Florida Senate - 2024 CS for SB 1582
By the Committee on Health Policy; and Senator Rodriguez
588-02970-24 20241582c1
1 A bill to be entitled
2 An act relating to the Department of Health; amending
3 s. 381.0101, F.S.; defining the term “environmental
4 health technician”; exempting environmental health
5 technicians from certain certification requirements
6 under certain circumstances; requiring the department,
7 in conjunction with the Department of Environmental
8 Protection, to adopt rules that establish certain
9 standards for environmental health technician
10 certification; requiring the Department of Health to
11 adopt by rule certain standards for environmental
12 health technician certification; revising provisions
13 related to exemptions and fees to conform to changes
14 made by the act; creating s. 381.991, F.S.; creating
15 the Andrew John Anderson Rare Pediatric Disease Grant
16 Program within the department for a specified purpose;
17 subject to an appropriation by the Legislature,
18 requiring the program to award grants for certain
19 scientific and clinical research; specifying entities
20 eligible to apply for the grants; specifying the types
21 of applications that may be considered for grant
22 funding; providing for a competitive, peer-reviewed
23 application and selection process; providing that the
24 remaining balance of appropriations for the program as
25 of a specified date may be carried forward for a
26 specified timeframe under certain circumstances;
27 amending s. 383.14, F.S.; providing that any health
28 care practitioner present at a birth or responsible
29 for primary care during the neonatal period has the
30 primary responsibility of administering certain
31 screenings; defining the term “health care
32 practitioner”; deleting identification and screening
33 requirements for newborns and their families for
34 certain environmental and health risk factors;
35 deleting certain related duties of the department;
36 revising the definition of the term “health care
37 practitioner” to include licensed genetic counselors;
38 requiring that blood specimens for screenings of
39 newborns be collected before a specified age;
40 requiring that newborns have a blood specimen
41 collected for newborn screenings, rather than only a
42 test for phenylketonuria, before a specified age;
43 deleting certain rulemaking authority of the
44 department; deleting a requirement that the department
45 furnish certain forms to specified entities; deleting
46 the requirement that such entities report the results
47 of certain screenings to the department; making
48 technical and conforming changes; deleting a
49 requirement that the department submit certain
50 certifications as part of its legislative budget
51 request; requiring certain health care practitioners
52 to prepare and send all newborn screening specimen
53 cards to the State Public Health Laboratory; defining
54 the term “health care practitioner”; amending s.
55 383.145, F.S.; defining the term “toddler”; revising
56 hearing loss screening requirements to include infants
57 and toddlers; revising hearing loss screening
58 requirements for licensed birth centers; revising the
59 timeframe in which a newborn’s primary health care
60 provider must refer a newborn for congenital
61 cytomegalovirus screening after the newborn fails the
62 hearing loss screening; requiring licensed birth
63 centers to complete newborn hearing loss screenings
64 before discharge, with an exception; amending s.
65 383.147, F.S.; revising sickle cell disease and sickle
66 cell trait screening requirements; requiring screening
67 providers to notify a newborn’s parent or guardian,
68 rather than the newborn’s primary care physician, of
69 certain information; authorizing the parents or
70 guardians of a newborn to opt out of the newborn’s
71 inclusion in the sickle cell registry; specifying the
72 manner in which a parent or guardian may opt out;
73 authorizing certain persons other than newborns who
74 have been identified as having sickle cell disease or
75 carrying a sickle cell trait to choose to be included
76 in the registry; creating s. 383.148, F.S.; requiring
77 the department to promote the screening of pregnant
78 women and infants for specified environmental risk
79 factors; requiring the department to develop a
80 multilevel screening process for prenatal and
81 postnatal risk screenings; specifying requirements for
82 such screening processes; providing construction;
83 requiring persons who object to a screening to give a
84 written statement of such objection to the physician
85 or other person required to administer and report the
86 screening; amending ss. 383.318, 395.1053, and
87 456.0496, F.S.; conforming cross-references; providing
88 an effective date.
89
90 Be It Enacted by the Legislature of the State of Florida:
91
92 Section 1. Present subsections (5), (6), and (7) of section
93 381.0101, Florida Statutes, are redesignated as subsections (6),
94 (7), and (8), respectively, a new subsection (5) is added to
95 that section, and subsections (1), (2), and (4) and present
96 subsections (5) and (6) of that section are amended, to read:
97 381.0101 Environmental health professionals.—
98 (1) DEFINITIONS.—As used in this section, the term:
99 (a) “Board” means the Environmental Health Professionals
100 Advisory Board.
101 (c)(b) “Department” means the Department of Health.
