CS for CS for CS for SB 1582              Second Engrossed (ntc)
       
       
       
       
       
       
       
       
       20241582e2
       
    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 Pediatric Rare 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; requiring
   59         licensed birth centers to complete newborn hearing
   60         loss screenings before discharge, with an exception;
   61         amending s. 383.147, F.S.; revising sickle cell
   62         disease and sickle cell trait screening requirements;
   63         requiring screening providers to notify a newborn’s
   64         parent or guardian, rather than the newborn’s primary
   65         care physician, of certain information; authorizing
   66         the parents or guardians of a newborn to opt out of
   67         the newborn’s inclusion in the sickle cell registry;
   68         specifying the manner in which a parent or guardian
   69         may opt out; authorizing certain persons other than
   70         newborns who have been identified as having sickle
   71         cell disease or carrying a sickle cell trait to choose
   72         to be included in the registry; creating s. 383.148,
   73         F.S.; requiring the department to promote the
   74         screening of pregnant women and infants for specified
   75         environmental risk factors; requiring the department
   76         to develop a multilevel screening process for prenatal
   77         and postnatal risk screenings; specifying requirements
   78         for such screening processes; providing construction;
   79         requiring persons who object to a screening to give a
   80         written statement of such objection to the physician
   81         or other person required to administer and report the
   82         screening; amending s. 1004.435, F.S.; revising the
   83         membership of the Florida Cancer Control and Research
   84         Advisory Council; revising quorum requirements for
   85         council actions; amending ss. 383.318, 395.1053, and
   86         456.0496, F.S.; conforming cross-references; requiring
   87         the department to grant certain applicants 90 days to
   88         cure deficiencies with their medical marijuana
   89         treatment center license applications pursuant to a
   90         specified errors and omissions process; requiring the
   91         department to grant such applicants a marijuana
   92         treatment center license if they cure the deficiencies
   93         within the specified timeframe; providing
   94         construction; providing that the death of an applicant
   95         during the cure process may not be a reason to deny
   96         the application or any resulting legal challenge;
   97         requiring the department to issue the license to the
   98         estate of a deceased applicant in the event of a
   99         successful cure or legal challenge; providing
  100         effective dates.
  101          
  102  Be It Enacted by the Legislature of the State of Florida:
  103  
  104         Section 1. Present subsections (5), (6), and (7) of section
  105  381.0101, Florida Statutes, are redesignated as subsections (6),
  106  (7), and (8), respectively, a new subsection (5) is added to
  107  that section, and subsections (1), (2), and (4) and present
  108  subsections (5) and (6) of that section are amended, to read:
  109         381.0101 Environmental health professionals.—
  110         (1) DEFINITIONS.—As used in this section, the term:
  111         (a) “Board” means the Environmental Health Professionals
  112  Advisory Board.
  113         (c)(b) “Department” means the Department of Health.
  114         (d)(c) “Environmental health” means that segment of public
  115  health work which deals with the examination of those factors in
  116  the human environment which may impact adversely on the health
  117  status of an individual or the public.
  118         (e)(d) “Environmental health professional” means a person
  119  who is employed or assigned the responsibility for assessing the
  120  environmental health or sanitary conditions, as defined by the
  121  department, within a building, on an individual’s property, or
  122  within the community at large, and who has the knowledge,
  123  skills, and abilities to carry out these tasks. Environmental
  124  health professionals may be either field, supervisory, or
  125  administrative staff members.
  126         (b)(e) “Certified” means a person who has displayed
  127  competency to perform evaluations of environmental or sanitary
  128  conditions through examination.
  129         (f)“Environmental health technician” means a person who is
  130  employed or assigned the responsibility for conducting septic
  131  inspections under the supervision of a certified environmental
  132  health professional. An environmental health technician must
  133  have completed training approved by the department and have the
  134  knowledge, skills, and abilities to carry out these tasks.
  135         (h)(f) “Registered sanitarian,” “R.S.,” “Registered
  136  Environmental Health Specialist,” or “R.E.H.S.” means a person
  137  who has been certified by either the National Environmental
  138  Health Association or the Florida Environmental Health
  139  Association as knowledgeable in the environmental health
  140  profession.
  141         (g) “Primary environmental health program” means those
  142  programs determined by the department to be essential for
  143  providing basic environmental and sanitary protection to the
  144  public. At a minimum, these programs shall include food
  145  protection program work.
  146         (2) CERTIFICATION; EXEMPTIONS REQUIRED.—A person may not
  147  perform environmental health or sanitary evaluations in any
  148  primary program area of environmental health without being
  149  certified by the department as competent to perform such
  150  evaluations. This section does not apply to any of the
  151  following:
  152         (a) Persons performing inspections of public food service
  153  establishments licensed under chapter 509.; or
  154         (b) Persons performing site evaluations in order to
  155  determine proper placement and installation of onsite wastewater
  156  treatment and disposal systems who have successfully completed a
  157  department-approved soils morphology course and who are working
  158  under the direct responsible charge of an engineer licensed
  159  under chapter 471.
  160         (c)Environmental health technicians employed by a
  161  department as defined in s. 20.03 who are assigned the
  162  responsibility for conducting septic tank inspections under the
  163  supervision of an environmental health professional certified in
  164  onsite sewage treatment and disposal.
