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.
   40  Be It Enacted by the Legislature of the State of Florida:
   42         Section 1. Section 409.9134, Florida Statutes, is created
   43  to read:
   44         409.9134Pilot 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.