102 (d)(c) “Environmental health” means that segment of public
103 health work which deals with the examination of those factors in
104 the human environment which may impact adversely on the health
105 status of an individual or the public.
106 (e)(d) “Environmental health professional” means a person
107 who is employed or assigned the responsibility for assessing the
108 environmental health or sanitary conditions, as defined by the
109 department, within a building, on an individual’s property, or
110 within the community at large, and who has the knowledge,
111 skills, and abilities to carry out these tasks. Environmental
112 health professionals may be either field, supervisory, or
113 administrative staff members.
114 (b)(e) “Certified” means a person who has displayed
115 competency to perform evaluations of environmental or sanitary
116 conditions through examination.
117 (f) “Environmental health technician” means a person who is
118 employed or assigned the responsibility for conducting septic
119 inspections under the supervision of a certified environmental
120 health professional. An environmental health technician must
121 have completed training approved by the department and have the
122 knowledge, skills, and abilities to carry out these tasks.
123 (h)(f) “Registered sanitarian,” “R.S.,” “Registered
124 Environmental Health Specialist,” or “R.E.H.S.” means a person
125 who has been certified by either the National Environmental
126 Health Association or the Florida Environmental Health
127 Association as knowledgeable in the environmental health
128 profession.
129 (g) “Primary environmental health program” means those
130 programs determined by the department to be essential for
131 providing basic environmental and sanitary protection to the
132 public. At a minimum, these programs shall include food
133 protection program work.
134 (2) CERTIFICATION; EXEMPTIONS REQUIRED.—A person may not
135 perform environmental health or sanitary evaluations in any
136 primary program area of environmental health without being
137 certified by the department as competent to perform such
138 evaluations. This section does not apply to any of the
139 following:
140 (a) Persons performing inspections of public food service
141 establishments licensed under chapter 509.; or
142 (b) Persons performing site evaluations in order to
143 determine proper placement and installation of onsite wastewater
144 treatment and disposal systems who have successfully completed a
145 department-approved soils morphology course and who are working
146 under the direct responsible charge of an engineer licensed
147 under chapter 471.
148 (c) Environmental health technicians employed by a
149 department as defined in s. 20.03 who are assigned the
150 responsibility for conducting septic tank inspections under the
151 supervision of an environmental health professional certified in
152 onsite sewage treatment and disposal.
153 (4) STANDARDS FOR CERTIFICATION.—The department shall adopt
154 rules that establish definitions of terms and minimum standards
155 of education, training, or experience for those persons subject
156 to this subsection section. The rules must also address the
157 process for application, examination, issuance, expiration, and
158 renewal of certification and ethical standards of practice for
159 the profession.
160 (a) Persons employed as environmental health professionals
161 shall exhibit a knowledge of rules and principles of
162 environmental and public health law in Florida through
163 examination. A person may not conduct environmental health
164 evaluations in a primary program area unless he or she is
165 currently certified in that program area or works under the
166 direct supervision of a certified environmental health
167 professional.
168 1. All persons who begin employment in a primary
169 environmental health program on or after September 21, 1994,
170 must be certified in that program within 6 months after
171 employment.
172 2. Persons employed in the primary environmental health
173 program of a food protection program or an onsite sewage
174 treatment and disposal system prior to September 21, 1994, shall
175 be considered certified while employed in that position and
176 shall be required to adhere to any professional standards
177 established by the department pursuant to paragraph (b),
178 complete any continuing education requirements imposed under
179 paragraph (d), and pay the certificate renewal fee imposed under
180 subsection (7) (6).
181 3. Persons employed in the primary environmental health
182 program of a food protection program or an onsite sewage
183 treatment and disposal system prior to September 21, 1994, who
184 change positions or program areas and transfer into another
185 primary environmental health program area on or after September
186 21, 1994, must be certified in that program within 6 months
187 after such transfer, except that they will not be required to
188 possess the college degree required under paragraph (e).
189 4. Registered sanitarians shall be considered certified and
190 shall be required to adhere to any professional standards
191 established by the department pursuant to paragraph (b).
192 (b) At a minimum, the department shall establish standards
193 for professionals in the areas of food hygiene and onsite sewage
194 treatment and disposal.
195 (c) Those persons conducting primary environmental health
196 evaluations shall be certified by examination to be
197 knowledgeable in any primary area of environmental health in
198 which they are routinely assigned duties.
199 (d) Persons who are certified shall renew their
200 certification biennially by completing not less than 24 contact
201 hours of continuing education for each program area in which
202 they maintain certification, subject to a maximum of 48 hours
203 for multiprogram certification.
204 (e) Applicants for certification shall have graduated from
205 an accredited 4-year college or university with a degree or
206 major coursework in public health, environmental health,
207 environmental science, or a physical or biological science.
