overview
On Monday, July 15, New Jersey Attorney General Matthew J. Platkin and the New Jersey Department of Consumer Affairs filed lawsuits against certain New Jersey health care providers, including:In other wordsRequires health care professionals (physician assistants, doctors, nurses, and midwives) who provide perinatal treatment and care to pregnant women to receive bias training. The training is intended to eradicate biases and stereotypes that may negatively impact the quality of care these health care professionals provide to patients during pregnancy, labor, delivery, the postpartum, and newborn periods. The proposed rule was issued as part of an effort to “address significant racial disparities in maternal and infant health outcomes in New Jersey.”
The public will have an opportunity to provide feedback on the proposed rules during a 60-day comment period. The comment period for the proposed rules for physician assistants ends on August 16, and the comment period for the proposed rules for physicians, nurse practitioners and midwives ends on September 13. After the public comment period ends, the State Physician Examining Board and the New Jersey Board of Nursing (collectively, the “Boards”) will review the comments. The Boards will issue a Notice of Adoption in 2025 summarizing the public comments and the Board’s responses to the comments. After the Notice of Adoption is issued, the proposed rules become final and will become effective 90 days later.
The proposed rule satisfies statutory provisions requiring certain health care professionals to receive explicit and implicit bias training. In May 2021, Governor Phil Murphy signed PL 2021, c.079, as part of his Administration’s efforts to lower maternal and infant mortality rates in New Jersey and provide equitable care to pregnant women and children of all races, religions and ethnicities. The proposed rule also builds on work by the Nurture Initiative, a statewide effort launched in 2019 by New Jersey First Lady Tammy Murphy to ensure equity in maternal and infant health outcomes and reduce overall maternal and infant mortality and morbidity.
Summary of the proposed rule
Current regulations of the State Board of Physician Examining and the New Jersey State Board of Nursing require licensees, such as physicians, physician assistants and nurse-midwives, to earn continuing education credits as a condition of licensure every two years. “Licensees” include health care professionals such as physicians, physician assistants and nurse-midwives. look NJ Administrative Law §§ 13:35-2A.2, 13:35-2B.2, 13:35-2B.8(a). If the proposed rule is finalized, it would require all licensees who provide perinatal treatment and care to pregnant women to complete one hour of training on a program or topic related to explicit and implicit bias.
The proposed rule establishes definitions to be referenced in mandatory bias training. Explicit bias means “attitudes or beliefs about individuals or groups at the conscious level.” And implicit bias means “biased judgments or behaviors that result from subtle cognitive processes that often operate below the level of awareness and without deliberate control, such as implicit prejudices and implicit stereotypes.” The proposed rule would require evidence-based explicit and implicit bias continuing education courses to cover, among other topics, the following:
- The presence of unconscious biases and misinformation when providing perinatal treatment and care to, or interacting with, pregnant women.
- Environmental, personal, interpersonal, institutional and cultural barriers to inclusion.
- the impact of historical and contemporary exclusion and oppression on minority communities;
- reproductive justice;
- Power structures and organizational decision-making and their impact on explicit and implicit bias.
- How inequities, racial, ethnic, and other disparities in the field of perinatal care, as well as explicit and implicit bias, affect pregnancy-related mortality and maternal and child health outcomes.
- Corrective measures to reduce explicit and implicit bias at the interpersonal and organizational levels.
Key Takeaways
- New Jersey’s proposed rule reflects the state’s focus areas of (i) reducing maternal health mortality and morbidity, and (ii) addressing health equity issues for communities of color. Specifically, the proposed rule, if finalized, would require explicit and implicit bias training for health care professionals who provide perinatal treatment and care to pregnant women.
- Given the proposed rule and New Jersey’s increased focus on health care equity, health care providers should remain aware of bias issues in their practice and take concrete steps to comply with specific training requirements that will be implemented following finalization of the proposed rule.
- Recent federal and state actions demonstrate a focus on efforts to address stigma and disparities in maternal health outcomes.
- The Biden Administration, through the Department of Health and Human Services (HHS), released a Maternal Health Action Plan to establish the Administration’s vision to improve maternal health, noting that it will support training of health care providers to reduce stigma in the delivery of care.
- The Centers for Medicare & Medicaid Services (CMS) announced a new value-based alternative payment model in December 2023 called the Transforming Maternal Health (TMaH) Model, the first model focused solely on improving maternal health for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.
- California has implemented training for health care providers to address health disparities.
For more information about the proposed rule and other maternal and child health policy developments, please contact our state Attorney General and health care practices lawyers and the experts at Crowell Health Solutions. For weekly updates on recent State Attorney General issues, subscribe to Crowell & Moring’s State Attorney General blog here.
