investigation or prosecution, the Department or its designee may inspect and copy information and records regarding a severe maternal morbidity event. Information, records, or reports maintained by any attorney for the Commonwealth shall be made available for inspection and copying by the Department or its designee pursuant to procedures that shall be developed by the Department and the Commonwealth's Attorneys' Services Council established by § 2.2-2617. Any presentence report prepared pursuant to § 19.2-299 for any person convicted of a crime that led to a severe maternal morbidity event shall be made available for inspection and copying by the Department or its designee. In addition, the Department or its designee may inspect and copy from any health care provider or hospital system in the Commonwealth, on behalf of the SMM Program, (i) 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 (ii) upon obtaining consent, from each adult regarding his records.

G. All information and records obtained or created by the SMM Program or on behalf of the SMM Program regarding a review shall be confidential and excluded from the Virginia Freedom of Information Act (§ 2.2-3700 et seq.) pursuant to subdivision 7 of § 2.2-3705.5. All such information and records shall be used by the SMM Program only in the exercise of its proper purpose and function and shall not be disclosed. In preparing information and records for review by the SMM Program, 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. § 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 SMM Program during a severe maternal morbidity review. The findings of the SMM Program may be disclosed or published in statistical or other form but shall not identify any individual. Upon conclusion of the severe maternal morbidity review, all information and records concerning the case shall be shredded or otherwise destroyed by the Department in order to ensure confidentiality.

All portions of meetings in which individual severe morbidity events are discussed by the SMM Program shall be closed pursuant to subdivision A 21 of § 2.2-3711. In addition to the requirements of § 2.2-3712, all SMM Program members and other persons attending closed SMM Program meetings, including any persons presenting information or records on specific severe maternal morbidity events to the SMM Program 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 SMM Program reviews a specific severe maternal morbidity event and (ii) not use any such information, records, discussions, or opinions disclosed during meetings at which the SMM Program reviews a specific severe maternal morbidity event for any purpose other than the exercise of the proper purpose and function of the SMM Program. Violations of this subsection are punishable as a Class 3 misdemeanor.

H. The Board shall promulgate regulations as necessary to implement the SMM Program.

2026, c. 842.