CS/HB 1269

1
A bill to be entitled
2An act relating to infant mortality; providing legislative
3intent relating to the black infant health practice
4initiative; providing definitions; providing objectives;
5providing for administration of the initiative; requiring
6a local community to develop a team to serve as a part of
7a statewide practice collaborative; requiring healthy
8start coalitions to conduct case reviews; requiring
9certain public universities or colleges to provide
10technical assistance, to assist in determining certain
11criteria, and to present findings and make
12recommendations; requiring the Department of Health to
13distribute funding to the coalitions; providing duties of
14each participating coalition; requiring the department to
15award grants; requiring the department to conduct an
16annual evaluation of the initiative; requiring each
17coalition to submit a report to the Governor, the
18Legislature, and the department; providing immunity from
19liability to participating coalitions; requiring the
20department to adopt rules; providing a timeframe for
21reviewing cases; providing an appropriation; providing an
22effective date.
23
24     WHEREAS, the Legislature recognizes that pregnancy, birth,
25and infant health outcomes are internationally recognized as
26measures of health for a community, as these outcomes are
27indicators of population sustenance, growth, and quality of
28life, and
29     WHEREAS, the Legislature also recognizes that infant
30mortality disproportionately affects African-American infants,
31as the resident infant mortality rate in 2005 for nonwhites is
3212.5 per 1,000 live births, which is more than double the infant
33mortality rate for whites, which is 5.3 per 1,000 live births,
34and
35     WHEREAS, the Legislature recognizes that a continued effort
36to identify the causes of racial disparities in infant mortality
37benefits all citizens of Florida, NOW, THEREFORE,
38
39Be It Enacted by the Legislature of the State of Florida:
40
41     Section 1.  Black infant health practice initiative.--
42     (1)  LEGISLATIVE INTENT.--It is the intent of the
43Legislature to create a black infant health practice initiative.
44The initiative shall include reviews of infant mortality in
45select counties in this state in order to identify factors in
46the health and social services systems contributing to higher
47mortality rates among African-American infants. It is also the
48intent of the Legislature that the initiative produce
49recommendations on how to address the factors identified by the
50reviews as contributing to these higher infant mortality rates.
51     (2)  DEFINITIONS.--As used in this section, the term:
52     (a)  "Coalition" means a federal or local healthy start
53coalition or consortium.
54     (b)  "Department" means the Department of Health.
55     (c)  "FIMR" means a fetal and infant mortality review
56committee.
57     (d)  "Infant mortality" means the death of a live-born
58infant within 364 days after the infant's birth.
59     (e)  "Infant mortality rate" means the number of infant
60deaths per 1,000 annual live births.
61     (3)  OBJECTIVES.--The objectives of the initiative include:
62     (a)  Determining the significant social, economic,
63cultural, safety, and health system factors that are associated
64with racial disparities in infant mortality rates through a
65practice collaborative approach using perinatal periods of risk
66and modified fetal infant mortality reviews.
67     (b)  Developing a series of interventions and policies that
68address these factors to improve the service systems and
69community resources.
70     (c)  Participating in the implementation of community-based
71interventions and policies that address racial disparities in
72infant mortality rates.
73     (d)  Assessing the progress of interventions.
74     (4)  ADMINISTRATION.--The black infant health practice
75initiative shall be administered through a collaboration among
76the department, federal and state healthy start coalitions, and
77public universities or colleges having expertise in public
78health. A local community shall develop an interdisciplinary
79team to serve as part of a statewide practice collaborative.
80Both perinatal periods of risk and fetal infant mortality
81reviews may be used. A case review shall be conducted by each
82participating healthy start coalition using professional in-
83house staff or through contracts with an outside professional.
84Public universities or colleges having expertise in public
85health shall provide technical assistance in developing a
86standard research methodology based on the fetal and infant
87mortality review method. Public universities or colleges having
88expertise in public health shall assist each participating
89coalition in determining the selection of comparison groups,
90identifying data collection and housing issues, and presenting
91findings and recommendations. A single methodology for the
92reviews conducted through the initiative shall be used by each
93participating coalition. The department shall distribute funding
94to each coalition that participates in the initiative through
95annual grants that are subject to specific appropriations by the
96Legislature.
97     (5)  FUNCTIONS OF THE INITIATIVE.--Each participating
98coalition shall:
99     (a)  Develop an interdisciplinary team to oversee the
100process in its local community.
101     (b)  Use perinatal periods of risk methodology when
102appropriate to examine infant deaths in its community.
103     (c)  Use a modified FIMR approach to examine infant deaths
104in its community by:
105     1.  Creating a case review FIMR team that may include
106obstetricians, neonatologists, perinatalogists, pathologists,
107registered nurses, social workers, hospital and clinic
108administrators, social service agencies, researchers, citizens
109and consumers, and other experts considered necessary to conduct
110a standardized review of infant mortality.
111     2.  Hiring or contracting with professional staff that may
112include licensed nurses and social workers to abstract and
113present individual case reviews that omit identifying
114information regarding infant deaths compared to live births to
115the case review team.
116     3.  Developing abstracts of sample infant mortalities and
117comparative live births that omit identifying information and
118that identify social, economic, cultural, safety, and health
119system factors that are associated with racial disparities in
120infant mortality rates. The number of abstracted cases that must
121be conducted by each participating coalition shall be determined
122by a standard research methodology developed in conjunction with
123a public university or college having expertise in public
124health.
125     4.  Presenting abstracts that omit identifying information
126to its case review team at least quarterly for their review and
127discussion.
128     (d)  Develop findings and recommendations for interventions
129and policy changes to reduce racial disparities in infant
130mortality.
131     (6)  GRANT AWARDS.--The department shall award annual
132grants, subject to specific appropriations by the Legislature.
133The department shall award at least one grant to a coalition
134representing urban counties and at least one grant to a
135coalition representing rural counties. Priority of grant awards
136shall be given to those coalitions representing counties having
137an average nonwhite infant mortality rate at least 1.75 times
138greater than the white infant mortality rate between 2003 and
1392005 and an average of at least 40 nonwhite infant deaths
140between 2003 and 2005 for urban counties or an average of at
141least 5 nonwhite infant deaths between 2003 and 2005 for rural
142counties.
143     (7)  EVALUATIONS AND REPORTS.--The department shall conduct
144an annual evaluation of the implementation of the initiative
145describing which areas are participating in the initiative, the
146number of reviews conducted by each participating coalition,
147grant balances, and recommendations for modifying the
148initiative. All participating coalitions shall produce a report
149on their collective findings and recommendations by January 1,
1502010, to the Governor, the President of the Senate, the Speaker
151of the House of Representatives, and the Secretary of Health.
152     (8)  IMMUNITY.--Each participating coalition, its case
153review team members, and professional staff are immune from
154liability pursuant to s. 766.101, Florida Statutes.
155     (9)  RULEMAKING.--The department shall adopt rules,
156pursuant to ss. 120.536(1) and 120.54, Florida Statutes,
157necessary to implement this section.
158     (10)  IMPLEMENTATION TIMELINE.--The department shall
159administer grants in a manner that will allow each participating
160coalition to begin reviewing cases no later than January 1,
1612008.
162     Section 2.  The sum of $1 million in nonrecurring revenue
163is appropriated from the General Revenue Fund to the Department
164of Health for the 2007-2008 fiscal year to implement the
165provisions of this act.
166     Section 3.  This act shall take effect July 1, 2007.


CODING: Words stricken are deletions; words underlined are additions.