Bill Text: FL S1582 | 2024 | Regular Session | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Department of Health
Spectrum: Slight Partisan Bill (? 3-1)
Status: (Passed) 2024-06-19 - Chapter No. 2024-246, companion bill(s) passed, see HB 7085 (Ch. 2024-225), CS/SB 7072 (Ch. 2024-247) [S1582 Detail]
Download: Florida-2024-S1582-Engrossed.html
Bill Title: Department of Health
Spectrum: Slight Partisan Bill (? 3-1)
Status: (Passed) 2024-06-19 - Chapter No. 2024-246, companion bill(s) passed, see HB 7085 (Ch. 2024-225), CS/SB 7072 (Ch. 2024-247) [S1582 Detail]
Download: Florida-2024-S1582-Engrossed.html
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; EXEMPTIONSREQUIRED.—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.; or154 (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 subsectionsection. 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 are262physicians, registered dietitians, certified laboratory263personnel, 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 467The department shall also promote the350identification and screening of all newborns in this state and351their families for environmental risk factors such as low352income, poor education, maternal and family stress, emotional353instability, substance abuse, and other high-risk conditions354associated with increased risk of infant mortality and morbidity355to provide early intervention, remediation, and prevention356services, including, but not limited to, parent support and357training programs, home visitation, and case management.358Identification, perinatal screening, and intervention efforts359shall begin prior to and immediately following the birth of the360child by the attending health care provider. Such efforts shall361be conducted in hospitals, perinatal centers, county health362departments, school health programs that provide prenatal care,363and birthing centers, and reported to the Office of Vital364Statistics.365(a)Prenatal screening.—The department shall develop a366multilevel screening process that includes a risk assessment367instrument to identify women at risk for a preterm birth or368other high-risk condition. The primary health care provider369shall complete the risk assessment instrument and report the370results to the Office of Vital Statistics so that the woman may371immediately be notified and referred to appropriate health,372education, and social services.373(b)Postnatal screening.—A risk factor analysis using the374department’s designated risk assessment instrument shall also be375conducted as part of the medical screening process upon the376birth of a child and submitted to the department’s Office of377Vital Statistics for recording and other purposes provided for378in this chapter. The department’s screening process for risk379assessment shall include a scoring mechanism and procedures that380establish thresholds for notification, further assessment,381referral, and eligibility for services by professionals or382paraprofessionals consistent with the level of risk. Procedures383for developing and using the screening instrument, notification,384referral, and care coordination services, reporting385requirements, management information, and maintenance of a386computer-driven registry in the Office of Vital Statistics which387ensures privacy safeguards must be consistent with the388provisions and plans established under chapter 411, Pub. L. No.38999-457, and this chapter. Procedures established for reporting390information and maintaining a confidential registry must include391a mechanism for a centralized information depository at the392state and county levels. The department shall coordinate with393existing risk assessment systems and information registries. The394department must ensure, to the maximum extent possible, that the395screening information registry is integrated with the396department’s automated data systems, including the Florida On397line Recipient Integrated Data Access (FLORIDA) system. 398 (a) Blood specimens for newborn screenings.—NewbornTests399andscreenings 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 Counciland 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’shearing and metabolic tests408orscreenings 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;ora 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 screeningsbe subjected to a test for427phenylketonuria; 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 necessaryfrom time to time. 447(b) After consultation with the Department of Education,448the department shall adopt and enforce rules requiring every449newborn in this state to be screened for environmental risk450factors that place children and their families at risk for451increased 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 383.148s. 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,469perinatal centers, birthing centers, and hospitals forms on470which environmental screening and the results of tests for471phenylketonuria and such other disorders for which testing may472be required from time to time shall be reported to the473department.474(c)Promote education of the public about the prevention 475 and management of metabolic, hereditary, and congenital 476 disordersand dangers associated with environmental risk477factors. 478 (c)(d)Maintain a confidential registry of cases, including 479 information of importance for the purpose of follow-upfollowup480 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 ofphenylketonuria and486othermetabolic 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.authorized497in this section, as follows:4981.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. 383.305per year. The department shall 502 calculate theannualassessment for each hospital and birth 503 center, and this assessment must be paidin equal amounts504 quarterly.Quarterly,The department shall generate and issue 505mail toeach hospital and birth center a statement of the amount 506 due. 5072. As part of the department’s legislative budget request508prepared pursuant to chapter 216, the department shall submit a509certification by the department’s inspector general, or the510director of auditing within the inspector general’s office, of511the annual costs of the uniform testing and reporting procedures512of the newborn screening program. In certifying the annual513costs, the department’s inspector general or the director of514auditing within the inspector general’s office shall calculate515the direct costs of the uniform testing and reporting516procedures, including applicable administrative costs.517Administrative costs shall be limited to those department costs518which are reasonably and directly associated with the519administration of the uniform testing and reporting procedures520of 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,andinfant, 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 birthbirthing553 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 birthbirthingfacility 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 fortoan appointmentaudiologist, a hospital, or another569newborn hearing screening providerfor a test to screen for 570 congenital cytomegalovirus before the newborn becomes 21 days of 571 agescreening for the detection of hearing loss to prevent the572consequences of unidentified disorders. The referral for573appointment 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: 666 383.147Newborn and infant screenings forSickle cell 667 disease and sickle cell traithemoglobin variants;registry.— 668 (1) Ifa screening provider detects thata newborn asor an669infant, as those terms aredefined 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 departmenthemoglobin variant, itmust: 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 or676infant and677 (b) Submit the results of such screeningto the Department678of Healthfor 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 parent684or guardian of the newborn or infant information regarding the685availability and benefits of geneticcounseling.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 individualsnewborns and infantswho are identified as having 690 sickle cell disease or carrying a sickle cell traithemoglobin691variant. The sickle cell registry must track sickle cell disease 692 outcome measures, except as provided in paragraph (1)(b).A693parent or guardian of a newborn or an infant in the registry may694request to have his or her child removed from the registry by695submitting 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: 720 383.148 ENVIRONMENTAL 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 76315members, 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 76615members. 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. NineEightmembers 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.