208 (f) A certificateholder shall notify the department within
209 60 days after any change of name or address from that which
210 appears on the current certificate.
211 (5) STANDARDS FOR ENVIRONMENTAL HEALTH TECHNICIAN
212 CERTIFICATION.—The department, in conjunction with the
213 Department of Environmental Protection, shall adopt rules that
214 establish definitions of terms and minimum standards of
215 education, training, and experience for those persons subject to
216 this subsection. The rules must also address the process for
217 application, examination, issuance, expiration, and renewal of
218 certification, and ethical standards of practice for the
219 profession.
220 (a) At a minimum, the department shall establish standards
221 for technicians in the areas of onsite sewage treatment and
222 disposal.
223 (b) A person conducting septic inspections must be
224 certified by examination to be knowledgeable in the area of
225 onsite sewage treatment and disposal.
226 (c) An applicant for certification as an environmental
227 health technician must, at a minimum, have received a high
228 school diploma or its equivalent.
229 (d) An applicant for certification as an environmental
230 health technician must be employed by a department as defined in
231 s. 20.30.
232 (e) An applicant for certification as an environmental
233 health technician must complete supervised field inspection work
234 as prescribed by department rule before examination.
235 (f) A certified environmental health technician must renew
236 his or her certification biennially by completing at least 24
237 contact hours of continuing education for each program area in
238 which he or she maintains certification, subject to a maximum of
239 48 hours for multiprogram certification.
240 (g) A certified environmental health technician shall
241 notify the department within 60 days after any change of name or
242 address from that which appears on the current certificate.
243 (6)(5) EXEMPTIONS.—A person who conducts primary
244 environmental evaluation activities and maintains a current
245 registration or certification from another state agency which
246 examined the person’s knowledge of the primary program area and
247 requires comparable continuing education to maintain the
248 certificate shall not be required to be certified by this
249 section. Examples of persons not subject to certification are
250 physicians, registered dietitians, certified laboratory
251 personnel, and nurses.
252 (7)(6) FEES.—The department shall charge fees in amounts
253 necessary to meet the cost of providing environmental health
254 professional certification. Fees for certification shall be not
255 less than $10 or more than $300 and shall be set by rule.
256 Application, examination, and certification costs shall be
257 included in this fee. Fees for renewal of a certificate shall be
258 no less than $25 nor more than $150 per biennium.
259 Section 2. Section 381.991, Florida Statutes, is created to
260 read:
261 381.991 Andrew John Anderson Pediatric Rare Disease Grant
262 Program.—
263 (1)(a) There is created within the Department of Health the
264 Andrew John Anderson Rare Pediatric Disease Grant Program. The
265 purpose of the program is to advance the progress of research
266 and cures for rare pediatric diseases by awarding grants through
267 a competitive, peer-reviewed process.
268 (b) Subject to an annual appropriation by the Legislature,
269 the program shall award grants for scientific and clinical
270 research to further the search for new diagnostics, treatments,
271 and cures for rare pediatric diseases.
272 (2)(a) Applications for grants for rare pediatric disease
273 research may be submitted by any university or established
274 research institute in the state. All qualified investigators in
275 the state, regardless of institutional affiliation, shall have
276 equal access and opportunity to compete for the research
277 funding. Preference may be given to grant proposals that foster
278 collaboration among institutions, researchers, and community
279 practitioners, as such proposals support the advancement of
280 treatments and cures of rare pediatric diseases through basic or
281 applied research. Grants shall be awarded by the department,
282 after consultation with the Rare Disease Advisory Council,
283 pursuant to s. 381.99, on the basis of scientific merit, as
284 determined by the competitive, peer-reviewed process to ensure
285 objectivity, consistency, and high quality. The following types
286 of applications may be considered for funding:
287 1. Investigator-initiated research grants.
288 2. Institutional research grants.
289 3. Collaborative research grants, including those that
290 advance the finding of treatment and cures through basic or
291 applied research.
292 (b) To ensure appropriate and fair evaluation of grant
293 applications based on scientific merit, the department shall
294 appoint peer review panels of independent, scientifically
295 qualified individuals to review the scientific merit of each
296 proposal and establish its priority score. The priority scores
297 shall be forwarded to the council and must be considered in
298 determining which proposals shall be recommended for funding.
299 (c) The council and the peer review panels shall establish
300 and follow rigorous guidelines for ethical conduct and adhere to
301 a strict policy with regard to conflicts of interest. A member
302 of the council or panel may not participate in any discussion or
303 decision of the council or panel with respect to a research
304 proposal by any firm, entity, or agency that the member is
305 associated with as a member of the governing body or as an
306 employee or with which the member has entered into a contractual
307 arrangement.
