CHAPTER 383

383.011 Administration of maternal and child health programs. (1) The Department of Health is designated as the state agency for: (a) Administering or providing for maternal and child health services to provide periodic prenatal care for patients who are at low or medium risk of complications during pregnancy and to provide referrals to higher level medical facilities for those patients who develop medical conditions for which treatment is beyond the scope and capabilities of the county health departments. Maternal and child health services shall include encouragement of breastfeeding. (b) Administering or providing for periodic medical examinations, nursing appraisals, and nutrition counseling for infant and child patients to assess developmental progress and general health conditions; administering or providing for treatment for health complications when such treatment is within the scope and capabilities of the county health departments or Children’s Medical Services. Nutrition counseling for newborn babies shall include encouragement of breastfeeding. (c) Administering and providing for the expansion of the maternal and child health services to include pediatric primary care programs subject to the availability of moneys and the limitations established by the General Appropriations Act or chapter 216. (d) Administering and providing for prenatal and infant health care delivery services through county health departments or subcontractors for the provision of the following enhanced services for medically and socially high-risk clients, subject to the availability of moneys and the limitations established by the General Appropriations Act or chapter 216: 1. Case finding or outreach. 2. Assessment of health, social, environmental, and behavioral risk factors. 3. Case management utilizing a service delivery plan. 4. Home visiting to support the delivery of and participation in prenatal and infant primary health care services. 5. Childbirth and parenting education, including encouragement of breastfeeding. 6. Father engagement activities, such as providing individualized support to fathers to increase participation in services that strengthen family and child well-being. (e) The department shall establish in each county health department a Healthy Start Care Coordination Program in which a care coordinator is responsible for receiving screening reports and risk assessment reports from the Office of Vital Statistics; conducting assessments as part of a multidisciplinary team, where appropriate; providing technical assistance to the district prenatal and infant care coalitions; directing family outreach efforts; and coordinating the provision of services within and outside the department using the plan developed by the coalition. The care coordination process must include, at a minimum, family outreach workers and health paraprofessionals who will assist in providing the following enhanced services to pregnant women, infants, and their families that are determined to be at potential risk by the department’s screening instrument: case finding or outreach; assessment of health, social, environmental, and behavioral risk factors; case management utilizing the family support plan; home visiting to support the delivery of and participation in prenatal and infant primary care services; childbirth and parenting education, including encouragement of breastfeeding; counseling; and social services, as appropriate. Family outreach workers may include social work professionals or nurses with public health education and counseling experience. Paraprofessionals may include resource mothers and fathers, trained health aides, and parent educators. The care coordination program shall be developed in a coordinated, nonduplicative manner with the Developmental Evaluation and Intervention Program of Children’s Medical Services, using the local assessment findings and plans of the prenatal and infant care coalitions and the programs and services established in chapter 411, Pub. L. No. 99-457, and this chapter. 1. Families determined to be at potential risk based on the thresholds established in the department’s screening instrument must be notified by the department of the determination and recommendations for followup services. All Medicaid-eligible families shall receive Early Periodic Screening, Diagnosis and Treatment (EPSDT) Services of the Florida Medicaid Program to help ensure continuity of care. All other families identified at potential risk shall be directed to seek additional health care followup visits as provided under s. 627.6579. A family identified as a family at potential risk is eligible for enhanced services under the care coordination process within the resources allocated, if it is not already receiving services from the Developmental Evaluation and Intervention Program. The department shall adopt rules regulating the assignment of family outreach workers and paraprofessionals based on the thresholds established in the department’s risk assessment tool. 2. As part of the care coordination process, the department must ensure that subsequent screenings are conducted for those families identified as families at potential risk. Procedures for subsequent screenings of all infants and toddlers must be consistent with the established periodicity schedule and the level of risk. Screening programs must be conducted in accessible locations, such as child care centers, local schools, teenage pregnancy programs, community centers, and county health departments. Care coordination must also include initiatives to provide immunizations in accessible locations. Such initiatives must seek ways to ensure that children not currently being served by immunization efforts are reached. 3. The provision of services under this section must be consistent with the provisions and plans established under chapter 411, Pub. L. No. 99-457, and this chapter. (f) Receiving the federal maternal and child health and preventive health services block grant funds. (g) Receiving the federal funds for the “Special Supplemental Nutrition Program for Women, Infants, and Children,” or WIC, authorized by the Child Nutrition Act of 1966, as amended, and for providing clinical leadership for the statewide WIC program. 