  165         (4) STANDARDS FOR CERTIFICATION.—The department shall adopt
  166  rules that establish definitions of terms and minimum standards
  167  of education, training, or experience for those persons subject
  168  to this subsection section. The rules must also address the
  169  process for application, examination, issuance, expiration, and
  170  renewal of certification and ethical standards of practice for
  171  the profession.
  172         (a) Persons employed as environmental health professionals
  173  shall exhibit a knowledge of rules and principles of
  174  environmental and public health law in Florida through
  175  examination. A person may not conduct environmental health
  176  evaluations in a primary program area unless he or she is
  177  currently certified in that program area or works under the
  178  direct supervision of a certified environmental health
  179  professional.
  180         1. All persons who begin employment in a primary
  181  environmental health program on or after September 21, 1994,
  182  must be certified in that program within 6 months after
  183  employment.
  184         2. Persons employed in the primary environmental health
  185  program of a food protection program or an onsite sewage
  186  treatment and disposal system prior to September 21, 1994, shall
  187  be considered certified while employed in that position and
  188  shall be required to adhere to any professional standards
  189  established by the department pursuant to paragraph (b),
  190  complete any continuing education requirements imposed under
  191  paragraph (d), and pay the certificate renewal fee imposed under
  192  subsection (7) (6).
  193         3. Persons employed in the primary environmental health
  194  program of a food protection program or an onsite sewage
  195  treatment and disposal system prior to September 21, 1994, who
  196  change positions or program areas and transfer into another
  197  primary environmental health program area on or after September
  198  21, 1994, must be certified in that program within 6 months
  199  after such transfer, except that they will not be required to
  200  possess the college degree required under paragraph (e).
  201         4. Registered sanitarians shall be considered certified and
  202  shall be required to adhere to any professional standards
  203  established by the department pursuant to paragraph (b).
  204         (b) At a minimum, the department shall establish standards
  205  for professionals in the areas of food hygiene and onsite sewage
  206  treatment and disposal.
  207         (c) Those persons conducting primary environmental health
  208  evaluations shall be certified by examination to be
  209  knowledgeable in any primary area of environmental health in
  210  which they are routinely assigned duties.
  211         (d) Persons who are certified shall renew their
  212  certification biennially by completing not less than 24 contact
  213  hours of continuing education for each program area in which
  214  they maintain certification, subject to a maximum of 48 hours
  215  for multiprogram certification.
  216         (e) Applicants for certification shall have graduated from
  217  an accredited 4-year college or university with a degree or
  218  major coursework in public health, environmental health,
  219  environmental science, or a physical or biological science.
  220         (f) A certificateholder shall notify the department within
  221  60 days after any change of name or address from that which
  222  appears on the current certificate.
  223         (5)STANDARDS FOR ENVIRONMENTAL HEALTH TECHNICIAN
  224  CERTIFICATION.—The department, in conjunction with the
  225  Department of Environmental Protection, shall adopt rules that
  226  establish definitions of terms and minimum standards of
  227  education, training, and experience for those persons subject to
  228  this subsection. The rules must also address the process for
  229  application, examination, issuance, expiration, and renewal of
  230  certification, and ethical standards of practice for the
  231  profession.
  232         (a)At a minimum, the department shall establish standards
  233  for technicians in the areas of onsite sewage treatment and
  234  disposal.
  235         (b)A person conducting septic inspections must be
  236  certified by examination to be knowledgeable in the area of
  237  onsite sewage treatment and disposal.
  238         (c)An applicant for certification as an environmental
  239  health technician must, at a minimum, have received a high
  240  school diploma or its equivalent.
  241         (d)An applicant for certification as an environmental
  242  health technician must be employed by a department as defined in
  243  s. 20.30.
  244         (e)An applicant for certification as an environmental
  245  health technician must complete supervised field inspection work
  246  as prescribed by department rule before examination.
  247         (f)A certified environmental health technician must renew
  248  his or her certification biennially by completing at least 24
  249  contact hours of continuing education for each program area in
  250  which he or she maintains certification, subject to a maximum of
  251  48 hours for multiprogram certification.
  252         (g)A certified environmental health technician shall
  253  notify the department within 60 days after any change of name or
  254  address from that which appears on the current certificate.
  255         (6)(5) EXEMPTIONS.—A person who conducts primary
  256  environmental evaluation activities and maintains a current
  257  registration or certification from another state agency which
  258  examined the person’s knowledge of the primary program area and
  259  requires comparable continuing education to maintain the
  260  certificate shall not be required to be certified by this
  261  section. Examples of persons not subject to certification are
  262  physicians, registered dietitians, certified laboratory
  263  personnel, and nurses.
  264         (7)(6) FEES.—The department shall charge fees in amounts
  265  necessary to meet the cost of providing environmental health
  266  professional certification. Fees for certification shall be not
  267  less than $10 or more than $300 and shall be set by rule.
  268  Application, examination, and certification costs shall be
  269  included in this fee. Fees for renewal of a certificate shall be
  270  no less than $25 nor more than $150 per biennium.