308 (d) Notwithstanding s. 216.301 and pursuant to s. 216.351,
309 the balance of any appropriation from the General Revenue Fund
310 for the Andrew John Anderson Pediatric Rare Disease Grant
311 Program that is not disbursed but that is obligated pursuant to
312 contract or committed to be expended by June 30 of the fiscal
313 year in which the funds are appropriated may be carried forward
314 for up to 5 years after the effective date of the original
315 appropriation.
316 Section 3. Present subsection (5) of section 383.14,
317 Florida Statutes, is redesignated as subsection (6), a new
318 subsection (5) is added to that section, and subsections (1),
319 (2), and (3) of that section are amended, to read:
320 383.14 Screening for metabolic disorders, other hereditary
321 and congenital disorders, and environmental risk factors.—
322 (1) SCREENING REQUIREMENTS.—To help ensure access to the
323 maternal and child health care system, the Department of Health
324 shall promote the screening of all newborns born in Florida for
325 metabolic, hereditary, and congenital disorders known to result
326 in significant impairment of health or intellect, as screening
327 programs accepted by current medical practice become available
328 and practical in the judgment of the department. Any health care
329 practitioner present at a birth or responsible for primary care
330 during the neonatal period has the primary responsibility of
331 administering screenings as required in ss. 383.14 and 383.145.
332 As used in this subsection, the term “health care practitioner”
333 means a physician or physician assistant licensed under chapter
334 458, an osteopathic physician or physician assistant licensed
335 under chapter 459, an advanced practice registered nurse
336 licensed under part I of chapter 464, or a midwife licensed
337 under chapter 467 The department shall also promote the
338 identification and screening of all newborns in this state and
339 their families for environmental risk factors such as low
340 income, poor education, maternal and family stress, emotional
341 instability, substance abuse, and other high-risk conditions
342 associated with increased risk of infant mortality and morbidity
343 to provide early intervention, remediation, and prevention
344 services, including, but not limited to, parent support and
345 training programs, home visitation, and case management.
346 Identification, perinatal screening, and intervention efforts
347 shall begin prior to and immediately following the birth of the
348 child by the attending health care provider. Such efforts shall
349 be conducted in hospitals, perinatal centers, county health
350 departments, school health programs that provide prenatal care,
351 and birthing centers, and reported to the Office of Vital
352 Statistics.
353 (a) Prenatal screening.—The department shall develop a
354 multilevel screening process that includes a risk assessment
355 instrument to identify women at risk for a preterm birth or
356 other high-risk condition. The primary health care provider
357 shall complete the risk assessment instrument and report the
358 results to the Office of Vital Statistics so that the woman may
359 immediately be notified and referred to appropriate health,
360 education, and social services.
361 (b) Postnatal screening.—A risk factor analysis using the
362 department’s designated risk assessment instrument shall also be
363 conducted as part of the medical screening process upon the
364 birth of a child and submitted to the department’s Office of
365 Vital Statistics for recording and other purposes provided for
366 in this chapter. The department’s screening process for risk
367 assessment shall include a scoring mechanism and procedures that
368 establish thresholds for notification, further assessment,
369 referral, and eligibility for services by professionals or
370 paraprofessionals consistent with the level of risk. Procedures
371 for developing and using the screening instrument, notification,
372 referral, and care coordination services, reporting
373 requirements, management information, and maintenance of a
374 computer-driven registry in the Office of Vital Statistics which
375 ensures privacy safeguards must be consistent with the
376 provisions and plans established under chapter 411, Pub. L. No.
377 99-457, and this chapter. Procedures established for reporting
378 information and maintaining a confidential registry must include
379 a mechanism for a centralized information depository at the
380 state and county levels. The department shall coordinate with
381 existing risk assessment systems and information registries. The
382 department must ensure, to the maximum extent possible, that the
383 screening information registry is integrated with the
384 department’s automated data systems, including the Florida On
385 line Recipient Integrated Data Access (FLORIDA) system.
