56 N.J.R. 1230(a)

VOLUME 56, ISSUE 14, JULY 15, 2024
RULE PROPOSALS

Reporter
56 N.J.R. 1230(a)
NJ - New Jersey Register  >  2024  >  JULY  >  JULY 15, 2024  >  RULE PROPOSALS  >  LAW AND PUBLIC SAFETY -- DIVISION OF CONSUMER AFFAIRS

Interested Persons Statement 

INTERESTED PERSONS 
Interested persons may submit comments, information or arguments concerning any of the rule proposals in this issue until the date indicated in the proposal. Submissions and any inquiries about submissions should be addressed to the agency officer specified for a particular proposal. 
The required minimum period for comment concerning a proposal is 30 days. A proposing agency may extend the 30-day comment period to accommodate public hearings or to elicit greater public response to a proposed new rule or amendment. Most notices of proposal include a 60-day comment period, in order to qualify the notice for an exception to the rulemaking calendar requirements of  N.J.S.A. 52:14B-3. An extended comment deadline will be noted in the heading of a proposal or appear in a subsequent notice in the Register. 
At the close of the period for comments, the proposing agency may thereafter adopt a proposal, without change, or with changes not in violation of the rulemaking procedures at      N.J.A.C. 1:30-6.3. The adoption becomes effective upon publication in the Register of a notice of adoption, unless otherwise indicated in the adoption notice. Promulgation in the New Jersey Register establishes a new or amended rule as an official part of the New Jersey Administrative Code. 
Agency