  271         Section 2. Section 381.991, Florida Statutes, is created to
  272  read:
  273         381.991 Andrew John Anderson Pediatric Rare Disease Grant
  274  Program.—
  275         (1)(a)There is created within the Department of Health the
  276  Andrew John Anderson Pediatric Rare Disease Grant Program. The
  277  purpose of the program is to advance the progress of research
  278  and cures for pediatric rare diseases by awarding grants through
  279  a competitive, peer-reviewed process.
  280         (b)Subject to an annual appropriation by the Legislature,
  281  the program shall award grants for scientific and clinical
  282  research to further the search for new diagnostics, treatments,
  283  and cures for pediatric rare diseases.
  284         (2)(a)Applications for grants for pediatric rare disease
  285  research may be submitted by any university or established
  286  research institute in the state. All qualified investigators in
  287  the state, regardless of institutional affiliation, shall have
  288  equal access and opportunity to compete for the research
  289  funding. Preference may be given to grant proposals that foster
  290  collaboration among institutions, researchers, and community
  291  practitioners, as such proposals support the advancement of
  292  treatments and cures of pediatric rare diseases through basic or
  293  applied research. Grants shall be awarded by the department,
  294  after consultation with the Rare Disease Advisory Council,
  295  pursuant to s. 381.99, on the basis of scientific merit, as
  296  determined by the competitive, peer-reviewed process to ensure
  297  objectivity, consistency, and high quality. The following types
  298  of applications may be considered for funding:
  299         1.Investigator-initiated research grants.
  300         2.Institutional research grants.
  301         3.Collaborative research grants, including those that
  302  advance the finding of treatment and cures through basic or
  303  applied research.
  304         (b)To ensure appropriate and fair evaluation of grant
  305  applications based on scientific merit, the department shall
  306  appoint peer review panels of independent, scientifically
  307  qualified individuals to review the scientific merit of each
  308  proposal and establish its priority score. The priority scores
  309  shall be forwarded to the council and must be considered in
  310  determining which proposals shall be recommended for funding.
  311         (c)The council and the peer review panels shall establish
  312  and follow rigorous guidelines for ethical conduct and adhere to
  313  a strict policy with regard to conflicts of interest. A member
  314  of the council or panel may not participate in any discussion or
  315  decision of the council or panel with respect to a research
  316  proposal by any firm, entity, or agency that the member is
  317  associated with as a member of the governing body or as an
  318  employee or with which the member has entered into a contractual
  319  arrangement.
  320         (d)Notwithstanding s. 216.301 and pursuant to s. 216.351,
  321  the balance of any appropriation from the General Revenue Fund
  322  for the Andrew John Anderson Pediatric Rare Disease Grant
  323  Program that is not disbursed but that is obligated pursuant to
  324  contract or committed to be expended by June 30 of the fiscal
  325  year in which the funds are appropriated may be carried forward
  326  for up to 5 years after the effective date of the original
  327  appropriation.
  328         Section 3. Present subsection (5) of section 383.14,
  329  Florida Statutes, is redesignated as subsection (6), a new
  330  subsection (5) is added to that section, and subsections (1),
  331  (2), and (3) of that section are amended, to read:
  332         383.14 Screening for metabolic disorders, other hereditary
  333  and congenital disorders, and environmental risk factors.—
  334         (1) SCREENING REQUIREMENTS.—To help ensure access to the
  335  maternal and child health care system, the Department of Health
  336  shall promote the screening of all newborns born in Florida for
  337  metabolic, hereditary, and congenital disorders known to result
  338  in significant impairment of health or intellect, as screening
  339  programs accepted by current medical practice become available
  340  and practical in the judgment of the department. Any health care
  341  practitioner present at a birth or responsible for primary care
  342  during the neonatal period has the primary responsibility of
  343  administering screenings as required in ss. 383.14 and 383.145.
  344  As used in this subsection, the term “health care practitioner”
  345  means a physician or physician assistant licensed under chapter
  346  458, an osteopathic physician or physician assistant licensed
  347  under chapter 459, an advanced practice registered nurse
  348  licensed under part I of chapter 464, or a midwife licensed
  349  under chapter 467 The department shall also promote the
  350  identification and screening of all newborns in this state and
  351  their families for environmental risk factors such as low
  352  income, poor education, maternal and family stress, emotional
  353  instability, substance abuse, and other high-risk conditions
  354  associated with increased risk of infant mortality and morbidity
  355  to provide early intervention, remediation, and prevention
  356  services, including, but not limited to, parent support and
  357  training programs, home visitation, and case management.
  358  Identification, perinatal screening, and intervention efforts
  359  shall begin prior to and immediately following the birth of the
  360  child by the attending health care provider. Such efforts shall
  361  be conducted in hospitals, perinatal centers, county health
  362  departments, school health programs that provide prenatal care,
  363  and birthing centers, and reported to the Office of Vital
  364  Statistics.
  365         (a) Prenatal screening.The department shall develop a
  366  multilevel screening process that includes a risk assessment
  367  instrument to identify women at risk for a preterm birth or
  368  other high-risk condition. The primary health care provider
  369  shall complete the risk assessment instrument and report the
  370  results to the Office of Vital Statistics so that the woman may
  371  immediately be notified and referred to appropriate health,
  372  education, and social services.