386 (a) Blood specimens for newborn screenings.—Newborn Tests
387 and screenings must be performed by the State Public Health
388 Laboratory, in coordination with Children’s Medical Services, at
389 such times and in such manner as is prescribed by the department
390 after consultation with the Genetics and Newborn Screening
391 Advisory Council and the Department of Education.
392 (b)(c) Release of screening results.—Notwithstanding any
393 law to the contrary, the State Public Health Laboratory may
394 release, directly or through the Children’s Medical Services
395 program, the results of a newborn’s hearing and metabolic tests
396 or screenings to the newborn’s health care practitioner, the
397 newborn’s parent or legal guardian, the newborn’s personal
398 representative, or a person designated by the newborn’s parent
399 or legal guardian. As used in this paragraph, the term “health
400 care practitioner” means a physician or physician assistant
401 licensed under chapter 458; an osteopathic physician or
402 physician assistant licensed under chapter 459; an advanced
403 practice registered nurse, registered nurse, or licensed
404 practical nurse licensed under part I of chapter 464; a midwife
405 licensed under chapter 467; a speech-language pathologist or
406 audiologist licensed under part I of chapter 468; or a dietician
407 or nutritionist licensed under part X of chapter 468; or a
408 genetic counselor licensed under part III of chapter 483.
409 (2) RULES.—
410 (a) After consultation with the Genetics and Newborn
411 Screening Advisory Council, the department shall adopt and
412 enforce rules requiring that every newborn in this state shall:
413 1. Before becoming 1 week of age, have a blood specimen
414 collected for newborn screenings be subjected to a test for
415 phenylketonuria;
416 2. Be tested for any condition included on the federal
417 Recommended Uniform Screening Panel which the council advises
418 the department should be included under the state’s screening
419 program. After the council recommends that a condition be
420 included, the department shall submit a legislative budget
421 request to seek an appropriation to add testing of the condition
422 to the newborn screening program. The department shall expand
423 statewide screening of newborns to include screening for such
424 conditions within 18 months after the council renders such
425 advice, if a test approved by the United States Food and Drug
426 Administration or a test offered by an alternative vendor is
427 available. If such a test is not available within 18 months
428 after the council makes its recommendation, the department shall
429 implement such screening as soon as a test offered by the United
430 States Food and Drug Administration or by an alternative vendor
431 is available; and
432 3. At the appropriate age, be tested for such other
433 metabolic diseases and hereditary or congenital disorders as the
434 department may deem necessary from time to time.
435 (b) After consultation with the Department of Education,
436 the department shall adopt and enforce rules requiring every
437 newborn in this state to be screened for environmental risk
438 factors that place children and their families at risk for
439 increased morbidity, mortality, and other negative outcomes.
440 (b)(c) The department shall adopt such additional rules as
441 are found necessary for the administration of this section and
442 ss. 383.145 and 383.148 s. 383.145, including rules providing
443 definitions of terms, rules relating to the methods used and
444 time or times for testing as accepted medical practice
445 indicates, rules relating to charging and collecting fees for
446 the administration of the newborn screening program authorized
447 by this section, rules for processing requests and releasing
448 test and screening results, and rules requiring mandatory
449 reporting of the results of tests and screenings for these
450 conditions to the department.
451 (3) DEPARTMENT OF HEALTH; POWERS AND DUTIES.—The department
452 shall administer and provide certain services to implement the
453 provisions of this section and shall:
454 (a) Assure the availability and quality of the necessary
455 laboratory tests and materials.
456 (b) Furnish all physicians, county health departments,
457 perinatal centers, birthing centers, and hospitals forms on
458 which environmental screening and the results of tests for
459 phenylketonuria and such other disorders for which testing may
460 be required from time to time shall be reported to the
461 department.
462 (c) Promote education of the public about the prevention
463 and management of metabolic, hereditary, and congenital
464 disorders and dangers associated with environmental risk
465 factors.
466 (c)(d) Maintain a confidential registry of cases, including
467 information of importance for the purpose of follow-up followup
468 services to prevent intellectual disabilities, to correct or
469 ameliorate physical disabilities, and for epidemiologic studies,
470 if indicated. Such registry shall be exempt from the provisions
471 of s. 119.07(1).
472 (d)(e) Supply the necessary dietary treatment products
473 where practicable for diagnosed cases of phenylketonuria and
474 other metabolic diseases for as long as medically indicated when
475 the products are not otherwise available. Provide nutrition
476 education and supplemental foods to those families eligible for
477 the Special Supplemental Nutrition Program for Women, Infants,
478 and Children as provided in s. 383.011.
479 (e)(f) Promote the availability of genetic studies,
480 services, and counseling in order that the parents, siblings,
481 and affected newborns may benefit from detection and available
482 knowledge of the condition.
483 (f)(g) Have the authority to charge and collect fees for
484 the administration of the newborn screening program. authorized
485 in this section, as follows:
486 1. A fee not to exceed $15 will be charged for each live
487 birth, as recorded by the Office of Vital Statistics, occurring
488 in a hospital licensed under part I of chapter 395 or a birth
489 center licensed under s. 383.305 per year. The department shall
490 calculate the annual assessment for each hospital and birth
491 center, and this assessment must be paid in equal amounts
492 quarterly. Quarterly, The department shall generate and issue
493 mail to each hospital and birth center a statement of the amount
494 due.
