Florida Senate - 2023                                    SB 1192
       By Senator Rodriguez
       40-00830B-23                                          20231192__
    1                        A bill to be entitled                      
    2         An act relating to certified nurse midwives; amending
    3         s. 464.0123, F.S.; requiring certain certified nurse
    4         midwives, in order to provide out-of-hospital
    5         intrapartum care, to maintain a written policy for the
    6         transfer of patients needing a higher acuity of care
    7         or emergency services; requiring that such policy
    8         prescribe and require the use of an emergency plan-of
    9         care form; providing requirements for the form;
   10         requiring such certified nurse midwives to document
   11         specified information on the form if the transfer of
   12         care is determined to be necessary; requiring
   13         certified nurse midwives, before such transfer of the
   14         patient, to verbally provide the receiving provider
   15         with specified information; requiring certified nurse
   16         midwives to provide the patient’s emergency plan-of
   17         care form to the receiving provider upon the patient’s
   18         transfer, as well as certain patient records;
   19         requiring the board to adopt certain rules; providing
   20         an effective date.
   22  Be It Enacted by the Legislature of the State of Florida:
   24         Section 1. Paragraph (b) of subsection (3) of section
   25  464.0123, Florida Statutes, is amended to read:
   26         464.0123 Autonomous practice by an advanced practice
   27  registered nurse.—
   28         (3) PRACTICE REQUIREMENTS.—
   29         (b)1.In order to provide out-of-hospital intrapartum care,
   30  a certified nurse midwife engaged in the autonomous practice of
   31  nurse midwifery must maintain a written policy for the transfer
   32  of patients needing a higher acuity of care or emergency
   33  services. The policy must prescribe and require use of an
   34  emergency plan-of-care form, which must be signed by the patient
   35  before admission to intrapartum care. At a minimum, the form
   36  must include all of the following:
   37         a.The name and address of the closest hospital with
   38  maternity and newborn services.
   39         b.Reasons for which transfer of care would be necessary,
   40  including the transfer-of-care conditions prescribed by board
   41  rule.
   42         c.Ambulances or other emergency medical services that
   43  would be used to transport the patient in the event of an
   44  emergency.
   45         2.If transfer of care is determined necessary by the
   46  certified nurse midwife, the certified nurse midwife must
   47  document all of the following information on the patient’s
   48  emergency plan-of-care form:
   49         a.The name, date of birth, and condition of the patient.
   50         b.The gravidity and parity of the patient and the
   51  gestational age and condition of the fetus or newborn infant.
   52         c.The reasons that necessitated the transfer of care.
   53         d.A description of the situation, relevant clinical
   54  background, assessment, and recommendations.
   55         e.The planned mode of transporting the patient to the
   56  receiving facility.
   57         f.The expected time of arrival at the receiving facility.
   58         3.Before transferring the patient, the certified nurse
   59  midwife must provide the receiving provider with a verbal
   60  summary of the information specified in subparagraph 2. Upon
   61  transfer of the patient to the receiving facility, the certified
   62  nurse midwife must provide the receiving provider with the
   63  patient’s emergency plan-of-care form.
   64         4.The certified nurse midwife shall provide the receiving
   65  provider with the patient’s prenatal records, including patient
   66  history, prenatal laboratory results, sonograms, prenatal care
   67  flow sheets, maternal fetal medical reports, and labor flow
   68  charting and current notations.
   69         5.The board shall adopt rules to prescribe transfer-of
   70  care conditions, monitor for excessive transfers, conduct
   71  reviews of adverse maternal and neonatal outcomes, and monitor
   72  the licensure of certified nurse midwives engaged in autonomous
   73  practice must have a written patient transfer agreement with a
   74  hospital and a written referral agreement with a physician
   75  licensed under chapter 458 or chapter 459 to engage in nurse
   76  midwifery.
   77         Section 2. This act shall take effect July 1, 2023.