  373         (b) Postnatal screening.A risk factor analysis using the
  374  department’s designated risk assessment instrument shall also be
  375  conducted as part of the medical screening process upon the
  376  birth of a child and submitted to the department’s Office of
  377  Vital Statistics for recording and other purposes provided for
  378  in this chapter. The department’s screening process for risk
  379  assessment shall include a scoring mechanism and procedures that
  380  establish thresholds for notification, further assessment,
  381  referral, and eligibility for services by professionals or
  382  paraprofessionals consistent with the level of risk. Procedures
  383  for developing and using the screening instrument, notification,
  384  referral, and care coordination services, reporting
  385  requirements, management information, and maintenance of a
  386  computer-driven registry in the Office of Vital Statistics which
  387  ensures privacy safeguards must be consistent with the
  388  provisions and plans established under chapter 411, Pub. L. No.
  389  99-457, and this chapter. Procedures established for reporting
  390  information and maintaining a confidential registry must include
  391  a mechanism for a centralized information depository at the
  392  state and county levels. The department shall coordinate with
  393  existing risk assessment systems and information registries. The
  394  department must ensure, to the maximum extent possible, that the
  395  screening information registry is integrated with the
  396  department’s automated data systems, including the Florida On
  397  line Recipient Integrated Data Access (FLORIDA) system.
  398         (a)Blood specimens for newborn screenings.Newborn Tests
  399  and screenings must be performed by the State Public Health
  400  Laboratory, in coordination with Children’s Medical Services, at
  401  such times and in such manner as is prescribed by the department
  402  after consultation with the Genetics and Newborn Screening
  403  Advisory Council and the Department of Education.
  404         (b)(c)Release of screening results.—Notwithstanding any
  405  law to the contrary, the State Public Health Laboratory may
  406  release, directly or through the Children’s Medical Services
  407  program, the results of a newborn’s hearing and metabolic tests
  408  or screenings to the newborn’s health care practitioner, the
  409  newborn’s parent or legal guardian, the newborn’s personal
  410  representative, or a person designated by the newborn’s parent
  411  or legal guardian. As used in this paragraph, the term “health
  412  care practitioner” means a physician or physician assistant
  413  licensed under chapter 458; an osteopathic physician or
  414  physician assistant licensed under chapter 459; an advanced
  415  practice registered nurse, registered nurse, or licensed
  416  practical nurse licensed under part I of chapter 464; a midwife
  417  licensed under chapter 467; a speech-language pathologist or
  418  audiologist licensed under part I of chapter 468; or a dietician
  419  or nutritionist licensed under part X of chapter 468; or a
  420  genetic counselor licensed under part III of chapter 483.
  421         (2) RULES.—
  422         (a) After consultation with the Genetics and Newborn
  423  Screening Advisory Council, the department shall adopt and
  424  enforce rules requiring that every newborn in this state shall:
  425         1. Before becoming 1 week of age, have a blood specimen
  426  collected for newborn screenings be subjected to a test for
  427  phenylketonuria;
  428         2. Be tested for any condition included on the federal
  429  Recommended Uniform Screening Panel which the council advises
  430  the department should be included under the state’s screening
  431  program. After the council recommends that a condition be
  432  included, the department shall submit a legislative budget
  433  request to seek an appropriation to add testing of the condition
  434  to the newborn screening program. The department shall expand
  435  statewide screening of newborns to include screening for such
  436  conditions within 18 months after the council renders such
  437  advice, if a test approved by the United States Food and Drug
  438  Administration or a test offered by an alternative vendor is
  439  available. If such a test is not available within 18 months
  440  after the council makes its recommendation, the department shall
  441  implement such screening as soon as a test offered by the United
  442  States Food and Drug Administration or by an alternative vendor
  443  is available; and
  444         3. At the appropriate age, be tested for such other
  445  metabolic diseases and hereditary or congenital disorders as the
  446  department may deem necessary from time to time.
  447         (b) After consultation with the Department of Education,
  448  the department shall adopt and enforce rules requiring every
  449  newborn in this state to be screened for environmental risk
  450  factors that place children and their families at risk for
  451  increased morbidity, mortality, and other negative outcomes.
  452         (b)(c) The department shall adopt such additional rules as
  453  are found necessary for the administration of this section and
  454  ss. 383.145 and 383.148 s. 383.145, including rules providing
  455  definitions of terms, rules relating to the methods used and
  456  time or times for testing as accepted medical practice
  457  indicates, rules relating to charging and collecting fees for
  458  the administration of the newborn screening program authorized
  459  by this section, rules for processing requests and releasing
  460  test and screening results, and rules requiring mandatory
  461  reporting of the results of tests and screenings for these
  462  conditions to the department.
  463         (3) DEPARTMENT OF HEALTH; POWERS AND DUTIES.—The department
  464  shall administer and provide certain services to implement the
  465  provisions of this section and shall:
  466         (a) Assure the availability and quality of the necessary
  467  laboratory tests and materials.
  468         (b) Furnish all physicians, county health departments,
  469  perinatal centers, birthing centers, and hospitals forms on
  470  which environmental screening and the results of tests for
  471  phenylketonuria and such other disorders for which testing may
  472  be required from time to time shall be reported to the
  473  department.
  474         (c) Promote education of the public about the prevention
  475  and management of metabolic, hereditary, and congenital
  476  disorders and dangers associated with environmental risk
  477  factors.
