HB2774 - 572R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 11-597, Arizona Revised Statutes, is amended to read:

START_STATUTE11-597. Autopsies; reports; exemption from liability

A. The county medical examiner or alternate medical examiner shall conduct a death investigation to determine whether or not the public interest requires an external examination, autopsy or other special investigation.

B. An external examination or autopsy is not required for deaths due to natural diseases that occur during surgical or anesthetic procedures unless the medical examiner or alternate medical examiner determines that an external examination or autopsy is necessary.

C. In the determination of the need for an autopsy, the county medical examiner or alternate medical examiner may consider the request for an autopsy made by private persons or public officials. If the county attorney or a superior court judge of the county where the death occurred requests an autopsy, the county medical examiner shall perform the autopsy, or, in the case of an alternate medical examiner, an autopsy shall be performed by a forensic pathologist.

D. A forensic pathologist shall perform an autopsy in cases of sudden and unexplained infant death in accordance with protocols adopted by the director of the department of health services. If the medical examiner or forensic pathologist determines that the infant died of sudden infant death syndrome, the medical examiner or forensic pathologist shall notify the department of health services. The medical examiner or forensic pathologist may retain tissue samples, specimens and other biological materials for diagnostic purposes.

E. If an autopsy is performed, a full record or report of the facts developed by the autopsy in the findings of the person performing the autopsy shall be properly made and filed in the office of the county medical examiner or the board of supervisors. If the person performing the autopsy determines that the report should be forwarded to the county where the death occurred or the county in which any injury contributing to or causing the death was sustained, the report shall be forwarded to the county attorney.

F. A county attorney may request and on request shall receive from the county medical examiner or alternate medical examiner a copy of the report on any autopsy performed.

g. If a county medical examiner, alternate medical examiner or forensic pathologist performs an autopsy and determines that the cause of death was due to a condition or side effect associated with the administration of a vaccine, the county medical examiner, alternate medical examiner or forensic pathologist shall submit a copy of the report to the DEPARTMENT Of health services.

G. h. The county medical examiner or alternate medical examiner may perform other tests deemed necessary to determine identity and the cause and manner of death and may retain tissues, specimens and other biological materials for subsequent examination.

H. I. When a death investigation, including an external examination, autopsy or other tests are performed by the a county medical examiner, alternate medical examiner or a forensic pathologist, no cause of action shall lie against the physician or any other person for:

1. Requesting, performing, participating in or determining the cause and manner of death or otherwise reporting the results from the external examination, death investigation, autopsy or other tests or for retaining specimens, tissues or other biological materials.

2. determining in good faith that the cause of death was due to a condition or side effect associated with the administration of a vaccine.END_STATUTE

Sec. 2. Section 36-104, Arizona Revised Statutes, is amended to read:

START_STATUTE36-104. Powers and duties

This section is not to be construed as a statement of the department's organization. This section is intended to be a statement of powers and duties in addition to the powers and duties granted by section 36-103. The director shall:

1. Administer the following services:

(a) Administrative services, which shall include at a minimum the functions of accounting, personnel, standards certification, electronic data processing, vital statistics and the development, operation and maintenance of buildings and grounds used by the department.

(b) Public health support services, which shall include at a minimum:

(i) Consumer health protection programs, consistent with paragraph 25 of this section, that include at least the functions of community water supplies, general sanitation, vector control and food and drugs.

(ii) Epidemiology and disease control programs that include at least the functions of chronic disease, accident and injury control, communicable diseases, tuberculosis, venereal disease and others.

(iii) Laboratory services programs.

(iv) Health education and training programs.

(v) Disposition of human bodies programs.

(i) Medical services programs that include at least the functions of maternal and child health, preschool health screening, family planning, public health nursing, premature and newborn program, immunizations, nutrition, dental care prevention and migrant health.

(ii) Dependency health care services programs that include at least the functions of need determination, availability of health resources to medically dependent individuals, quality control, utilization control and industry monitoring.

(iii) Children with physical disabilities services programs.

(iv) Programs for the prevention and early detection of an intellectual disability.

(d) Program planning, which shall include at least the following:

(i) An organizational unit for comprehensive health planning programs.

(ii) Program coordination, evaluation and development.

(iii) Need determination programs.

(iv) Health information programs.

2. Include and administer, within the office of the director, staff services, which shall include at a minimum budget preparation, public information, appeals, hearings, legislative and federal government liaison, grant development and management and departmental and interagency coordination.

3. Make rules for the organization and proper and efficient operation of the department.

4. Determine when a health care emergency or medical emergency situation exists or occurs within this state that cannot be satisfactorily controlled, corrected or treated by the health care delivery systems and facilities available. When such a situation is determined to exist, the director shall immediately report that situation to the legislature and the governor. The report shall include information on the scope of the emergency, recommendations for solution of the emergency and estimates of costs involved.

5. Provide a system of unified and coordinated health services and programs between this state and county governmental health units at all levels of government.

6. Formulate policies, plans and programs to effectuate the missions and purposes of the department.

7. Make contracts and incur obligations within the general scope of the department's activities and operations subject to the availability of monies.

8. Be designated as the single state agency for the purposes of administering and in furtherance of each federally supported state plan.

9. Provide information and advice on request by local, state and federal agencies and by private citizens, business enterprises and community organizations on matters within the scope of the department's duties subject to the departmental rules and regulations on the confidentiality of information.

10. Establish and maintain separate financial accounts as required by federal law or regulations.

11. Advise with and make recommendations to the governor and the legislature on all matters concerning the department's objectives.

12. Take appropriate steps to reduce or contain costs in the field of health services.

13. Encourage and assist in the adoption of practical methods of improving systems of comprehensive planning, of program planning, of priority setting and of allocating resources.