1. The department shall establish an interagency agreement with the Department of Children and Families for fiscal management of the program. Responsibilities are delegated to each department, as follows: a. The department shall provide clinical leadership, manage program eligibility, and distribute nutritional guidance and information to participants. b. The Department of Children and Families shall develop and implement an electronic benefits transfer system. c. The Department of Children and Families shall develop a cost containment plan that provides timely and accurate adjustments based on wholesale price fluctuations and adjusts for the number of cash registers in calculating statewide averages. d. The department shall coordinate submission of information to appropriate federal officials in order to obtain approval of the electronic benefits system and cost containment plan, which must include participation of WIC-only stores. 2. The department shall assist the Department of Children and Families in the development of the electronic benefits system to ensure full implementation no later than July 1, 2013. (h) Designating facilities that provide maternity services or newborn infant care as “baby-friendly” when the facility has established a breastfeeding policy under s. 383.016. (i) Receiving federal funds for children eligible for assistance through the portion of the federal Child and Adult Care Food Program for children, which is referred to as the Child Care Food Program, and for establishing and administering this program. The purpose of the Child Care Food Program is to provide nutritious meals and snacks for children in nonresidential day care. To ensure the quality and integrity of the program, the department shall develop standards and procedures that govern sponsoring organizations, day care homes, child care centers, and centers that operate outside school hours. Standards and procedures must address the following: participation criteria for sponsoring organizations, which may include administrative budgets, staffing requirements, requirements for experience in operating similar programs, operating hours and availability, bonding requirements, geographic coverage, and a required minimum number of homes or centers; procedures for investigating complaints and allegations of noncompliance; application and renewal requirements; audit requirements; meal pattern requirements; requirements for managing funds; participant eligibility for free and reduced-price meals; food storage and preparation; food service companies; reimbursements; use of commodities; administrative reviews and monitoring; training requirements; record-keeping requirements; and criteria pertaining to imposing sanctions and penalties, including the denial, termination, and appeal of program eligibility. (2) The Department of Health shall follow federal requirements and may adopt any rules necessary for the implementation of the maternal and child health care program, the WIC program, and the Child Care Food Program. (a) The department may adopt rules that are necessary to administer the maternal and child health care program. The rules may include, but need not be limited to, requirements for client eligibility, program standards, service delivery, system responsibilities of county health departments and system assurance for healthy start coalitions, care coordination, enhanced services, quality assurance, and provider selection. The rules may also include provisions for the identification, screening, and intervention efforts by health care providers prior to and following the birth of a child and responsibilities for the interprogram coordination of prenatal and infant care coalitions. (b) The department may adopt rules that are necessary to administer the statewide WIC program. The rules may include, but need not be limited to, criteria for grocers’ participation, client eligibility, contracts with local agencies for service delivery, and food purchases and penalties for program abuse. (c) With respect to the Child Care Food Program, the department shall adopt rules that interpret and implement relevant federal regulations, including 7 C.F.R. part 226. The rules may address at least those program requirements and procedures identified in paragraph (1)(i). History. — s. 1, ch. 88-153; s. 23, ch. 91-282; s. 3, ch. 94-217; s. 54, ch. 97-101; s. 16, ch. 98-151; s. 24, ch. 98-191; s. 56, ch. 99-397; s. 17, ch. 2000-242; s. 71, ch. 2012-184; s. 68, ch. 2014-19; s. 5, ch. 2022-67. 383.013 Prenatal care. The Department of Health shall: (1) Provide a statewide prenatal care program for low-income pregnant women, which includes early, regular prenatal care by practitioners trained in prenatal care and delivery. (2) Provide a risk factor analysis to identify women at risk for a preterm birth, or other high-risk conditions, and provide education regarding maintaining healthy birth conditions. (3) Monitor the availability and accessibility of prenatal care services and the development of special outreach programs for medically underserved and rural areas. (4) Establish by rule the eligibility criteria for prenatal care for indigent pregnant women when state funds are used for prenatal care. (5) Develop guidelines for expediting the provision of prenatal care for eligible women and monitor the implementation of the guidelines to determine the need for further action. (6) Expand, to the extent possible, training of state and local health providers in programs and practices pertaining to improved pregnancy outcomes. (7) Provide regional perinatal intensive care satellite clinics to deliver Level III obstetric outpatient services to women diagnosed as being high risk, which includes an interdisciplinary team to deliver specialized high-risk obstetric care. The provision of satellite clinics is subject to the availability of moneys and the limitations established by the General Appropriations Act or chapter 216. History. — s. 11, ch. 83-379; s. 24, ch. 91-282; s. 55, ch. 97-101. 383.0131 Pregnancy and parenting resources website. (1) The Department of Health, in consultation with the Department of Children and Families and the Agency for Health Care Administration, shall maintain a website, distinct from their own websites, which provides information and links to public and private resources for expectant families and new parents, which resources include, but are not limited to: (a) Educational materials on pregnancy and parenting. (b) Maternal health services. (c) Prenatal and postnatal services. (d) Educational and mentorship programs for fathers. (e) Social services. (f) Financial assistance. (g) Adoption services. (2) The Department of Health, the Department of Children and Families, and the Agency for Health Care Administration shall include a clear and conspicuous link to the website on their respective websites. (3) The Department of Health shall contract with a third party for the development of the website, which must be operational by January 1, 2025. History. — s. 1, ch. 2024-198. 