  478         (c)(d) Maintain a confidential registry of cases, including
  479  information of importance for the purpose of follow-up followup
  480  services to prevent intellectual disabilities, to correct or
  481  ameliorate physical disabilities, and for epidemiologic studies,
  482  if indicated. Such registry shall be exempt from the provisions
  483  of s. 119.07(1).
  484         (d)(e) Supply the necessary dietary treatment products
  485  where practicable for diagnosed cases of phenylketonuria and
  486  other metabolic diseases for as long as medically indicated when
  487  the products are not otherwise available. Provide nutrition
  488  education and supplemental foods to those families eligible for
  489  the Special Supplemental Nutrition Program for Women, Infants,
  490  and Children as provided in s. 383.011.
  491         (e)(f) Promote the availability of genetic studies,
  492  services, and counseling in order that the parents, siblings,
  493  and affected newborns may benefit from detection and available
  494  knowledge of the condition.
  495         (f)(g) Have the authority to charge and collect fees for
  496  the administration of the newborn screening program. authorized
  497  in this section, as follows:
  498         1. A fee not to exceed $15 will be charged for each live
  499  birth, as recorded by the Office of Vital Statistics, occurring
  500  in a hospital licensed under part I of chapter 395 or a birth
  501  center licensed under s. 383.305 per year. The department shall
  502  calculate the annual assessment for each hospital and birth
  503  center, and this assessment must be paid in equal amounts
  504  quarterly. Quarterly, The department shall generate and issue
  505  mail to each hospital and birth center a statement of the amount
  506  due.
  507         2. As part of the department’s legislative budget request
  508  prepared pursuant to chapter 216, the department shall submit a
  509  certification by the department’s inspector general, or the
  510  director of auditing within the inspector general’s office, of
  511  the annual costs of the uniform testing and reporting procedures
  512  of the newborn screening program. In certifying the annual
  513  costs, the department’s inspector general or the director of
  514  auditing within the inspector general’s office shall calculate
  515  the direct costs of the uniform testing and reporting
  516  procedures, including applicable administrative costs.
  517  Administrative costs shall be limited to those department costs
  518  which are reasonably and directly associated with the
  519  administration of the uniform testing and reporting procedures
  520  of the newborn screening program.
  521         (g)(h) Have the authority to bill third-party payors for
  522  newborn screening tests.
  523         (h)(i) Create and make available electronically a pamphlet
  524  with information on screening for, and the treatment of,
  525  preventable infant and childhood eye and vision disorders,
  526  including, but not limited to, retinoblastoma and amblyopia.
  527  
  528  All provisions of this subsection must be coordinated with the
  529  provisions and plans established under this chapter, chapter
  530  411, and Pub. L. No. 99-457.
  531         (5)SUBMISSION OF NEWBORN SCREENING SPECIMEN CARDS.—Any
  532  health care practitioner whose duty it is to administer
  533  screenings under this section shall prepare and send all newborn
  534  screening specimen cards to the State Public Health Laboratory
  535  in accordance with rules adopted under this section. As used in
  536  this subsection, the term “health care practitioner” means a
  537  physician or physician assistant licensed under chapter 458, an
  538  osteopathic physician or physician assistant licensed under
  539  chapter 459, an advanced practice registered nurse licensed
  540  under part I of chapter 464, or a midwife licensed under chapter
  541  467.
  542         Section 4. Paragraph (k) is added to subsection (2) of
  543  section 383.145, Florida Statutes, and subsection (3) of that
  544  section is amended, to read:
  545         383.145 Newborn, and infant, and toddler hearing
  546  screening.—
  547         (2) DEFINITIONS.—As used in this section, the term:
  548         (k)“Toddler” means a child from 12 months to 36 months of
  549  age.
  550         (3) REQUIREMENTS FOR SCREENING OF NEWBORNS, INFANTS, AND
  551  TODDLERS; INSURANCE COVERAGE; REFERRAL FOR ONGOING SERVICES.—
  552         (a) Each hospital or other state-licensed birth birthing
  553  facility that provides maternity and newborn care services shall
  554  ensure that all newborns are, before discharge, screened for the
  555  detection of hearing loss to prevent the consequences of
  556  unidentified disorders. If a newborn fails the screening for the
  557  detection of hearing loss, the hospital or other state-licensed
  558  birth birthing facility must administer a test approved by the
  559  United States Food and Drug Administration or another
  560  diagnostically equivalent test on the newborn to screen for
  561  congenital cytomegalovirus before the newborn becomes 21 days of
  562  age or before discharge, whichever occurs earlier.
  563         (b) Each licensed birth center that provides maternity and
  564  newborn care services shall ensure that all newborns are, before
  565  discharge, screened for the detection of hearing loss. Within 7
  566  days after the birth, the licensed birth center must ensure that
  567  all newborns who do not pass the hearing screening are referred
  568  for to an appointment audiologist, a hospital, or another
  569  newborn hearing screening provider for a test to screen for
  570  congenital cytomegalovirus before the newborn becomes 21 days of
  571  age screening for the detection of hearing loss to prevent the
  572  consequences of unidentified disorders. The referral for
  573  appointment must be made within 7 days after discharge. Written
  574  documentation of the referral must be placed in the newborn’s
  575  medical chart.
