Florida Senate - 2021 CS for SB 1540
By the Committee on Health Policy; and Senator Gibson
1 A bill to be entitled
2 An act relating to maternal health outcomes; amending
3 s. 381.7353, F.S.; revising the Department of Health’s
4 duties under the Closing the Gap grant program;
5 amending s. 381.7355, F.S.; revising the requirements
6 for Closing the Gap grant proposals; creating s.
7 383.2163, F.S.; requiring the department to establish
8 telehealth minority maternity care pilot programs in
9 Duval County and Orange County by a specified date;
10 defining terms; providing program purposes; requiring
11 the pilot programs to provide specified telehealth
12 services, or coordinate with prenatal home visiting
13 programs to provide specified services, to eligible
14 pregnant women for a specified period; requiring pilot
15 programs to train participating health care
16 practitioners and perinatal professionals on specified
17 topics; providing for funding for the pilot programs;
18 requiring the department’s Division of Community
19 Health Promotion and Office of Minority Health and
20 Health Equity to apply for certain federal funding;
21 authorizing the department to adopt rules; providing
22 an effective date.
24 Be It Enacted by the Legislature of the State of Florida:
26 Section 1. Paragraph (e) of subsection (2) of section
27 381.7353, Florida Statutes, is amended to read:
28 381.7353 Reducing Racial and Ethnic Health Disparities:
29 Closing the Gap grant program; administration; department
31 (2) The department shall:
32 (e) Coordinate with existing community-based programs, such
33 as chronic disease community intervention programs, cancer
34 prevention and control programs, diabetes control programs, the
35 Healthy Start program, the Florida Kidcare Program, the HIV/AIDS
36 program, immunization programs, maternal health programs, and
37 other related programs at the state and local levels, to avoid
38 duplication of effort and promote consistency.
39 Section 2. Paragraph (a) of subsection (2) of section
40 381.7355, Florida Statutes, is amended to read:
41 381.7355 Project requirements; review criteria.—
42 (2) A proposal must include each of the following elements:
43 (a) The purpose and objectives of the proposal, including
44 identification of the particular racial or ethnic disparity the
45 project will address. The proposal must address one or more of
46 the following priority areas:
47 1. Decreasing racial and ethnic disparities in maternal and
48 infant mortality rates.
49 2. Decreasing racial and ethnic disparities in severe
50 maternal morbidity rates and other maternal health outcomes.
51 3. Decreasing racial and ethnic disparities in morbidity
52 and mortality rates relating to cancer.
3. Decreasing racial and ethnic disparities in morbidity
54 and mortality rates relating to HIV/AIDS.
55 5. 4. Decreasing racial and ethnic disparities in morbidity
56 and mortality rates relating to cardiovascular disease.
57 6. 5. Decreasing racial and ethnic disparities in morbidity
58 and mortality rates relating to diabetes.
59 7. 6. Increasing adult and child immunization rates in
60 certain racial and ethnic populations.
61 8. 7. Decreasing racial and ethnic disparities in oral
62 health care.
63 9. 8. Decreasing racial and ethnic disparities in morbidity
64 and mortality rates relating to sickle cell disease.
65 10. 9. Decreasing racial and ethnic disparities in morbidity
66 and mortality rates relating to Lupus.
67 11. 10. Decreasing racial and ethnic disparities in
68 morbidity and mortality rates relating to Alzheimer’s disease
69 and dementia.
70 12. 11. Improving neighborhood social determinants of
71 health, such as transportation, safety, and food access, as
72 outlined by the Centers for Disease Control and Prevention’s
73 “Tools for Putting Social Determinants of Health into Action.”
74 Section 3. Effective January 1, 2022, section 383.2163,
75 Florida Statutes, is created to read:
76 383.2163 Telehealth minority maternity care pilot
77 programs.—By July 1, 2022, the department shall establish a
78 telehealth minority maternity care pilot program in Duval County
79 and Orange County which uses telehealth to expand the capacity
80 for positive maternal health outcomes in racial and ethnic
81 minority populations. The department shall direct and assist the
82 county health departments in Duval County and Orange County to
83 implement the programs.
84 (1) DEFINITIONS.—As used in this section, the term:
85 (a) “Department” means the Department of Health.
86 (b) “Eligible pregnant woman” means a pregnant woman who is
87 receiving, or is eligible to receive, maternal or infant care
88 services from the department under chapter 381 or chapter 383.
89 (c) “Health care practitioner” has the same meaning as in
90 s. 456.001.
91 (d) “Health professional shortage area” means a geographic
92 area designated as such by the Health Resources and Services
93 Administration of the United States Department of Health and
94 Human Services.
95 (e) “Indigenous population” means any Indian tribe, band,
96 or nation or other organized group or community of Indians
97 recognized as eligible for services provided to Indians by the
98 United States Secretary of the Interior because of their status
99 as Indians, including any Alaskan native village as defined in
100 43 U.S.C. s. 1602(c), the Alaska Native Claims Settlement Act,
101 as that definition existed on the effective date of this act.
102 (f) “Maternal mortality” means a death occurring during
103 pregnancy or the postpartum period which is caused by pregnancy
104 or childbirth complications.