383.014 Perinatal mental health care. By January 1, 2019, the Department of Health shall offer perinatal mental health care information through the Family Health Line toll-free hotline, accessible to the general public, which: (1) Provides basic information on postpartum depression; (2) May recommend that a caller be further evaluated by a qualified health care provider; and (3) May refer a caller to an appropriate health care provider in the caller’s local area. History. — s. 2, ch. 2018-98. 383.015 Breastfeeding. The breastfeeding of a baby is an important and basic act of nurture which must be encouraged in the interests of maternal and child health and family values, and in furtherance of this goal: (1) A mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether the nipple of the mother’s breast is uncovered during or incidental to the breastfeeding. (2) A facility lawfully providing maternity services or newborn infant care may use the designation “baby-friendly” if it establishes a breastfeeding policy in accordance with s. 383.016. History. — s. 1, ch. 93-4; s. 2, ch. 94-217. 383.016 Breastfeeding policy for “baby-friendly” facilities providing maternity services and newborn infant care. A facility lawfully providing maternity services or newborn infant care may use the designation “baby-friendly” on its promotional materials if the facility has complied with at least 80 percent of the requirements developed by the Department of Health in accordance with UNICEF and World Health Organization baby-friendly hospital initiatives. History. — s. 1, ch. 94-217; s. 56, ch. 97-101. 383.04 Prophylactic required for eyes of infants. Every physician, midwife, or other person in attendance at the birth of a child in the state is required to instill or have instilled into the eyes of the baby within 1 hour after birth an effective prophylactic recommended by the Committee on Infectious Diseases of the American Academy of Pediatrics for the prevention of neonatal ophthalmia. This section does not apply to cases where the parents file with the physician, midwife, or other person in attendance at the birth of a child written objections on account of religious beliefs contrary to the use of drugs. In such case the physician, midwife, or other person in attendance shall maintain a record that such measures were or were not employed and attach thereto any written objection. History. — s. 1, ch. 20690, 1941; ss. 19, 35, ch. 69-106; s. 123, ch. 77-147; s. 27, ch. 87-387; s. 57, ch. 97-101; s. 25, ch. 98-191. 383.06 Report of inflammation or discharge in infant’s eyes. Any person who shall nurse or attend any infant shall report any inflammation or unnatural discharge in the eyes of said child that shall develop within 2 weeks after birth, to the local health officer or licensed physician, which report shall be made within 6 hours. History. — s. 3, ch. 20690, 1941. 383.07 Penalty for violation. Any person who fails to comply with the provisions of ss. 383.04-383.06 shall be guilty of a misdemeanor of the second degree, punishable as provided in s. 775.083. History. — s. 4, ch. 20690, 1941; s. 332, ch. 71-136. 383.11 Reports. The laboratory report on the serological test shall be made on a form to be provided by the Department of Health. In submitting the sample of blood for the test, the physician shall designate that this is a pregnancy test; and the laboratory report shall state that this was a pregnancy test. History. — s. 4, ch. 22644, 1945; ss. 19, 35, ch. 69-106; s. 126, ch. 77-147; s. 59, ch. 97-101. 383.13 Use of information by department. The Department of Health shall be authorized to use the information derived from pregnancy serological tests for such followup procedures as are required by law or deemed necessary by said department for the protection of the public health. History. — s. 6, ch. 22644, 1945; ss. 19, 35, ch. 69-106; s. 128, ch. 77-147; s. 60, ch. 97-101. 383.14 Screening for metabolic disorders, other hereditary and congenital disorders, and environmental risk factors. (1) SCREENING REQUIREMENTS. — To help ensure access to the maternal and child health care system, the Department of Health shall promote the screening of all newborns born in Florida for metabolic, hereditary, and congenital disorders known to result in significant impairment of health or intellect, as screening programs accepted by current medical practice become available and practical in the judgment of the department. Any health care practitioner present at a birth or responsible for primary care during the neonatal period has the primary responsibility of administering screenings as required in this section and s. 383.145. As used in this subsection, the term “health care practitioner” means a physician or physician assistant licensed under chapter 458, an osteopathic physician or physician assistant licensed under chapter 459, an advanced practice registered nurse licensed under part I of chapter 464, or a midwife licensed under chapter 467. (a) Blood specimens for newborn screenings. — Newborn screenings must be performed by the State Public Health Laboratory, in coordination with Children’s Medical Services, at such times and in such manner as is prescribed by the department after consultation with the Genetics and Newborn Screening Advisory Council. (b) Release of screening results. — Notwithstanding any law to the contrary, the State Public Health Laboratory may release, directly or through the Children’s Medical Services program, the results of a newborn’s screenings to the newborn’s health care practitioner, the newborn’s parent or legal guardian, the newborn’s personal representative, or a person designated by the newborn’s parent or legal guardian. As used in this paragraph, the term “health care practitioner” means a physician or physician assistant licensed under chapter 458; an osteopathic physician or physician assistant licensed under chapter 459; an advanced practice registered nurse, registered nurse, or licensed practical nurse licensed under part I of chapter 464; a midwife licensed under chapter 467; a speech-language pathologist or audiologist licensed under part I of chapter 468; a dietitian or nutritionist licensed under part X of chapter 468; or a genetic counselor licensed under part III of chapter 483. (2) RULES. — (a) After consultation with the Genetics and Newborn Screening Advisory Council, the department shall adopt and enforce rules requiring that every newborn in this