Florida Senate - 2018 SB 434 By Senator Passidomo 28-00496B-18 2018434__ 1 A bill to be entitled 2 An act relating to a neonatal abstinence syndrome 3 pilot project; creating s. 409.9134, F.S.; defining 4 terms; requiring the Agency for Health Care 5 Administration, in consultation with the Department of 6 Children and Families, to establish a pilot project to 7 license one or more facilities in Medicaid Region 8 to 8 treat infants who suffer from neonatal abstinence 9 syndrome in certain circumstances; providing a start 10 and end date for the pilot project, subject to 11 appropriation; requiring the agency, in consultation 12 with the department, to adopt by rule minimum 13 licensure standards for facilities providing care 14 under this section; requiring certain criteria to be 15 included in licensure standards; authorizing the 16 agency to charge an initial licensure fee and a 17 biennial renewal fee; establishing minimum 18 requirements for a facility to obtain licensure and 19 participate in the pilot project; prohibiting a 20 facility licensed under this section from treating an 21 infant for longer than 6 months; requiring background 22 screening of certain facility personnel; subjecting 23 facilities licensed under this section to specific 24 licensing requirements; providing that facilities 25 licensed under this section are not required to obtain 26 a certificate of need; requiring the Department of 27 Health to contract with a state university to study 28 certain components of the pilot project and establish 29 certain baseline data for studies on the 30 neurodevelopmental outcomes of infants with neonatal 31 abstinence syndrome; requiring the Department of 32 Health to report results of the study to specified 33 legislative officials by a certain date; requiring 34 facilities licensed under this section, hospitals 35 meeting certain criteria, and Medicaid managed medical 36 assistance plans to provide financial and medical data 37 to the university under certain conditions; providing 38 an effective date. 39 40 Be It Enacted by the Legislature of the State of Florida: 41 42 Section 1. Section 409.9134, Florida Statutes, is created 43 to read: 44 409.9134 Pilot project for the treatment of infants with 45 neonatal abstinence syndrome.— 46 (1) For purposes of this section, the term: 47 (a) “Infant” includes both a newborn and an infant, as 48 those terms are defined in s. 383.145. 49 (b) “Neonatal abstinence syndrome” means the postnatal 50 opioid withdrawal experienced by an infant who is exposed in 51 utero to opioids or agents used to treat maternal opioid 52 addiction. 53 (2) The Agency for Health Care Administration, in 54 consultation with the department, shall establish a pilot 55 project to license one or more facilities in Medicaid Region 8 56 to treat infants who suffer from neonatal abstinence syndrome, 57 providing a community-based care option, rather than 58 hospitalization, after an infant has been stabilized. Subject to 59 specific appropriation, the pilot project shall begin on July 1, 60 2018 and expire on June 30, 2020. 61 (3) The agency, in consultation with the department, shall 62 adopt by rule minimum licensure standards for facilities 63 licensed to provide care under this section. 64 (a) Licensure standards adopted by the agency must include, 65 at a minimum: 66 1. Requirements for the physical plant and maintenance of 67 facilities; 68 2. Compliance with local building and fire safety codes; 69 3. The number, training, and qualifications of essential 70 personnel employed by and working under contract with the 71 facility; 72 4. Staffing requirements intended to ensure adequate 73 staffing to protect the safety of infants being treated in the 74 facility; 75 5. Sanitation requirements for the facility; 76 6. Requirements for programs, basic services, and care 77 provided to infants treated by the facility and their parents; 78 7. Requirements for the maintenance of medical records, 79 data, and other relevant information related to infants treated 80 by the facility; and 81 8. Requirements for application for initial licensure and 82 licensure renewal. 83 (b) The agency may charge an initial licensure fee and a 84 biennial renewal fee, each not to exceed $1,000. 85 (4) In order to obtain a license and participate in the 86 pilot project a facility must, at a minimum: 87 (a) Be a private, not-for-profit Florida corporation; 88 (b) Be a Medicaid provider; 89 (c) Have an on-call medical director; 90 (d) Demonstrate an ability to provide 24-hour nursing and 91 nurturing care to infants with neonatal abstinence syndrome; 92 (e) Demonstrate an ability to provide for the medical needs 93 of an infant being treated within the facility, including, but 94 not limited to, pharmacotherapy and nutrition management; 95 (f) Maintain a transfer agreement with a nearby hospital 96 that is not more than a 30-minute drive from the licensed 97 facility; 98 (g) Demonstrate an ability to provide comfortable 99 residential-type accommodations for an eligible mother to 100 breastfeed her infant or to reside within the facility while her 101 infant is being treated at that facility, if not contraindicated 102 and if funding is available for residential services. The 103 facility may request at any time that the mother’s breast milk 104 be tested for contaminants or that the mother submit to a drug 105 test. The mother shall vacate the facility if she refuses to 106 allow her breast milk to be tested or to consent to a drug test 107 or if the facility determines that the mother poses a risk to 108 her infant; 109 (h) Be able to provide or make available parenting 110 education, breastfeeding education, counseling, and other 111 resources to the parents of infants being treated at the 112 facility including, if necessary, a referral for addiction 113 treatment services; 114 (i) Contract and coordinate with Medicaid managed medical 115 assistance plans as appropriate to ensure that services for both 116 the infant and the parent or the infant’s representative are 117 timely and unduplicated; 118 (j) Identify, and refer parents to, social service 119 providers, such as Healthy Start, Early Steps, and Head Start 120 programs, prior to discharge, if appropriate; and 121 (k) Adhere to all applicable standards established by the 122 agency by rule pursuant to subsection (3). 123 (5) A facility licensed under this section may not accept 124 an infant for treatment if the infant has a serious or life 125 threatening condition other than neonatal abstinence syndrome. 126 (6) A facility licensed under this section may not treat an 127 infant for longer than 6 months. 128 (7) The agency shall require level 2 background screening 129 for facility personnel as required in s. 408.809(1)(e) pursuant 130 to chapter 435 and s. 408.809. 131 (8) Facilities licensed under this section are subject to 132 the requirements of part II of chapter 408. 133 (9) Facilities licensed under this section are not required 134 to obtain a certificate of need. 135 (10)(a) The Department of Health shall contract with a 136 state university to study the risks, benefits, cost 137 differentials, and the transition of infants to the social 138 service providers identified in paragraph (4)(j) for the 139 treatment of infants with neonatal abstinence syndrome in 140 hospital settings and facilities licensed under the pilot 141 project. By December 21, 2019, the Department of Health shall 142 report to the President of the Senate and the Speaker of the 143 House of Representatives the study results and recommendations 144 for the continuation or expansion of the pilot project. 145 (b) The contract must also require the establishment of 146 baseline data for longitudinal studies on the neurodevelopmental 147 outcomes of infants with neonatal abstinence syndrome, and may 148 require the evaluation of outcomes and length of stay in 149 facilities for nonpharmacologic and pharmacologic treatment of 150 neonatal abstinence syndrome. 151 (c) Facilities licensed under this section, licensed 152 hospitals providing services for infants born with neonatal 153 abstinence syndrome, and Medicaid medical assistance plans shall 154 provide relevant financial and medical data consistent with the 155 Health Insurance Portability and Accountability Act of 1996 156 (HIPAA) and related regulations to the contracted university for 157 research and studies authorized pursuant to this subsection. 158 Section 2. This act shall take effect upon becoming a law.