495 2. As part of the department’s legislative budget request
496 prepared pursuant to chapter 216, the department shall submit a
497 certification by the department’s inspector general, or the
498 director of auditing within the inspector general’s office, of
499 the annual costs of the uniform testing and reporting procedures
500 of the newborn screening program. In certifying the annual
501 costs, the department’s inspector general or the director of
502 auditing within the inspector general’s office shall calculate
503 the direct costs of the uniform testing and reporting
504 procedures, including applicable administrative costs.
505 Administrative costs shall be limited to those department costs
506 which are reasonably and directly associated with the
507 administration of the uniform testing and reporting procedures
508 of the newborn screening program.
509 (g)(h) Have the authority to bill third-party payors for
510 newborn screening tests.
511 (h)(i) Create and make available electronically a pamphlet
512 with information on screening for, and the treatment of,
513 preventable infant and childhood eye and vision disorders,
514 including, but not limited to, retinoblastoma and amblyopia.
515
516 All provisions of this subsection must be coordinated with the
517 provisions and plans established under this chapter, chapter
518 411, and Pub. L. No. 99-457.
519 (5) SUBMISSION OF NEWBORN SCREENING SPECIMEN CARDS.—Any
520 health care practitioner whose duty it is to administer
521 screenings under this section shall prepare and send all newborn
522 screening specimen cards to the State Public Health Laboratory
523 in accordance with rules adopted under this section. As used in
524 this subsection, the term “health care practitioner” means a
525 physician or physician assistant licensed under chapter 458, an
526 osteopathic physician or physician assistant licensed under
527 chapter 459, an advanced practice registered nurse licensed
528 under part I of chapter 464, or a midwife licensed under chapter
529 467.
530 Section 4. Paragraph (k) is added to subsection (2) of
531 Section 383.145, Florida Statutes, and subsection (3) of that
532 section is amended, to read:
533 383.145 Newborn, and infant, and toddler hearing
534 screening.—
535 (2) DEFINITIONS.—As used in this section, the term:
536 (k) “Toddler” means a child from 12 months to 36 months of
537 age.
538 (3) REQUIREMENTS FOR SCREENING OF NEWBORNS, INFANTS, AND
539 TODDLERS; INSURANCE COVERAGE; REFERRAL FOR ONGOING SERVICES.—
540 (a) Each hospital or other state-licensed birth birthing
541 facility that provides maternity and newborn care services shall
542 ensure that all newborns are, before discharge, screened for the
543 detection of hearing loss to prevent the consequences of
544 unidentified disorders. If a newborn fails the screening for the
545 detection of hearing loss, the hospital or other state-licensed
546 birth birthing facility must administer a test approved by the
547 United States Food and Drug Administration or another
548 diagnostically equivalent test on the newborn to screen for
549 congenital cytomegalovirus before the newborn becomes 21 days of
550 age or before discharge, whichever occurs earlier.
551 (b) Each licensed birth center that provides maternity and
552 newborn care services shall ensure that all newborns are, before
553 discharge, screened for the detection of hearing loss. Within 7
554 days after the birth, the licensed birth center must ensure that
555 all newborns who do not pass the hearing screening are referred
556 for to an appointment audiologist, a hospital, or another
557 newborn hearing screening provider for a test to screen for
558 congenital cytomegalovirus before the newborn becomes 21 days of
559 age screening for the detection of hearing loss to prevent the
560 consequences of unidentified disorders. The referral for
561 appointment must be made within 7 days after discharge. Written
562 documentation of the referral must be placed in the newborn’s
563 medical chart.
564 (c) If the parent or legal guardian of the newborn objects
565 to the screening, the screening must not be completed. In such
566 case, the physician, midwife, or other person attending the
567 newborn shall maintain a record that the screening has not been
568 performed and attach a written objection that must be signed by
569 the parent or guardian.
570 (d) For home births, the health care provider in attendance
571 is responsible for coordination and referral to an audiologist,
572 a hospital, or another newborn hearing screening provider. The
573 health care provider in attendance must make the referral for
574 appointment within 7 days after the birth. In cases in which the
575 home birth is not attended by a health care provider, the
576 newborn’s primary health care provider is responsible for
577 coordinating the referral.
578 (e) For home births and births in a licensed birth center,
579 if a newborn is referred to a newborn hearing screening provider
580 and the newborn fails the screening for the detection of hearing
581 loss, the newborn’s primary health care provider must refer the
582 newborn for administration of a test approved by the United
583 States Food and Drug Administration or another diagnostically
584 equivalent test on the newborn to screen for congenital
585 cytomegalovirus before the newborn becomes 21 days of age.