state shall: 1. Before becoming 1 week of age, have a blood specimen collected for newborn screenings; 2. Be tested for any condition included on the federal Recommended Uniform Screening Panel which the council advises the department should be included under the state’s screening program. After the council recommends that a condition be included, the department shall submit a legislative budget request to seek an appropriation to add testing of the condition to the newborn screening program. The department shall expand statewide screening of newborns to include screening for such conditions within 18 months after the council renders such advice, if a test approved by the United States Food and Drug Administration or a test offered by an alternative vendor is available. If such a test is not available within 18 months after the council makes its recommendation, the department shall implement such screening as soon as a test offered by the United States Food and Drug Administration or by an alternative vendor is available; 3. At the appropriate age, be tested for such other metabolic diseases and hereditary or congenital disorders as the department may deem necessary; and 4. Beginning January 1, 2027, be screened for all of the following: a. Duchenne muscular dystrophy. b. Infantile Krabbe disease. c. Metachromatic leukodystrophy. (b) The department shall adopt such additional rules as are found necessary for the administration of this section and ss. 383.145 and 383.148, including rules providing definitions of terms, rules relating to the methods used and time or times for testing as accepted medical practice indicates, rules relating to charging and collecting fees for the administration of the newborn screening program authorized by this section, rules for processing requests and releasing test and screening results, and rules requiring mandatory reporting of the results of tests and screenings for these conditions to the department. (3) DEPARTMENT OF HEALTH; POWERS AND DUTIES. — The department shall administer and provide certain services to implement the provisions of this section and shall: (a) Assure the availability and quality of the necessary laboratory tests and materials. (b) Promote education of the public about the prevention and management of metabolic, hereditary, and congenital disorders. (c) Maintain a confidential registry of cases, including information of importance for the purpose of follow-up services to prevent intellectual disabilities, to correct or ameliorate physical disabilities, and for epidemiologic studies, if indicated. Such registry shall be exempt from the provisions of s. 119.07(1). (d) Supply the necessary dietary treatment products where practicable for diagnosed cases of metabolic diseases for as long as medically indicated when the products are not otherwise available. Provide nutrition education and supplemental foods to those families eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children as provided in s. 383.011. (e) Promote the availability of genetic studies, services, and counseling in order that the parents, siblings, and affected newborns may benefit from detection and available knowledge of the condition. (f) Have the authority to charge and collect fees for the administration of the newborn screening program. A fee not to exceed $15 will be charged for each live birth, as recorded by the Office of Vital Statistics, occurring in a hospital licensed under part I of chapter 395 or a birth center licensed under s. 383.305. The department shall calculate the assessment for each hospital and birth center, and this assessment must be paid quarterly. The department shall generate and issue each hospital and birth center a statement of the amount due. (g) Have the authority to bill third-party payors for newborn screening tests. (h) Create and make available electronically a pamphlet with information on screening for, and the treatment of, preventable infant and childhood eye and vision disorders, including, but not limited to, retinoblastoma and amblyopia. All provisions of this subsection must be coordinated with the provisions and plans established under this chapter, chapter 411, and Pub. L. No. 99-457. (4) OBJECTIONS OF PARENT OR GUARDIAN. — The provisions of this section shall not apply when the parent or guardian of the child objects thereto. A written statement of such objection shall be presented to the physician or other person whose duty it is to administer and report tests and screenings under this section. (5) SUBMISSION OF NEWBORN SCREENING SPECIMEN CARDS. — Any health care practitioner whose duty it is to administer screenings under this section shall prepare and send all newborn screening specimen cards to the State Public Health Laboratory in accordance with rules adopted under this section. As used in this subsection, the term “health care practitioner” means a physician or physician assistant licensed under chapter 458, an osteopathic physician or physician assistant licensed under chapter 459, an advanced practice registered nurse licensed under part I of chapter 464, or a midwife licensed under chapter 467. (6) ADVISORY COUNCIL. — There is established a Genetics and Newborn Screening Advisory Council made up of 15 members appointed by the State Surgeon General. The council shall be composed of two consumer members, three practicing pediatricians, at least one of whom must be a pediatric hematologist, a representative from each of four medical schools in this state, the State Surgeon General or his or her designee, one representative from the Department of Health representing Children’s Medical Services, one representative from the Florida Hospital Association, one individual with experience in newborn screening programs, one individual representing audiologists, and one representative from the Agency for Persons with Disabilities. All appointments shall be for a term of 4 years. The chairperson of the council shall be elected from the membership of the council and shall serve for a period of 2 years. The council shall meet at least semiannually or upon the call of the chairperson. The council may establish ad hoc or temporary technical advisory groups to assist the council with specific topics which come before the council. Council members shall serve without pay. Pursuant to the provisions of s. 112.061, the council members are entitled to be reimbursed for per diem and travel expenses. It is the purpose of the council to advise the department about: (a) Conditions for which testing should be included under the screening program and the