LAW AND PUBLIC SAFETY > DIVISION OF CONSUMER AFFAIRS > BOARD OF MEDICAL EXAMINERS

Administrative Code Citation


Proposed Amendment: N.J.A.C. 13:35-6.15      

Text

 Explicit and Implicit Bias Continuing Education
Authorized By: Board of Medical Examiners, Antonia Winstead, Executive Director.
Authority: N.J.S.A. 45:9-2.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2024-088.
Submit written comments by September 13, 2024, to:
Antonia Winstead, Executive Director
Board of Medical Examiners
140 East Front Street, 2nd Floor
PO Box 183
Trenton, NJ 08625
or electronically at:
http://www.njconsumeraffairs.gov/Proposals/Pages/default.aspx
The agency proposal follows:
Summary
P.L. 2021, c. 79, requires physicians who provide perinatal treatment and care to pregnant persons to complete one credit of continuing education concerning explicit and implicit bias. The law sets forth the topics that the continuing education course must cover, including:
1. Identifying previous and current unconscious biases and misinformation when providing perinatal treatment and care to, or interacting with, pregnant persons;
2. Identifying environmental, personal, interpersonal, institutional, and cultural barriers to inclusion;
3. Information on the effects of historical and contemporary exclusion and oppression of minority communities;
4. Information about cultural identity across racial, ethnic, and other marginalized groups;
5. Information about communicating more effectively across racial, ethnic, religious, and gender identities;
6. Information about reproductive justice;
7. A discussion on power dynamics and organizational decision-making and their effects on explicit and implicit bias;
8. A discussion on inequities and racial, ethnic, and other disparities within the field of perinatal care, and how explicit and implicit bias may contribute to pregnancy-related deaths and maternal and infant health outcomes;
9. Corrective measures to decrease explicit and implicit bias at the interpersonal and institutional levels; and
10. Review of the annual report of the New Jersey Maternal Mortality Review Committee.
The Board of Medical Examiners (Board) proposes amendments at N.J.A.C. 13:35-6.15 to effectuate P.L. 2021, c. 79. Specifically, the Board proposes to amend existing N.J.A.C. 13:35-6.15(b) to reflect proposed recodifications in the rule and proposes to amend existing subsection (c), so that provisions regarding continuing education in prescription opioid drugs are relocated to proposed new subsection (d). Proposed new subsections (e) and (f) address continuing education requirements in explicit and implicit bias required pursuant to P.L. 2021, c. 79. Requiring continuing education on these topics will help ensure that physicians who provide perinatal treatment and care to pregnant persons have a basic understanding of the factors that contribute to the high rates of maternal and infant mortality and morbidity in historically underserved communities.
The Board has determined that the comment period for this notice of proposal will be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this notice is excepted from the rulemaking calendar requirement.
Social Impact
The Board believes that the proposed amendments will benefit patients who receive perinatal treatment and care from physicians. The continuing education credit in implicit and explicit bias will help to ensure that such physicians understand the role of implicit and explicit bias in perpetuating deeply rooted disparities in maternal and infant health outcomes. Recognizing the influence of implicit and explicit bias on perinatal treatment and care is an essential step toward eliminating those disparities.
Economic Impact
The Board does not anticipate that the proposed amendments will have any economic impact as the proposed amendments do not increase the total number of continuing education credits a physician is required to complete.
Federal Standards Statement
A Federal standards analysis is not required because there are no Federal laws or standards applicable to the proposed amendments.
Jobs Impact
The Board does not believe that the proposed amendments will result in an increase or decrease in the number of jobs in New Jersey.
Agriculture Industry Impact
The Board does not believe that the proposed amendments will have any impact on the agriculture industry of this State.
[page=1231] 
Regulatory Flexibility Analysis
Any physician who is a "business which is resident in this State, independently owned and operated and not dominant in its field, and which employs fewer than 100 full-time employees" constitutes a "small business" within the meaning of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq. (RFA). To the extent that a physician may qualify as a "small business" within the meaning of the RFA, the following analysis applies, pursuant to N.J.S.A. 52:14B-19.
The proposed amendments will not impose any costs and the Board does not believe that physicians will need to employ any professional services to comply with the requirements of the proposed amendments. The proposed amendments impose no new recordkeeping or reporting requirements. However, they do impose compliance requirements as detailed in the Summary above.
The Board believes that the proposed amendments promote the welfare and safety of patients who receive perinatal treatment and care from physicians. Therefore, the proposed amendments must be applied uniformly to all physicians regardless of business size.
Housing Affordability Impact Analysis
The proposed amendments will have an insignificant impact on the affordability of housing in New Jersey and there is an extreme unlikelihood that the proposed amendments would evoke a change in the average costs associated with housing because the proposed amendments concern continuing education requirements for physicians.
Smart Growth Development Impact Analysis
The proposed amendments will have an insignificant impact on smart growth and there is an extreme unlikelihood that the proposed amendments would evoke a change in housing production in Planning Areas 1 or 2, or within designated centers, pursuant to the State Development and Redevelopment Plan in New Jersey because the proposed amendments concern continuing education requirements for physicians.
Racial and Ethnic Community Criminal Justice and Public Safety Impact
The Board has evaluated this rulemaking and determined that it will not have an impact on pretrial detention, sentencing, probation, or parole policies concerning adults and juveniles in the State. Accordingly, no further analysis is required.
Full text of the proposal follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):
SUBCHAPTER 6. GENERAL RULES OF PRACTICE
13:35-6.15 Continuing medical education
(a) (No change.)
(b) Except as provided [in (d)] at (g) below, a licensee applying for a biennial license renewal shall complete 100 continuing medical education credits in Category I or Category II courses, of which at least 40 of such credits shall be in Category I.
(c) Commencing with the biennial renewal period beginning on July 1, 2013, two of the 40 credits in Category I courses shall, pursuant to P.L. 2011, c. 145 (N.J.S.A. 45:9-7.7), be in programs or topics related to end-of-life care.
(d) Commencing with the biennial renewal period beginning on July 1, 2017, one of the 40 credits in Category I courses shall, pursuant to P.L. 2017, c. 28, be in programs or topics concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion.
(e) Commencing with the biennial renewal period beginning on July 1, 2025, for a licensee who provides perinatal treatment and care to pregnant persons, one of the 40 credits in Category I courses shall, pursuant to P.L. 2021, c. 79, consist of evidence-based training in explicit and implicit bias that includes:
1. Identifying previous and current unconscious biases and misinformation when providing perinatal treatment and care to, or interacting with, pregnant persons;
2. Identifying environmental, personal, interpersonal, institutional, and cultural barriers to inclusion;
3. Information on the effects of historical and contemporary exclusion and oppression of minority communities;
4. Information about cultural identity across racial, ethnic, and other marginalized groups;
5. Information about communicating more effectively across racial, ethnic, religious, and gender identities;
6. Information about reproductive justice;
7. A discussion on power dynamics and organizational decision-making and their effects on explicit and implicit bias;
8. A discussion on inequities and racial, ethnic, and other disparities within the field of perinatal care, and how explicit and implicit bias may contribute to pregnancy-related deaths and maternal and infant health outcomes;
9. Corrective measures to decrease explicit and implicit bias at the interpersonal and institutional levels; and
10. Review of the annual report of the New Jersey Maternal Mortality Review Committee.
(f) For the purposes of (e) above, the following words and terms shall have the following meanings when used in this section:
"Explicit bias" means attitudes and beliefs about a person or group on a conscious level.
"Implicit bias" means a bias in judgment or behavior that results from subtle cognitive processes, including implicit prejudice and implicit stereotypes, that often operate at a level below conscious awareness and without intentional control.
"Implicit stereotypes" means the unconscious attributions of particular qualities to a member of a certain social group, influenced by experience, and based on learned associations between various qualities and social categories, including race and gender.
"Perinatal care" means the provision of care during pregnancy, labor, delivery, postpartum, and neonatal periods.
Recodify existing (d)-(o) as (g)-(r) (No change in text.)