14. Encourage an effective use of available federal resources in this state.

15. Research, recommend, advise and assist in the establishment of community or area health facilities, both public and private, and encourage the integration of planning, services and programs for the development of the state's health delivery capability.

16. Promote the effective use of health manpower and health facilities that provide health care for the citizens of this state.

17. Take appropriate steps to provide health care services to the medically dependent citizens of this state.

18. Certify training on the nature of sudden infant death syndrome, which shall include information on the investigation and handling of cases involving sudden and unexplained infant death for use by law enforcement officers as part of their basic training requirement.

19. Adopt protocols on the manner in which an autopsy shall be conducted under section 11-597, subsection D in cases of sudden and unexplained infant death.

20. Cooperate with the Arizona-Mexico commission in the governor's office and with researchers at universities in this state to collect data and conduct projects in the United States and Mexico on issues that are within the scope of the department's duties and that relate to quality of life, trade and economic development in this state in a manner that will help the Arizona-Mexico commission to assess and enhance the economic competitiveness of this state and of the Arizona-Mexico region.

21. Administer the federal family violence prevention and services act grants, and the department is designated as this state's recipient of federal family violence prevention and services act grants.

22. Accept and spend private grants of monies, gifts and devises for the purposes of methamphetamine education. The department shall disburse these monies to local prosecutorial or law enforcement agencies with existing programs, faith-based organizations and nonprofit entities that are qualified under section 501(c)(3) of the United States internal revenue code, including nonprofit entities providing services to women with a history of dual diagnosis disorders, and that provide educational programs on the repercussions of methamphetamine use. State general fund monies shall not be spent for the purposes of this paragraph. If the director does not receive sufficient monies from private sources to carry out the purposes of this paragraph, the director shall not provide the educational programs prescribed in this paragraph. Grant monies received pursuant to this paragraph are not lapsing and do not revert to the state general fund at the close of the fiscal year.

23. Identify successful methamphetamine prevention programs in other states that may be implemented in this state.

24. Pursuant to chapter 13, article 8 of this title, coordinate all public health and risk assessment issues associated with a chemical or other toxic fire event if a request for the event is received from the incident commander, the emergency response commission or the department of public safety and if funding is available. Coordination of public health issues shall include general environmental health consultation and risk assessment services consistent with chapter 13, article 8 of this title and, in consultation with the Arizona poison control system, informing the public as to potential public health risks from the environmental exposure. Pursuant to chapter 13, article 8 of this title, the department of health services shall also prepare a report, in consultation with appropriate state, federal and local governmental agencies, that evaluates the public health risks from the environmental exposure. The department of health services' report shall include any department of environmental quality report and map of smoke dispersion from the fire, the results of any environmental samples taken by the department of environmental quality and the toxicological implications and public health risks of the environmental exposure. The department of health services shall consult with the Arizona poison control system regarding toxicology issues and shall prepare and produce its report for the public as soon as practicable after the event. The department of health services shall not use any monies pursuant to section 49-282, subsection E to implement this paragraph.

25. Consult, cooperate, collaborate and, if necessary, enter into interagency agreements and memoranda of understanding with the Arizona department of agriculture concerning its administration, pursuant to title 3, chapter 3, article 4.1, of this state's authority under the United States food and drug administration produce safety rule (21 Code of Federal Regulations part 112) and any other federal produce safety regulation, order or guideline or other requirement adopted pursuant to the FDA food safety modernization act (P.L. 111-353; 21 United States Code sections 2201 through 2252).

26. Adopt rules pursuant to title 32, chapter 32, article 5 prescribing the designated database information to be collected by health profession regulatory boards for the health professionals workforce database.

27. Establish and maintain a secure method for receiving reports submitted pursuant to section 11-597, SUBSECTION G and publish quarterly summaries of all reports received pursuant to section 11-597, subsection G. END_STATUTE

Sec. 3. Legislative findings

A. The legislature finds that:

1. Public health and safety depend on full, honest and unimpeded reporting of findings relating to a cause of death.

2. There have been increased reports from medical professionals of abnormal blood clotting and other anomalies that warrant further study and reporting.

3. Fear of retaliation, reputational harm or regulatory sanctions may discourage a county medical examiner, an alternate medical examiner or a forensic pathologist from making good faith reports of findings in death investigations and autopsies.

4. The COVID-19 pandemic introduced widespread vaccination programs. It is important to monitor, report and analyze possible adverse effects of vaccines, including adverse effects detected as part of a death investigation or autopsy.

5. A county medical examiner, an alternate medical examiner or a forensic pathologist who conducts death investigations and autopsies can detect anomalies and report public health data.

6. This state has a compelling interest in ensuring that no law, policy or workplace culture prevents or discourages the transparent scientific and nonpolitical reporting of medical and pathological information that is relevant to public health and safety.

7. Legal protections are necessary to encourage honest, good faith reporting without fear from the county medical examiner, alternate medical examiner or forensic pathologist of reprisal, censorship or disciplinary action.

B. The legislature intends to do the following:

1. Create a legal safe harbor for a county medical examiner, an alternate medical examiner or a forensic pathologist who reports good faith pathological findings related to suspected vaccine related effects.

2. Protect a county medical examiner, an alternate medical examiner or a forensic pathologist from professional or legal repercussions when the county medical examiner, alternate medical examiner or forensic pathologist report findings that are relevant to public health and safety.

3. Encourage transparent and honest reporting of any anomalies found in the course of a death investigation or autopsy.

4. Ensure that all death investigation and autopsy reports are treated confidentially and seriously and are provided to appropriate health authorities for evaluating public health concerns.

5. Establish that there will be no fear of retaliation, reputational harm or regulatory sanctions against a county medical examiner, an alternate medical examiner or a forensic pathologist who makes good faith death investigation reports or autopsy reports.