genetics program. Within 1 year after a condition is added to the federal Recommended Uniform Screening Panel, the council shall consider whether the condition should be included under the state’s screening program. (b) Procedures for collection and transmission of specimens and recording of results. (c) Methods whereby screening programs and genetics services for children now provided or proposed to be offered in the state may be more effectively evaluated, coordinated, and consolidated. History. — s. 1, ch. 65-519; ss. 19, 35, ch. 69-106; s. 1, ch. 71-140; s. 129, ch. 77-147; s. 1, ch. 78-245; s. 2, ch. 79-26; s. 1, ch. 82-46; s. 2, ch. 83-265; s. 8, ch. 86-220; ss. 1, 5, 6, ch. 89-93; s. 2, ch. 90-344; s. 22, ch. 91-282; s. 5, ch. 91-429; s. 672, ch. 95-148; s. 9, ch. 95-394; s. 1, ch. 96-306; s. 194, ch. 96-406; s. 188, ch. 97-101; s. 29, ch. 97-237; s. 23, ch. 99-397; s. 45, ch. 2000-139; s. 18, ch. 2000-242; s. 15, ch. 2000-337; s. 14, ch. 2001-53; s. 62, ch. 2001-277; s. 3, ch. 2004-245; s. 13, ch. 2004-350; s. 7, ch. 2006-227; s. 37, ch. 2008-6; s. 4, ch. 2010-210; s. 269, ch. 2011-142; s. 8, ch. 2013-162; s. 1, ch. 2014-121; s. 1, ch. 2017-78; s. 6, ch. 2017-181; s. 11, ch. 2018-24; s. 17, ch. 2018-106; s. 43, ch. 2019-116; s. 1, ch. 2020-79; s. 7, ch. 2021-10; s. 8, ch. 2021-52; s. 3, ch. 2024-246; s. 1, ch. 2025-51; s. 2, ch. 2026-236. 383.1401 Neonatal nutrition. The Department of Health shall create an evidence-based, educational pamphlet on the nutritional needs of preterm infants. By January 1, 2027, the department shall make the pamphlet available electronically to hospitals licensed under chapter 395 to provide neonatal intensive care services. Such hospitals may provide the pamphlet to parents and guardians of infants receiving care in a neonatal intensive care unit. The pamphlet must include, but need not be limited to, information on preterm infants relating to all of the following: (1) The specific nutritional needs of preterm infants; (2) The health risks associated with nutritional deficits and the potential need for nutritional supplementation; (3) Different nutritional sources for infants, including maternal breast milk, pasteurized human donor milk, infant formula, human-milk-derived fortifiers, and bovine-milk-derived fortifiers, and the recommended uses for each type of nutritional source; (4) The importance of maternal breast milk for meeting the nutritional and developmental needs of infants, and the alternative of pasteurized human donor milk if maternal breast milk is not available; (5) The importance of having a physician discuss with family members the risks and benefits of all nutritional sources available, based on the preterm infant’s individual situation; and (6) Necrotizing enterocolitis, the risk factors for necrotizing enterocolitis, and the potential for a human-milk-based diet, including maternal and pasteurized donor breast milk, to reduce the risk of necrotizing enterocolitis. History. — s. 3, ch. 2026-236. 383.141 Prenatally diagnosed conditions; patient to be provided information; definitions; information clearinghouse; advisory council. (1) As used in this section, the term: (a) “Down syndrome” means a chromosomal disorder caused by an error in cell division which results in the presence of an extra whole or partial copy of chromosome 21. (b) “Developmental disability” includes Down syndrome and other developmental disabilities defined by s. 393.063. (c) “Health care provider” means a practitioner licensed or registered under chapter 458 or chapter 459 or an advanced practice registered nurse licensed under chapter 464. (d) “Prenatally diagnosed condition” means an adverse fetal health condition identified by prenatal testing. (e) “Prenatal test” or “prenatal testing” means a diagnostic procedure or screening procedure performed on a pregnant woman or her unborn offspring to obtain information about the offspring’s health or development. (2) When a developmental disability is diagnosed based on the results of a prenatal test, the health care provider who ordered the prenatal test, or his or her designee, shall provide the patient with current information about the nature of the developmental disability, the accuracy of the prenatal test, and resources for obtaining relevant support services, including hotlines, resource centers, and information clearinghouses related to Down syndrome or other prenatally diagnosed developmental disabilities; support programs for parents and families; and developmental evaluation and intervention services under this part. (3) The Department of Health shall develop and implement a comprehensive information clearinghouse to educate health care providers, inform parents, and increase public awareness regarding brain development, developmental disabilities and delays, and all services, resources, and interventions available to mitigate the effects of impaired development among children. The clearinghouse must use the term “unique abilities” as much as possible when identifying infants or children with developmental disabilities and delays. The clearinghouse must provide: (a) Health information on conditions that may lead to impaired development of physical, learning, language, or behavioral skills. (b) Education and information to support parents whose unborn children have been prenatally diagnosed with developmental disabilities or whose children have diagnosed or suspected developmental delays. (c) Education and training for health care providers to recognize and respond appropriately to developmental disabilities, delays, and conditions related to disabilities or delays. Specific information approved by the advisory council shall be made available to health care providers for use in counseling parents whose unborn children have been prenatally diagnosed with developmental disabilities or whose children have diagnosed or suspected developmental delays. (d) Promotion of public awareness of availability of supportive services, such as resource centers, educational programs, other support programs for parents and families, and developmental evaluation and intervention services. (e) Hotlines specific to Down syndrome and other prenatally diagnosed developmental disabilities. The hotlines and the department’s clearinghouse must provide information to parents and families or other caregivers regarding the Early Steps Program under s. 391.301, the Florida Diagnostic and Learning Resources System, the Early Learning program, Healthy Start, Help Me Grow, and any other intervention programs. Information offered must include directions on how