Senate Bill sb2120

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    Florida Senate - 2007                                  SB 2120

    By Senator Joyner





    18-1629-07

  1                      A bill to be entitled

  2         An act relating to infant mortality; providing

  3         legislative intent relating to the black infant

  4         health practice initiative; providing

  5         definitions; providing objectives; providing

  6         for administration of the initiative; requiring

  7         a local community to develop a team to serve as

  8         a part of a statewide practice collaborative;

  9         requiring healthy start coalitions to conduct

10         case reviews; requiring certain public

11         universities or colleges to provide technical

12         assistance and to assist in determining certain

13         criteria and to present findings and make

14         recommendations; requiring the Department of

15         Health to distribute funding to the coalitions;

16         providing duties of each participating

17         coalition; requiring the department to award

18         grants; requiring the department to conduct an

19         annual evaluation of the initiative; requiring

20         each coalition to submit a report to the

21         Governor and the Legislature; providing

22         immunity to participating coalitions; requiring

23         the department to adopt rules; providing a

24         timeframe for reviewing cases; providing an

25         appropriation; providing an effective date.

26  

27         WHEREAS, the Legislature recognizes that pregnancy,

28  birth, and infant health outcomes are internationally

29  recognized as measures of health for a community, as these

30  outcomes are indicators of population sustenance, growth, and

31  quality of life, and

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    Florida Senate - 2007                                  SB 2120
    18-1629-07




 1         WHEREAS, the Legislature also recognizes that infant

 2  mortality disproportionately affects African-American infants,

 3  in the resident infant mortality rate in 2005 for nonwhites

 4  (12.5 per 1,000 live births) being more than double the infant

 5  mortality rate for whites (5.3 per 1,000 live births), and

 6         WHEREAS, the Legislature recognizes that a continued

 7  effort to identify the causes of racial disparities in infant

 8  mortality benefits all citizens of Florida, NOW, THEREFORE,

 9  

10  Be It Enacted by the Legislature of the State of Florida:

11  

12         Section 1.  Black infant health practice initiative.--

13         (1)  LEGISLATIVE INTENT.--It is the intent of the

14  Legislature to create a black infant health practice

15  initiative. The initiative shall include reviews of infant

16  mortalities in select counties in this state in order to

17  identify factors in the health and social services systems

18  contributing to higher mortality rates among African-American

19  infants. It is also the intent of the Legislature that the

20  initiative produce recommendations on how to address the

21  factors identified by the reviews as contributing to these

22  higher infant mortality rates.

23         (2)  DEFINITIONS.--As used in this section, the term:

24         (a)  "Coalition" means a federal or local healthy start

25  coalition or consortium.

26         (b)  "Department" means the Department of Health.

27         (c)  "FIMR" means a fetal and infant mortality review

28  committee.

29         (d)  "Infant mortality" means the death of a live-born

30  infant within 364 days after the infant's birth.

31  

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    Florida Senate - 2007                                  SB 2120
    18-1629-07




 1         (e)  "Infant mortality rate" means the number of infant

 2  deaths per 1,000 annual live births.

 3         (3)  OBJECTIVES.--The objectives of the initiative

 4  include:

 5         (a)  Determining the significant social, economic,

 6  cultural, safety, and health-system factors that are

 7  associated with racial disparities in infant mortality rates

 8  through a practice collaborative approach using perinatal

 9  periods of risk and modified fetal infant mortality reviews.

10         (b)  Developing a series of interventions and policies

11  that address these factors to improve the service systems and

12  community resources.

13         (c)  Participating in the implementation of

14  community-based interventions and policies that address racial

15  disparities in infant mortality rates.

16         (d)  Assessing the progress of interventions.

17         (4)  ADMINISTRATION.--The black infant health practice

18  initiative shall be administered through a collaboration among

19  the department, federal and state healthy start coalitions,

20  and public universities or colleges having expertise in public

21  health. A local community shall develop an interdisciplinary

22  team to serve as part of a statewide practice collaborative.

23  Both perinatal periods of risk and fetal infant mortality

24  reviews may be used. A case review shall be conducted by each

25  participating healthy start coalition using professional

26  in-house staff or through contracts with an outside

27  professional. Public universities or colleges having expertise

28  in public health shall provide technical assistance in

29  developing a standard research methodology based on the fetal

30  and infant mortality review method. Public universities or

31  colleges having expertise in public health shall assist each

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    Florida Senate - 2007                                  SB 2120
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 1  participating coalition in determining the selection of

 2  comparison groups, identifying data collection and housing

 3  issues, and presenting findings and recommendations. A single

 4  methodology for the reviews conducted through the initiative

 5  shall be used by each participating coalition. The department

 6  shall distribute funding to each coalition that participates

 7  in the initiative through annual grants that are subject to

 8  specific appropriations by the Legislature.