586 (f) All newborn and infant hearing screenings must be
587 conducted by an audiologist, a physician, or an appropriately
588 supervised individual who has completed documented training
589 specifically for newborn hearing screening. Every hospital that
590 provides maternity or newborn care services shall obtain the
591 services of an audiologist, a physician, or another newborn
592 hearing screening provider, through employment or contract or
593 written memorandum of understanding, for the purposes of
594 appropriate staff training, screening program supervision,
595 monitoring the scoring and interpretation of test results,
596 rendering of appropriate recommendations, and coordination of
597 appropriate follow-up services. Appropriate documentation of the
598 screening completion, results, interpretation, and
599 recommendations must be placed in the medical record within 24
600 hours after completion of the screening procedure.
601 (g) The screening of a newborn’s hearing must be completed
602 before the newborn is discharged from the hospital or licensed
603 birth center. However, if the screening is not completed before
604 discharge due to scheduling or temporary staffing limitations,
605 the screening must be completed within 21 days after the birth.
606 Screenings completed after discharge or performed because of
607 initial screening failure must be completed by an audiologist, a
608 physician, a hospital, or another newborn hearing screening
609 provider.
610 (h) Each hospital shall formally designate a lead physician
611 responsible for programmatic oversight for newborn hearing
612 screening. Each birth center shall designate a licensed health
613 care provider to provide such programmatic oversight and to
614 ensure that the appropriate referrals are being completed.
615 (i) When ordered by the treating physician, screening of a
616 newborn’s, infant’s, or toddler’s hearing must include auditory
617 brainstem responses, or evoked otoacoustic emissions, or
618 appropriate technology as approved by the United States Food and
619 Drug Administration.
620 (j) The results of any test conducted pursuant to this
621 section, including, but not limited to, newborn hearing loss
622 screening, congenital cytomegalovirus testing, and any related
623 diagnostic testing, must be reported to the department within 7
624 days after receipt of such results.
625 (k) The initial procedure for screening the hearing of the
626 newborn or infant and any medically necessary follow-up
627 reevaluations leading to diagnosis shall be a covered benefit
628 for Medicaid patients covered by a fee-for-service program. For
629 Medicaid patients enrolled in HMOs, providers shall be
630 reimbursed directly by the Medicaid Program Office at the
631 Medicaid rate. This service may not be considered a covered
632 service for the purposes of establishing the payment rate for
633 Medicaid HMOs. All health insurance policies and health
634 maintenance organizations as provided under ss. 627.6416,
635 627.6579, and 641.31(30), except for supplemental policies that
636 only provide coverage for specific diseases, hospital indemnity,
637 or Medicare supplement, or to the supplemental policies, shall
638 compensate providers for the covered benefit at the contracted
639 rate. Nonhospital-based providers are eligible to bill Medicaid
640 for the professional and technical component of each procedure
641 code.
642 (l) A child who is diagnosed as having permanent hearing
643 loss must be referred to the primary care physician for medical
644 management, treatment, and follow-up services. Furthermore, in
645 accordance with Part C of the Individuals with Disabilities
646 Education Act, Pub. L. No. 108-446, Infants and Toddlers with
647 Disabilities, any child from birth to 36 months of age who is
648 diagnosed as having hearing loss that requires ongoing special
649 hearing services must be referred to the Children’s Medical
650 Services Early Intervention Program serving the geographical
651 area in which the child resides.
652 Section 5. Section 383.147, Florida Statutes, is amended to
653 read:
654 383.147 Newborn and infant screenings for Sickle cell
655 disease and sickle cell trait hemoglobin variants; registry.—
656 (1) If a screening provider detects that a newborn as or an
657 infant, as those terms are defined in s. 383.145(2), is
658 identified as having sickle cell disease or carrying a sickle
659 cell trait through the newborn screening program as described in
660 s. 383.14, the department hemoglobin variant, it must:
661 (a) Notify the parent or guardian of the newborn and
662 provide information regarding the availability and benefits of
663 genetic counseling. primary care physician of the newborn or
664 infant and
665 (b) Submit the results of such screening to the Department
666 of Health for inclusion in the sickle cell registry established
667 under paragraph (2)(a), unless the parent or guardian of the
668 newborn provides an opt-out form obtained from the department,
669 or otherwise indicates in writing to the department his or her
670 objection to having the newborn included in the sickle cell
671 registry. The primary care physician must provide to the parent
672 or guardian of the newborn or infant information regarding the
673 availability and benefits of genetic counseling.