to obtain early intervention, rehabilitative, and habilitative services and devices. (4)(a) There is established an advisory council within the Department of Health which consists of health care providers and caregivers who perform health care services for persons who have developmental disabilities, including Down syndrome and autism. This group shall consist of nine members as follows: 1. Three members appointed by the Governor; 2. Three members appointed by the President of the Senate; and 3. Three members appointed by the Speaker of the House of Representatives. (b) The advisory council shall provide technical assistance to the Department of Health in the establishment of the information clearinghouse and give the department the benefit of the council members’ knowledge and experience relating to the needs of patients and families of patients with developmental disabilities and available support services. (c) Members of the council shall elect a chairperson and a vice chairperson. The elected chairperson and vice chairperson shall serve in these roles until their terms of appointment on the council expire. (d) The advisory council shall meet quarterly to review this clearinghouse of information, and may meet more often at the call of the chairperson or as determined by a majority of members. (e) The council members shall be appointed to 4-year terms, except that, to provide for staggered terms, one initial appointee each from the Governor, the President of the Senate, and the Speaker of the House of Representatives shall be appointed to a 2-year term, one appointee each from these officials shall be appointed to a 3-year term, and the remaining initial appointees shall be appointed to 4-year terms. All subsequent appointments shall be for 4-year terms. A vacancy shall be filled for the remainder of the unexpired term in the same manner as the original appointment. (f) Members of the council shall serve without compensation. Meetings of the council may be held in person, without reimbursement for travel expenses, or by teleconference or other electronic means. (g) The Department of Health shall provide administrative support for the advisory council. History. — s. 72, ch. 2012-184; s. 11, ch. 2016-140; s. 3, ch. 2016-238; s. 18, ch. 2018-106; s. 12, ch. 2023-273. 383.145 Newborn, infant, and toddler hearing screening. (1) LEGISLATIVE INTENT. — It is the intent of the Legislature to provide a statewide comprehensive and coordinated interdisciplinary program of early hearing loss screening, identification, and follow-up care for newborns. The goal is to screen all newborns for hearing loss in order to alleviate the adverse effects of hearing loss on speech and language development, academic performance, and cognitive development. It is further the intent of the Legislature that this section only be implemented to the extent that funds are specifically included in the General Appropriations Act for carrying out the purposes of this section. (2) DEFINITIONS. — As used in this section, the term: (a) “Audiologist” means a person licensed under part I of chapter 468 to practice audiology. (b) “Department” means the Department of Health. (c) “Hearing loss” means a hearing loss of 30 dB HL or greater in the frequency region important for speech recognition and comprehension in one or both ears, approximately 500 through 4,000 hertz. (d) “Hospital” means a facility as defined in s. 395.002(13) and licensed under chapter 395 and part II of chapter 408. (e) “Infant” means an age range from 30 days through 12 months. (f) “Licensed health care provider” means a physician or physician assistant licensed under chapter 458; an osteopathic physician or physician assistant licensed under chapter 459; an advanced practice registered nurse, a registered nurse, or a licensed practical nurse licensed under part I of chapter 464; a midwife licensed under chapter 467; or a speech-language pathologist or an audiologist licensed under part I of chapter 468. (g) “Management” means the habilitation of the child with hearing loss. (h) “Newborn” means an age range from birth through 29 days. (i) “Physician” means a person licensed under chapter 458 to practice medicine or chapter 459 to practice osteopathic medicine. (j) “Screening” means a test or battery of tests administered to determine the need for an in-depth hearing diagnostic evaluation. (k) “Toddler” means a child from 12 months to 36 months of age. (3) REQUIREMENTS FOR SCREENING OF NEWBORNS, INFANTS, AND TODDLERS; INSURANCE COVERAGE; REFERRAL FOR ONGOING SERVICES. — (a)1. Each hospital or other state-licensed birth facility that provides maternity and newborn care services shall ensure that all newborns are, before discharge, screened for the detection of hearing loss to prevent the consequences of unidentified disorders. If a newborn fails the screening for the detection of hearing loss, the hospital or other state-licensed birth facility must administer a test approved by the United States Food and Drug Administration or another diagnostically equivalent test on the newborn to screen for congenital cytomegalovirus before the newborn becomes 21 days of age or before discharge, whichever occurs earlier. 2. Each hospital that provides neonatal intensive care services shall administer a test approved by the United States Food and Drug Administration or another diagnostically equivalent test to screen for congenital cytomegalovirus in each newborn admitted to the hospital as a result of a premature birth occurring before 35 weeks’ gestation, for cardiac care, or for medical or surgical treatment requiring an anticipated stay of 3 weeks or longer. Such screening must be initiated before the newborn becomes 21 days of age. 3. If a newborn requires transfer to another hospital for a higher level of care, the receiving hospital must initiate the congenital cytomegalovirus screening if it was not already performed by the transferring hospital or birthing facility. For newborns transferred or admitted for intensive and prolonged care, the congenital cytomegalovirus screening must be initiated regardless of whether the newborn failed a hearing screening. (b) Each licensed birth center that provides maternity and newborn care services shall ensure that all newborns are, before discharge, screened for the detection of hearing loss. Within 7 days after the birth, the licensed birth center must ensure that all newborns who do not pass the hearing screening are referred for an appointment for a test to screen for congenital cytomegalovirus before the newborn becomes 21 days of age. Written