  576         (c) If the parent or legal guardian of the newborn objects
  577  to the screening, the screening must not be completed. In such
  578  case, the physician, midwife, or other person attending the
  579  newborn shall maintain a record that the screening has not been
  580  performed and attach a written objection that must be signed by
  581  the parent or guardian.
  582         (d) For home births, the health care provider in attendance
  583  is responsible for coordination and referral to an audiologist,
  584  a hospital, or another newborn hearing screening provider. The
  585  health care provider in attendance must make the referral for
  586  appointment within 7 days after the birth. In cases in which the
  587  home birth is not attended by a health care provider, the
  588  newborn’s primary health care provider is responsible for
  589  coordinating the referral.
  590         (e) For home births and births in a licensed birth center,
  591  if a newborn is referred to a newborn hearing screening provider
  592  and the newborn fails the screening for the detection of hearing
  593  loss, the newborn’s primary health care provider must refer the
  594  newborn for administration of a test approved by the United
  595  States Food and Drug Administration or another diagnostically
  596  equivalent test on the newborn to screen for congenital
  597  cytomegalovirus.
  598         (f) All newborn and infant hearing screenings must be
  599  conducted by an audiologist, a physician, or an appropriately
  600  supervised individual who has completed documented training
  601  specifically for newborn hearing screening. Every hospital that
  602  provides maternity or newborn care services shall obtain the
  603  services of an audiologist, a physician, or another newborn
  604  hearing screening provider, through employment or contract or
  605  written memorandum of understanding, for the purposes of
  606  appropriate staff training, screening program supervision,
  607  monitoring the scoring and interpretation of test results,
  608  rendering of appropriate recommendations, and coordination of
  609  appropriate follow-up services. Appropriate documentation of the
  610  screening completion, results, interpretation, and
  611  recommendations must be placed in the medical record within 24
  612  hours after completion of the screening procedure.
  613         (g) The screening of a newborn’s hearing must be completed
  614  before the newborn is discharged from the hospital or licensed
  615  birth center. However, if the screening is not completed before
  616  discharge due to scheduling or temporary staffing limitations,
  617  the screening must be completed within 21 days after the birth.
  618  Screenings completed after discharge or performed because of
  619  initial screening failure must be completed by an audiologist, a
  620  physician, a hospital, or another newborn hearing screening
  621  provider.
  622         (h) Each hospital shall formally designate a lead physician
  623  responsible for programmatic oversight for newborn hearing
  624  screening. Each birth center shall designate a licensed health
  625  care provider to provide such programmatic oversight and to
  626  ensure that the appropriate referrals are being completed.
  627         (i) When ordered by the treating physician, screening of a
  628  newborn’s, infant’s, or toddler’s hearing must include auditory
  629  brainstem responses, or evoked otoacoustic emissions, or
  630  appropriate technology as approved by the United States Food and
  631  Drug Administration.
  632         (j) The results of any test conducted pursuant to this
  633  section, including, but not limited to, newborn hearing loss
  634  screening, congenital cytomegalovirus testing, and any related
  635  diagnostic testing, must be reported to the department within 7
  636  days after receipt of such results.
  637         (k) The initial procedure for screening the hearing of the
  638  newborn or infant and any medically necessary follow-up
  639  reevaluations leading to diagnosis shall be a covered benefit
  640  for Medicaid patients covered by a fee-for-service program. For
  641  Medicaid patients enrolled in HMOs, providers shall be
  642  reimbursed directly by the Medicaid Program Office at the
  643  Medicaid rate. This service may not be considered a covered
  644  service for the purposes of establishing the payment rate for
  645  Medicaid HMOs. All health insurance policies and health
  646  maintenance organizations as provided under ss. 627.6416,
  647  627.6579, and 641.31(30), except for supplemental policies that
  648  only provide coverage for specific diseases, hospital indemnity,
  649  or Medicare supplement, or to the supplemental policies, shall
  650  compensate providers for the covered benefit at the contracted
  651  rate. Nonhospital-based providers are eligible to bill Medicaid
  652  for the professional and technical component of each procedure
  653  code.
  654         (l) A child who is diagnosed as having permanent hearing
  655  loss must be referred to the primary care physician for medical
  656  management, treatment, and follow-up services. Furthermore, in
  657  accordance with Part C of the Individuals with Disabilities
  658  Education Act, Pub. L. No. 108-446, Infants and Toddlers with
  659  Disabilities, any child from birth to 36 months of age who is
  660  diagnosed as having hearing loss that requires ongoing special
  661  hearing services must be referred to the Children’s Medical
  662  Services Early Intervention Program serving the geographical
  663  area in which the child resides.
