AN ACT DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY ISSUES PERTAINING TO HIGH‑QUALITY, RISK‑APPROPRIATE MATERNAL AND NEONATAL CARE and to allow simultaneous cremation of certain fetuses and infants.

Whereas, pregnant and postpartum women require timely, comprehensive medical services matched to their clinical complexity; and
Whereas, medically complex pregnant mothers and newborns should be cared for in a medical facility that can meet their specific medical needs; and
Whereas, maternity and newborn care providers are not geographically distributed to best meet health care needs; and
Whereas, studies have demonstrated that timely access to risk appropriate neonatal and obstetric care can reduce infant mortality and maternal severe morbidity and mortality; and
Whereas, health care facilities across North Carolina have varied capabilities to care for mothers and newborns with complex needs; and
Whereas, designating facilities with specific "levels of care" offers uniform criteria about the capability of health care facilities to provide complexity of care to pregnant women and newborns; and this approach is endorsed by the American College of Obstetricians and Gynecologists, the Society for Maternal‑Fetal Medicine, the American Academy of Pediatrics, and a number of other national medical organizations; Now, therefore,

The General Assembly of North Carolina enacts:

SECTION 1.(a)  The Department of Health and Human Services shall study and analyze North Carolina's ability to provide women with timely and equitable access to high‑quality, risk‑appropriate maternal and neonatal care. The study shall examine at least all of the following:
(1)	The complexity levels of care currently being provided by all delivering hospitals in caring for birth mothers and newborns.
(2)	How current systems of referral and transport to different facilities and specialty providers based on patient risk are being managed.
(3)	Disparities in access to risk‑appropriate maternal and hospital care.
(4)	Service gaps.
(5)	Issues that impact the ability to most appropriately match patient need with provider skill.
(6)	Recommendations for actionable steps that can be taken in North Carolina to best ensure that pregnant women receive quality prenatal care and that mothers and newborns are cared for in a facility that can meet their specific clinical needs.
(7)	Any other issues the Department deems relevant to this study.
SECTION 1.(b)  The Department shall make an interim report of its findings and recommendations to the 2019 Regular Session of the 2019 General Assembly on or before May 1, 2019, and a final report of its findings and recommendations, including any recommended legislation, to the 2020 General Assembly.
SECTION 2.  G.S. 90‑210.129 reads as rewritten:
"§ 90‑210.129.  Cremation procedures.
…
(h)	The simultaneous cremation of the human remains of more than one person within the same cremation chamber is forbidden, provided that the following human remains may be cremated simultaneously upon the express written direction of the authorized agent:
(1)	The human remains of multiple fetuses from the same mother and the same birth.
(2)	The human remains of multiple persons up to the age of one year old from the same mother and the same birth.
…."
SECTION 3.  This act is effective when it becomes law.
In the General Assembly read three times and ratified this the 15th day of June, 2018.

	s/	 Philip E. Berger
	 President Pro Tempore of the Senate

	s/	 Tim Moore
	 Speaker of the House of Representatives

	_____________________________________
		 Roy Cooper
	 Governor

Approved __________.m. this ______________ day of ___________________, 2018