documentation of the referral must be placed in the newborn’s medical chart. (c) If the parent or legal guardian of the newborn objects to the screening, the screening must not be completed. In such case, the physician, midwife, or other person attending the newborn shall maintain a record that the screening has not been performed and attach a written objection that must be signed by the parent or guardian. (d) For home births, the health care provider in attendance is responsible for coordination and referral to an audiologist, a hospital, or another newborn hearing screening provider. The health care provider in attendance must make the referral for appointment within 7 days after the birth. In cases in which the home birth is not attended by a health care provider, the newborn’s primary health care provider is responsible for coordinating the referral. (e) For home births and births in a licensed birth center, if a newborn is referred to a newborn hearing screening provider and the newborn fails the screening for the detection of hearing loss, the newborn’s primary health care provider must refer the newborn for administration of a test approved by the United States Food and Drug Administration or another diagnostically equivalent test on the newborn to screen for congenital cytomegalovirus. (f) All newborn and infant hearing screenings must be conducted by an audiologist, a physician, or an appropriately supervised individual who has completed documented training specifically for newborn hearing screening. Every hospital that provides maternity or newborn care services shall obtain the services of an audiologist, a physician, or another newborn hearing screening provider, through employment or contract or written memorandum of understanding, for the purposes of appropriate staff training, screening program supervision, monitoring the scoring and interpretation of test results, rendering of appropriate recommendations, and coordination of appropriate follow-up services. Appropriate documentation of the screening completion, results, interpretation, and recommendations must be placed in the medical record within 24 hours after completion of the screening procedure. (g) The screening of a newborn’s hearing must be completed before the newborn is discharged from the hospital or licensed birth center. However, if the screening is not completed before discharge due to scheduling or temporary staffing limitations, the screening must be completed within 21 days after the birth. Screenings completed after discharge or performed because of initial screening failure must be completed by an audiologist, a physician, a hospital, or another newborn hearing screening provider. (h) Each hospital shall formally designate a lead physician responsible for programmatic oversight for newborn hearing screening. Each birth center shall designate a licensed health care provider to provide such programmatic oversight and to ensure that the appropriate referrals are being completed. (i) When ordered by the treating physician, screening of a newborn’s, infant’s, or toddler’s hearing must include auditory brainstem responses, or evoked otoacoustic emissions, or appropriate technology as approved by the United States Food and Drug Administration. (j) The results of any test conducted pursuant to this section, including, but not limited to, newborn hearing loss screening, congenital cytomegalovirus testing, and any related diagnostic testing, must be reported to the department within 7 days after receipt of such results. (k) The initial procedures for the congenital cytomegalovirus screening and the hearing screening of the newborn or infant and any medically necessary follow-up reevaluations leading to diagnosis are covered benefits for Medicaid patients covered by a fee-for-service program. For Medicaid patients enrolled in HMOs, providers must be reimbursed directly by the Medicaid Program Office at the Medicaid rate. This service is not considered a covered service for the purposes of establishing the payment rate for Medicaid HMOs. All health insurance policies and health maintenance organizations as provided under ss. 627.6416, 627.6579, and 641.31(30), except for supplemental policies that only provide coverage for specific diseases, hospital indemnity, or Medicare supplement, or to the supplemental policies, must compensate providers for the covered benefit at the contracted rate. Nonhospital-based providers are eligible to bill Medicaid for the professional and technical component of each procedure code. (l) A child diagnosed as having permanent hearing loss or a congenital cytomegalovirus infection must be referred to the primary care physician for medical management, treatment, and follow-up services. Furthermore, in accordance with Part C of the Individuals with Disabilities Education Act, Pub. L. No. 108-446, Infants and Toddlers with Disabilities, any child from birth to 36 months of age diagnosed as having hearing loss that requires ongoing special hearing services must be referred to the Children’s Medical Services Early Intervention Program serving the geographical area in which the child resides. A child diagnosed with a congenital cytomegalovirus infection without hearing loss must be referred to the Children’s Medical Services Early Intervention Program and be deemed eligible for a baseline evaluation and any medically necessary follow-up reevaluations and monitoring. History. — s. 1, ch. 2000-177; s. 2, ch. 2014-121; s. 1, ch. 2022-25; s. 79, ch. 2023-8; s. 1, ch. 2024-164; s. 4, ch. 2024-246. 383.146 Infants and toddlers who are deaf or hard of hearing; notice of service providers. (1) At the time that an audiologist diagnoses an infant or toddler as having a permanent hearing impairment, the audiologist or the audiologist’s designee shall ask the child’s parent or legal guardian if he or she would like to provide contact information to receive direct correspondence from qualified Early Steps providers that offer early intervention services and specialize in serving children with hearing loss. A parent or legal guardian shall authorize the release of the contact information by signing a consent form. (2) The department shall post on its website a list of qualified Early Steps providers of early intervention services that specialize in serving children with hearing loss and have notified the department of their interest to provide direct communication to families who wish to receive information about the services that they provide. (3) The audiologist or designee shall send by secure transmission the consent form to those providers listed on the department’s website. History. — s. 3, ch. 2014-121. 