  664         Section 5. Section 383.147, Florida Statutes, is amended to
  665  read:
  666         383.147 Newborn and infant screenings for Sickle cell
  667  disease and sickle cell trait hemoglobin variants; registry.—
  668         (1) If a screening provider detects that a newborn as or an
  669  infant, as those terms are defined in s. 383.145(2), is
  670  identified as having sickle cell disease or carrying a sickle
  671  cell trait through the newborn screening program as described in
  672  s. 383.14, the department hemoglobin variant, it must:
  673         (a) Notify the parent or guardian of the newborn and
  674  provide information regarding the availability and benefits of
  675  genetic counseling. primary care physician of the newborn or
  676  infant and
  677         (b) Submit the results of such screening to the Department
  678  of Health for inclusion in the sickle cell registry established
  679  under paragraph (2)(a), unless the parent or guardian of the
  680  newborn provides an opt-out form obtained from the department,
  681  or otherwise indicates in writing to the department his or her
  682  objection to having the newborn included in the sickle cell
  683  registry. The primary care physician must provide to the parent
  684  or guardian of the newborn or infant information regarding the
  685  availability and benefits of genetic counseling.
  686         (2)(a) The Department of Health shall contract with a
  687  community-based sickle cell disease medical treatment and
  688  research center to establish and maintain a registry for
  689  individuals newborns and infants who are identified as having
  690  sickle cell disease or carrying a sickle cell trait hemoglobin
  691  variant. The sickle cell registry must track sickle cell disease
  692  outcome measures, except as provided in paragraph (1)(b). A
  693  parent or guardian of a newborn or an infant in the registry may
  694  request to have his or her child removed from the registry by
  695  submitting a form prescribed by the department by rule.
  696         (b) In addition to newborns identified and included in the
  697  registry under subsection (1), persons living in this state who
  698  have been identified as having sickle cell disease or carrying a
  699  sickle cell trait may choose to be included in the registry by
  700  providing the department with notification as prescribed by
  701  rule.
  702         (c) The Department of Health shall also establish a system
  703  to ensure that the community-based sickle cell disease medical
  704  treatment and research center notifies the parent or guardian of
  705  a child who has been included in the registry that a follow-up
  706  consultation with a physician is recommended. Such notice must
  707  be provided to the parent or guardian of such child at least
  708  once during early adolescence and once during late adolescence.
  709  The department shall make every reasonable effort to notify
  710  persons included in the registry who are 18 years of age that
  711  they may request to be removed from the registry by submitting a
  712  form prescribed by the department by rule. The department shall
  713  also provide to such persons information regarding available
  714  educational services, genetic counseling, and other beneficial
  715  resources.
  716         (3) The Department of Health shall adopt rules to implement
  717  this section.
  718         Section 6. Section 383.148, Florida Statutes, is created to
  719  read:
  720         383.148ENVIRONMENTAL RISK SCREENING.—
  721         (1)RISK SCREENING.—To help ensure access to the maternal
  722  and child health care system, the Department of Health shall
  723  promote the screening of all pregnant women and infants in this
  724  state for environmental risk factors, such as low income, poor
  725  education, maternal and family stress, mental health, substance
  726  use disorder, and other high-risk conditions, and promote
  727  education of the public about the dangers associated with
  728  environmental risk factors.
  729         (2)PRENATAL RISK SCREENING REQUIREMENTS.—The department
  730  shall develop a multilevel screening process that includes a
  731  risk assessment instrument to identify women at risk for a
  732  preterm birth or other high-risk condition.
  733         (a)A primary health care provider must complete the risk
  734  screening at a pregnant woman’s first prenatal visit using the
  735  form and in the manner prescribed by rules adopted under this
  736  section, so that the woman may immediately be notified and
  737  referred to appropriate health, education, and social services.
  738         (b)This subsection does not apply if the pregnant woman
  739  objects to the screening in a manner prescribed by department
  740  rule.
  741         (3)POSTNATAL RISK SCREENING REQUIREMENTS.—The department
  742  shall develop a multilevel screening process that includes a
  743  risk assessment instrument to identify factors associated with
  744  increased risk of infant mortality and morbidity to provide
  745  early intervention, remediation, and prevention services,
  746  including, but not limited to, parent support and training
  747  programs, home visitation, and case management.
  748         (a)A hospital or birth center must complete the risk
  749  screening immediately following the birth of the infant, before
  750  discharge from the hospital or birth center, using the form and
  751  in the manner prescribed by rules adopted under this section.
  752         (b)This subsection does not apply if a parent or guardian
  753  of the newborn objects to the screening in a manner prescribed
  754  by department rule.
  755         Section 7. Paragraphs (a) and (d) of subsection (4) of
  756  section 1004.435, Florida Statutes, are amended to read:
  757         1004.435 Cancer control and research.—
  758         (4) FLORIDA CANCER CONTROL AND RESEARCH ADVISORY COUNCIL;
  759  CREATION; COMPOSITION.—
  760         (a) There is created within the H. Lee Moffitt Cancer
  761  Center and Research Institute, Inc., the Florida Cancer Control
  762  and Research Advisory Council. The council shall consist of 16
  763  15 members, which includes the chairperson, all of whom must be
  764  residents of this state. The State Surgeon General or his or her
  765  designee within the Department of Health shall be one of the 16
  766  15 members. Members, except those appointed by the Governor, the
  767  Speaker of the House of Representatives, or the President of the
  768  Senate, must be appointed by the chief executive officer of the
  769  institution or organization represented, or his or her designee.