105 (g) “Medically underserved population” means the population
106 of an urban or rural area designated by the United States
107 Secretary of Health and Human Services as an area with a
108 shortage of personal health care services or a population group
109 designated by the United States Secretary of Health and Human
110 Services as having a shortage of such services.
111 (h) “Perinatal professionals” means doulas, personnel from
112 Healthy Start and home visiting programs, childbirth educators,
113 community health workers, peer supporters, certified lactation
114 consultants, nutritionists and dietitians, social workers, and
115 other licensed and nonlicensed professionals who assist women
116 through their prenatal or postpartum periods.
117 (i) “Postpartum” means the 1-year period beginning on the
118 last day of a woman’s pregnancy.
119 (j) “Severe maternal morbidity” means an unexpected outcome
120 caused by a woman’s labor and delivery which results in
121 significant short-term or long-term consequences to the woman’s
123 (k) “Technology-enabled collaborative learning and capacity
124 building model” means a distance health care education model
125 that connects health care professionals, particularly
126 specialists, with other health care professionals through
127 simultaneous interactive videoconferencing for the purpose of
128 facilitating case-based learning, disseminating best practices,
129 and evaluating outcomes in the context of maternal health care.
130 (2) PURPOSE.—The purpose of the pilot programs is to:
131 (a) Expand the use of technology-enabled collaborative
132 learning and capacity building models to improve maternal health
133 outcomes for the following populations and demographics:
134 1. Ethnic and minority populations.
135 2. Health professional shortage areas.
136 3. Areas with significant racial and ethnic disparities in
137 maternal health outcomes and high rates of adverse maternal
138 health outcomes, including, but not limited to, maternal
139 mortality and severe maternal morbidity.
140 4. Medically underserved populations.
141 5. Indigenous populations.
142 (b) Provide for the adoption and use of telehealth services
143 that allow for screening and treatment of common pregnancy
144 related complications, including, but not limited to, anxiety,
145 depression, substance use disorder, hemorrhage, infection,
146 amniotic fluid embolism, thrombotic pulmonary or other embolism,
147 hypertensive disorders relating to pregnancy, diabetes,
148 cerebrovascular accidents, cardiomyopathy, and other
149 cardiovascular conditions.
150 (3) TELEHEALTH SERVICES AND EDUCATION.—The pilot programs
151 shall adopt the use of telehealth or coordinate with prenatal
152 home visiting programs to provide all of the following services
153 and education to eligible pregnant women up to the last day of
154 their postpartum periods, as applicable:
155 (a) Referrals to Healthy Start’s coordinated intake and
156 referral program to offer families prenatal home visiting
158 (b) Services and education addressing social determinants
159 of health, including, but not limited to, all of the following:
160 1. Housing placement options.
161 2. Transportation services or information on how to access
162 such services.
163 3. Nutrition counseling.
164 4. Access to healthy foods.
165 5. Lactation support.
166 6. Lead abatement and other efforts to improve air and
167 water quality.
168 7. Child care options.
169 8. Car seat installation and training.
170 9. Wellness and stress management programs.
171 10. Coordination across safety net and social support
172 services and programs.
173 (c) Evidence-based health literacy and pregnancy,
174 childbirth, and parenting education for women in the prenatal
175 and postpartum periods.
176 (d) For women during their pregnancies through the
177 postpartum periods, connection to support from doulas and other
178 perinatal health workers.
179 (e) Tools for prenatal women to conduct key components of
180 maternal wellness checks, including, but not limited to, all of
181 the following:
182 1. A device to measure body weight, such as a scale.
183 2. A device to measure blood pressure which has a verbal
184 reader to assist the pregnant woman in reading the device and to
185 ensure that the health care practitioner performing the wellness
186 check through telehealth is able to hear the reading.
187 3. A device to measure blood sugar levels with a verbal
188 reader to assist the pregnant woman in reading the device and to
189 ensure that the health care practitioner performing the wellness
190 check through telehealth is able to hear the reading.
191 4. Any other device that the health care practitioner
192 performing wellness checks through telehealth deems necessary.
193 (4) TRAINING.—The pilot programs shall provide training to
194 participating health care practitioners and other perinatal
195 professionals on all of the following:
196 (a) Implicit and explicit biases, racism, and
197 discrimination in the provision of maternity care and how to
198 eliminate these barriers to accessing adequate and competent
199 maternity care.
200 (b) The use of remote patient monitoring tools for
201 pregnancy-related complications.
202 (c) How to screen for social determinants of health risks
203 in the prenatal and postpartum periods, such as inadequate
204 housing, lack of access to nutritional foods, environmental
205 risks, transportation barriers, and lack of continuity of care.
206 (d) Best practices in screening for and, as needed,
207 evaluating and treating maternal mental health conditions and
208 substance use disorders.
209 (e) Information collection, recording, and evaluation
210 activities to:
211 1. Study the impact of the pilot program;
212 2. Ensure access to and the quality of care;
213 3. Evaluate patient outcomes as a result of the pilot
215 4. Measure patient experience; and
216 5. Identify best practices for the future expansion of the
217 pilot program.
218 (5) FUNDING.—The pilot programs shall be funded using funds
219 appropriated by the Legislature for the Closing the Gap grant
220 program. The department’s Division of Community Health Promotion
221 and Office of Minority Health and Health Equity shall also work
222 in partnership to apply for federal funds that are available to
223 assist the department in accomplishing the program’s purpose and
224 successfully implementing the pilot programs.
225 (6) RULES.—The department may adopt rules to implement this
227 Section 4. This act shall take effect July 1, 2021.