674 (2)(a) The Department of Health shall contract with a
675 community-based sickle cell disease medical treatment and
676 research center to establish and maintain a registry for
677 individuals newborns and infants who are identified as having
678 sickle cell disease or carrying a sickle cell trait hemoglobin
679 variant. The sickle cell registry must track sickle cell disease
680 outcome measures, except as provided in paragraph (1)(b). A
681 parent or guardian of a newborn or an infant in the registry may
682 request to have his or her child removed from the registry by
683 submitting a form prescribed by the department by rule.
684 (b) In addition to newborns identified and included in the
685 registry under subsection (1), persons living in this state who
686 have been identified as having sickle cell disease or carrying a
687 sickle cell trait may choose to be included in the registry by
688 providing the department with notification as prescribed by
689 rule.
690 (c) The Department of Health shall also establish a system
691 to ensure that the community-based sickle cell disease medical
692 treatment and research center notifies the parent or guardian of
693 a child who has been included in the registry that a follow-up
694 consultation with a physician is recommended. Such notice must
695 be provided to the parent or guardian of such child at least
696 once during early adolescence and once during late adolescence.
697 The department shall make every reasonable effort to notify
698 persons included in the registry who are 18 years of age that
699 they may request to be removed from the registry by submitting a
700 form prescribed by the department by rule. The department shall
701 also provide to such persons information regarding available
702 educational services, genetic counseling, and other beneficial
703 resources.
704 (3) The Department of Health shall adopt rules to implement
705 this section.
706 Section 6. Section 383.148, Florida Statutes, is created to
707 read:
708 383.148 ENVIRONMENTAL RISK SCREENING.—
709 (1) RISK SCREENING.—To help ensure access to the maternal
710 and child health care system, the Department of Health shall
711 promote the screening of all pregnant women and infants in this
712 state for environmental risk factors, such as low income, poor
713 education, maternal and family stress, mental health, substance
714 use disorder, and other high-risk conditions, and promote
715 education of the public about the dangers associated with
716 environmental risk factors.
717 (2) PRENATAL RISK SCREENING REQUIREMENTS.—The department
718 shall develop a multilevel screening process that includes a
719 risk assessment instrument to identify women at risk for a
720 preterm birth or other high-risk condition.
721 (a) A primary health care provider must complete the risk
722 screening at a pregnant woman’s first prenatal visit using the
723 form and in the manner prescribed by rules adopted under this
724 section, so that the woman may immediately be notified and
725 referred to appropriate health, education, and social services.
726 (b) This subsection does not apply if the pregnant woman
727 objects to the screening in a manner prescribed by department
728 rule.
729 (3) POSTNATAL RISK SCREENING REQUIREMENTS.—The department
730 shall develop a multilevel screening process that includes a
731 risk assessment instrument to identify factors associated with
732 increased risk of infant mortality and morbidity to provide
733 early intervention, remediation, and prevention services,
734 including, but not limited to, parent support and training
735 programs, home visitation, and case management.
736 (a) A hospital or birth center must complete the risk
737 screening immediately following the birth of the infant, before
738 discharge from the hospital or birth center, using the form and
739 in the manner prescribed by rules adopted under this section.
740 (b) This subsection does not apply if a parent or guardian
741 of the newborn objects to the screening in a manner prescribed
742 by department rule.
743 Section 7. Paragraph (i) of subsection (3) of section
744 383.318, Florida Statutes, is amended to read:
745 383.318 Postpartum care for birth center clients and
746 infants.—
747 (3) The birth center shall provide a postpartum evaluation
748 and followup care that includes all of the following:
749 (i) Provision of the informational pamphlet on infant and
750 childhood eye and vision disorders created by the department
751 pursuant to s. 383.14(3)(h) s. 383.14(3)(i).
752 Section 8. Section 395.1053, Florida Statutes, is amended
753 to read:
754 395.1053 Postpartum education.—A hospital that provides
755 birthing services shall incorporate information on safe sleep
756 practices and the possible causes of Sudden Unexpected Infant
757 Death into the hospital’s postpartum instruction on the care of
758 newborns and provide to each parent the informational pamphlet
759 on infant and childhood eye and vision disorders created by the
760 department pursuant to s. 383.14(3)(h) s. 383.14(3)(i).
761 Section 9. Section 456.0496, Florida Statutes, is amended
762 to read:
763 456.0496 Provision of information on eye and vision
764 disorders to parents during planned out-of-hospital births.—A
765 health care practitioner who attends an out-of-hospital birth
766 must ensure that the informational pamphlet on infant and
767 childhood eye and vision disorders created by the department
768 pursuant to s. 383.14(3)(h) s. 383.14(3)(i) is provided to each
769 parent after such a birth.
770 Section 10. This act shall take effect July 1, 2024.