  770  One member must be a representative of the American Cancer
  771  Society; one member must be a representative of the Sylvester
  772  Comprehensive Cancer Center of the University of Miami; one
  773  member must be a representative of the University of Florida
  774  Shands Cancer Center; one member must be a representative of the
  775  Florida Nurses Association who specializes in the field of
  776  oncology and is not from an institution or organization already
  777  represented on the council; one member must be a representative
  778  of the Florida Osteopathic Medical Association who specializes
  779  in the field of oncology; one member must be a member of the
  780  Florida Medical Association who specializes in the field of
  781  oncology and who represents a cancer center not already
  782  represented on the council; one member must be a representative
  783  of the H. Lee Moffitt Cancer Center and Research Institute,
  784  Inc.; one member must be a representative of the Mayo Clinic in
  785  Jacksonville; one member must be a member of the Florida
  786  Hospital Association who specializes in the field of oncology
  787  and who represents a comprehensive cancer center not already
  788  represented on the council; one member must be a representative
  789  of the Association of Community Cancer Centers; one member must
  790  specialize in pediatric oncology research or clinical care
  791  appointed by the Governor; one member must specialize in
  792  oncology clinical care or research appointed by the President of
  793  the Senate; one member must be a current or former cancer
  794  patient or a current or former caregiver to a cancer patient
  795  appointed by the Speaker of the House of Representatives; one
  796  member must be a member of the House of Representatives
  797  appointed by the Speaker of the House of Representatives; and
  798  one member must be a member of the Senate appointed by the
  799  President of the Senate. At least four of the members must be
  800  individuals who are minority persons as defined by s. 288.703.
  801         (d) The council shall meet no less than semiannually at the
  802  call of the chairperson or, in his or her absence or incapacity,
  803  at the call of the State Surgeon General. Nine Eight members
  804  constitute a quorum for the purpose of exercising all of the
  805  powers of the council. A vote of the majority of the members
  806  present is sufficient for all actions of the council.
  807         Section 8. Paragraph (i) of subsection (3) of section
  808  383.318, Florida Statutes, is amended to read:
  809         383.318 Postpartum care for birth center clients and
  810  infants.—
  811         (3) The birth center shall provide a postpartum evaluation
  812  and followup care that includes all of the following:
  813         (i) Provision of the informational pamphlet on infant and
  814  childhood eye and vision disorders created by the department
  815  pursuant to s. 383.14(3)(h) s. 383.14(3)(i).
  816         Section 9. Section 395.1053, Florida Statutes, is amended
  817  to read:
  818         395.1053 Postpartum education.—A hospital that provides
  819  birthing services shall incorporate information on safe sleep
  820  practices and the possible causes of Sudden Unexpected Infant
  821  Death into the hospital’s postpartum instruction on the care of
  822  newborns and provide to each parent the informational pamphlet
  823  on infant and childhood eye and vision disorders created by the
  824  department pursuant to s. 383.14(3)(h) s. 383.14(3)(i).
  825         Section 10. Section 456.0496, Florida Statutes, is amended
  826  to read:
  827         456.0496 Provision of information on eye and vision
  828  disorders to parents during planned out-of-hospital births.—A
  829  health care practitioner who attends an out-of-hospital birth
  830  must ensure that the informational pamphlet on infant and
  831  childhood eye and vision disorders created by the department
  832  pursuant to s. 383.14(3)(h) s. 383.14(3)(i) is provided to each
  833  parent after such a birth.
  834         Section 11. (1)Effective upon this act becoming a law and
  835  notwithstanding any provision of s. 381.986(8)(a)2.b., Florida
  836  Statutes, to the contrary, the Department of Health must grant
  837  an applicant 90 days to cure, pursuant to the errors and
  838  omissions process established in department Form DH8035-OMMU
  839  10/2021 as incorporated by the department in rule 64ER21-16,
  840  Florida Administrative Code, any remaining deficiencies cited by
  841  the department regarding the application if the applicant:
  842         (a)Applied for a medical marijuana treatment center
  843  license during the application window created by the department
  844  to accept applications for licensure pursuant to s.
  845  381.986(8)(a)2.b., Florida Statutes; and
  846         (b)Has not been awarded a license, either from the initial
  847  application process or through the cure process established in
  848  section 2 of chapter 2023-292, Laws of Florida.
  849         (2)If the applicant cures the deficiencies within the 90
  850  day timeframe, the department must issue a medical marijuana
  851  treatment center license to the applicant.
  852         (3)For purposes of the cure process detailed in
  853  subsections (1) and (2), the department must consider all
  854  deficiencies with an applicant’s application to be cured if the
  855  sole remaining deficiency cited is:
  856         (a) A failure to meet the requirement in s.
  857  381.986(8)(b)1., Florida Statutes; or
  858         (b) The applicant died after March 25, 2022. In the case of
  859  the death of an applicant under this paragraph, the department
  860  must issue the license to the heirs of the applicant.
  861         (4)If an applicant who was alive as of February 1, 2024,
  862  dies before the completion of the cure process detailed in
  863  subsections (1) and (2), the death of the applicant may not be a
  864  reason to deny the application during the cure process or any
  865  resulting legal challenges. In such case, and in the event of a
  866  successful cure or challenge, the department must issue the
  867  license to the estate of the applicant.
  868         Section 12. Except as otherwise expressly provided in this
  869  act and except for this section, which shall take effect upon
  870  this act becoming a law, this act shall take effect July 1,
  871  2024.