 9         (5)  FUNCTIONS OF THE INITIATIVE.--Each participating

10  coalition shall:

11         (a)  Develop an interdisciplinary team to oversee the

12  process in its local community.

13         (b)  Use perinatal periods of risk methodology when

14  appropriate to examine infant deaths in its community.

15         (c)  Use a modified FIMR approach to examine infant

16  deaths in its community by:

17         1.  Creating a case review FIMR team that may include

18  obstetricians, neonatologists, perinatalogists, pathologists,

19  registered nurses, social workers, hospital and clinic

20  administrators, social service agencies, researchers, citizens

21  and consumers, and other experts considered necessary to

22  conduct a standardized review of infant mortalities.

23          2.  Hiring or contracting with professional staff that

24  may include licensed nurses and social workers to abstract and

25  present individual case reviews that omit identifying

26  information of infant deaths and comparative live births to

27  the case review team.

28         3.  Developing abstracts of sample infant mortalities

29  and comparative live births that omit identifying information

30  and that identify social, economic, cultural, safety, and

31  health-system factors that are associated with racial

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    Florida Senate - 2007                                  SB 2120
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 1  disparities in infant mortality rates. The number of

 2  abstracted cases that must be conducted by each participating

 3  coalition shall be determined by a standard research

 4  methodology developed in conjunction with a public university

 5  or college having expertise in public health.

 6         4.  Presenting abstracts that omit identifying

 7  information to its case review team at least quarterly for

 8  their review and discussion.

 9         (d)  Develop findings and recommendations for

10  interventions and policy changes to reduce racial disparities

11  in infant mortality.

12         (6)  GRANT AWARDS.--The department shall award annual

13  grants through a request-for-proposal process that is subject

14  to specific appropriations by the Legislature. The department

15  shall award five grants to coalitions representing urban

16  counties and five grants to coalitions representing rural

17  counties. Priority of grant awards shall be given to those

18  coalitions representing counties having a nonwhite infant

19  mortality rate at least two times greater than the white

20  infant mortality rate and at least 40 nonwhite infant deaths

21  annually between 2003 and 2005 for urban counties and five

22  nonwhite infant deaths annually between 2003 and 2005 for

23  rural counties.

24         (7)  EVALUATIONS AND REPORTS.--The department shall

25  conduct an annual evaluation of the implementation of the

26  initiative describing which areas are participating in the

27  initiative, the number of reviews conducted by each

28  participating coalition, grant balances, and recommendations

29  for modifying the initiative. A participating coalition shall

30  produce a report on its collective findings and

31  recommendations by January 1, 2010, to the Governor, the

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    Florida Senate - 2007                                  SB 2120
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 1  President of the Senate, the Speaker of the House of

 2  Representatives, and the Secretary of Health.

 3         (8)  IMMUNITY.--Each participating coalition, its case

 4  review team members, and professional staff are immune from

 5  liability pursuant to s. 766.101, Florida Statutes.

 6         (9)  RULEMAKING.--The department shall adopt rules

 7  necessary to implement this section.

 8         (10)  IMPLEMENTATION TIMELINE.--The department shall

 9  release a request for proposals in a manner that will allow

10  each participating coalition to begin reviewing cases no later

11  than January 1, 2008.

12         Section 2.  The sum of $1 million is appropriated from

13  the General Revenue Fund to the Department of Health for the

14  purpose of implementing the black infant health practice

15  initiative and for one full-time equivalent position is

16  authorized for the purpose of implementing this act.

17         Section 3.  This act shall take effect July 1, 2007.

18  

19            *****************************************

20                          SENATE SUMMARY

21    Provides legislative intent relating to the black infant
      health practice initiative. Provides for the
22    administration of the initiative. Requires a local
      community to develop a team to serve as a part of a
23    statewide practice collaborative. Requires healthy start
      coalitions to conduct case reviews. Requires certain
24    public universities or colleges to provide technical
      assistance and to assist in determining certain criteria
25    and to present findings and make recommendations.
      Requires the Department of Health to distribute funding
26    to the coalitions. Provides duties of each participating
      coalition. Requires the department to award grants.
27    Requires the department to conduct an annual evaluation
      of the initiative. Requires each coalition to submit a
28    report to the Governor and the Legislature. Provides
      immunity to participating coalitions. Requires the
29    department to adopt rules. Provides a timeframe for
      reviewing cases. Provides an appropriation.
30  

31  

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