Florida Senate - 2020                        COMMITTEE AMENDMENT
       Bill No. SB 1764
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Health Policy (Flores) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (5) of section 467.015, Florida
    6  Statutes, is amended to read
    7         467.015 Responsibilities of the midwife.—
    8         (5) The midwife, whether providing an in-hospital or out
    9  of-hospital birth, shall do all of the following:
   10         (a)Upon acceptance of a patient into care, advise the
   11  patient of the clinical outcomes of births in low-risk patients
   12  during an out-of-hospital birth and any increased risks
   13  associated with an individual having a vaginal birth after
   14  having a caesarean section, a breech birth, or a multiple
   15  gestation pregnancy. The licensed health care practitioner
   16  providing out-of-hospital births shall further advise, but may
   17  not require, the patient to consult an obstetrician for more
   18  information related to such clinical outcomes and increased
   19  risks.
   20         (b)(a) Prepare a written plan of action with the patient
   21  and the patient’s family, if any, to ensure continuity of
   22  medical care throughout labor and delivery and to provide for
   23  immediate medical care if an emergency arises. The family should
   24  have specific plans for medical care throughout the prenatal,
   25  intrapartal, and postpartal periods.
   26         (c)(b)If a home birth is planned, instruct the patient and
   27  family regarding the preparation of the environment and ensure
   28  availability of equipment and supplies needed for delivery and
   29  infant care, if a home birth is planned.
   30         (d)(c) Instruct the patient in the hygiene of pregnancy and
   31  nutrition as it relates to prenatal care.
   32         (e)(d) Maintain equipment and supplies in conformity with
   33  the rules adopted pursuant to this chapter.
   34         (f)Upon initial contact with the patient during the
   35  intrapartal period, measure and record the vital signs of the
   36  mother and fetus to serve as a baseline during labor and
   37  delivery.
   38         (g)Transfer care of the patient to a hospital with
   39  obstetrical services in accordance with the written emergency
   40  plan if any of the following occurs or presents during labor or
   41  delivery or immediately thereafter:
   42         1.An unexpected nonvertex presentation of the fetus;
   43         2.Indication that the mother’s uterus has ruptured;
   44         3.Evidence of severe and persistent fetal or maternal
   45  distress;
   46         4.Pregnancy-induced hypertension;
   47         5.An umbilical cord prolapse;
   48         6.An active infectious disease process; or
   49         7.Any other severe emergent condition.
   50         Section 2. Section 467.016, Florida Statutes, is amended to
   51  read:
   52         467.016 Informed consent.—The department shall develop a
   53  uniform patient informed consent client informed-consent form to
   54  be used by the midwife providing out-of-hospital births to
   55  inform the patient client of the qualifications of a licensed
   56  midwife and the nature and risk of the procedures to be used by
   57  a midwife and to obtain the patient’s client’s consent for the
   58  provision of out-of-hospital birth midwifery services. The form
   59  must be signed by the patient and the midwife providing out-of
   60  hospital births, and a copy must be provided to the patient. The
   61  form shall include, at a minimum, all of the following:
   62         (a)A statement advising the patient of the clinical
   63  outcomes of births in low-risk patients during an out-of
   64  hospital birth and any increased risks associated with having a
   65  vaginal birth after having a caesarean section, a breech birth,
   66  or a multiple gestation pregnancy.
   67         (b)A detailed statement explaining to the patient hospital
   68  admitting privileges and the requirements for a health care
   69  practitioner to obtain and maintain such privileges.
   70         (c)Disclosure of each hospital and specific department, if
   71  any, where the health care practitioner providing out-of
   72  hospital births has been granted admitting privileges, including
   73  the scope and duration of the admitting privileges, the current
   74  contact information for the specific hospital or department that
   75  has granted the health care practitioner admitting privileges,
   76  and a copy of documentation from the hospital or department
   77  providing proof of such admitting privileges. A health care
   78  practitioner providing out-of-hospital births who does not have
   79  admitting privileges at any hospital must explicitly state that
   80  fact on the form.
   82  ================= T I T L E  A M E N D M E N T ================
   83  And the title is amended as follows:
   84         Delete everything before the enacting clause
   85  and insert:
   86                        A bill to be entitled                      
   87         An act relating to midwifery; amending s. 467.015,
   88         F.S.; revising responsibilities of licensed midwives
   89         providing out-of-hospital births; amending s. 467.016,
   90         F.S.; revising the requirements for the uniform
   91         patient informed consent form used by licensed
   92         midwives providing out-of-hospital births; providing
   93         an effective date.