How would you measure the health of a place? One way is to look at the rate at which infants are dying. And Maine has seen a long-term increase in its infant mortality rate, even though it’s declined in every other state, as the BDN’s Maine Focus team first reported last August.
What’s more, a panel charged with examining the circumstances surrounding infant deaths, to figure out how to better support parents, was unable to do its job over the last couple years. The state’s Maternal, Fetal, and Infant Mortality Review Panel didn’t meet for years.
It’s not as if the panel didn’t want to do its job. Its members expressed frustration to the BDN about laws holding it back.
The main problem is that the panel and its coordinator don’t have automatic access to relevant medical records. Under the law that governs the panel, the state health officer must request them in writing through a letter to the family, and the health officer can’t send that letter until four months after an infant or mother’s death. The four-month waiting period also applies to a request from the panel coordinator to interview family members.
The restrictions have proved virtually unworkable and are unusual. Jodi Shaefer, director of the National Fetal and Infant Mortality Review Program, which assists maternal and infant mortality review panels across the country, said in December she had never heard of a panel that has to wait four months to contact a family.
It’s unlikely families would want to talk after that length of time, she said. It’s also common for people to move following the death of a baby, reducing the chances that a letter from the state would reach the family. In fact, no case has ever come to the panel because of a letter from the Maine CDC.
This is when the Maine Legislature can prove its worth and make a couple simple changes to ensure the panel can do its important work. Luckily, the Department of Health and Human Services is open to amending the law. It proposed legislation, sponsored by Rep. Deborah Sanderson, R-Chelsea, that would give the panel coordinator access to medical records without having to obtain permission in all cases.
Sen. Lisa Keim, R-Dixfield, has also sponsored legislation that would give the coordinator easier access to records. In addition, it would require that the panel examine why Maine’s infant mortality rate has risen in the past 10 years and report back to the Legislature, and put a requirement in law that the panel meet at least twice annually.
The additional requirements are understandable given the panel’s previous inaction. Reporting back to the Legislature will provide a clear way for both lawmakers and the public to understand why Maine has earned such a dubious distinction as the only state to see its infant mortality rate rise long-term.
Clearly the Maternal, Fetal and Infant Mortality Review panel should be given the right to subpoena records and contact families without restriction. The panel members — most of whom come from the medical field — are well-versed in confidentiality and capable of treating a grieving family with dignity. A similar panel, the Child Death and Serious Injury Review Panel, already has the same powers these two bills would grant to the infant death panel.
The Legislature should grant the panel greater authority as soon as possible, so it can make up for lost time. Then, it will need to listen well to the panel’s findings.