383.147 Sickle cell disease and sickle cell trait registry. (1) If a newborn as defined in s. 383.145(2) is identified as having sickle cell disease or sickle cell trait through the newborn screening program as described in s. 383.14, the department must: (a) Notify the parent or guardian of the newborn and provide information regarding the availability and benefits of genetic counseling. (b) Submit the results of such screening for inclusion in the sickle cell registry established under paragraph (2)(a), unless the parent or guardian of the newborn provides an opt-out form obtained from the department, or otherwise indicates in writing to the department his or her objection to having the newborn included in the sickle cell registry. (2)(a) The Department of Health shall contract with a community-based sickle cell disease medical treatment and research center to establish and maintain a registry for individuals who are identified as having sickle cell disease or carrying a sickle cell trait. The sickle cell registry must track sickle cell disease outcome measures, except as provided in paragraph (1)(b). (b) In addition to newborns identified and included in the registry under subsection (1), other persons living in this state who have been identified as having sickle cell disease or carrying a sickle cell trait may choose to be included in the registry by providing the department with notification as prescribed by rule. (c) The Department of Health shall also establish a system to ensure that the community-based sickle cell disease medical treatment and research center notifies the parent or guardian of a child who has been included in the registry that a follow-up consultation with a physician is recommended. Such notice must be provided to the parent or guardian of such child at least once during early adolescence and once during late adolescence. The department shall make every reasonable effort to notify persons included in the registry who are 18 years of age that they may request to be removed from the registry by submitting a form prescribed by the department by rule. The department shall also provide to such persons information regarding available educational services, genetic counseling, and other beneficial resources. (3) The Department of Health shall adopt rules to implement this section. History. — s. 1, ch. 2023-258; s. 2, ch. 2024-225; s. 5, ch. 2024-246. 383.148 Environmental risk screening. (1) RISK SCREENING. — To help ensure access to the maternal and child health care system, the Department of Health shall promote the screening of all pregnant women and infants in this state for environmental risk factors, such as low income, poor education, maternal and family stress, mental health, substance use disorder, and other high-risk conditions, and promote education of the public about the dangers associated with environmental risk factors. (2) PRENATAL RISK SCREENING REQUIREMENTS. — The department shall develop a multilevel screening process that includes a risk assessment instrument to identify women at risk for a preterm birth or other high-risk condition. (a) A primary health care provider must complete the risk screening at a pregnant woman’s first prenatal visit using the form and in the manner prescribed by rules adopted under this section, so that the woman may immediately be notified and referred to appropriate health, education, and social services. (b) This subsection does not apply if the pregnant woman objects to the screening in a manner prescribed by department rule. (3) POSTNATAL RISK SCREENING REQUIREMENTS. — The department shall develop a multilevel screening process that includes a risk assessment instrument to identify factors associated with increased risk of infant mortality and morbidity to provide early intervention, remediation, and prevention services, including, but not limited to, parent support and training programs, home visitation, and case management. (a) A hospital or birth center must complete the risk screening immediately following the birth of the infant, before discharge from the hospital or birth center, using the form and in the manner prescribed by rules adopted under this section. (b) This subsection does not apply if a parent or guardian of the newborn objects to the screening in a manner prescribed by department rule. History. — s. 6, ch. 2024-246. 383.15 Legislative intent; perinatal intensive care services. The Legislature finds that many perinatal diseases and disabilities have debilitating, costly, and often fatal consequences if left untreated. Many of these debilitating conditions could be prevented or ameliorated if services were available to the public through a regional perinatal intensive care centers program. Perinatal intensive care services are critical to the well-being and development of a healthy society and represent a constructive, cost-beneficial, and essential investment in the future of our state. Therefore, it is the intent of the Legislature to develop a regional perinatal intensive care centers program. The Legislature further intends that development of such program not reduce or dilute the current financial commitment of the state, as indicated through appropriation, to the existing regional perinatal intensive care centers. It is also the intent of the Legislature that any additional centers authorized under s. 383.19 after July 1, 1993, not receive payments under a disproportionate share program for regional perinatal intensive care centers authorized under chapter 409 unless specific appropriations are provided to expand such payments to additional hospitals. History. — s. 1, ch. 76-54; s. 1, ch. 77-171; s. 1, ch. 94-140; s. 1, ch. 2012-33. 383.16 Definitions; ss. 383.15-383.19. As used in ss. 383.15-383.19, the term: (1) “Department” means the Department of Health. (2) “Regional perinatal intensive care center” or “center” means a unit designated by the department, located within a hospital, and specifically designed to provide a full range of health services to its patients. (3) “Patient” means a woman who is experiencing a high-risk pregnancy and who has been declared financially and medically eligible or a newborn infant who needs intensive care and who is declared financially and medically eligible. History. — s. 2, ch. 76-54; s. 1, ch. 77-171; s. 1, ch. 79-351; s. 1, ch. 85-225; s. 2, ch. 94-140; s. 61, ch. 97-101; s. 85, ch. 2014-17. 383.17 Regional perinatal intensive care centers program; authority. The department may contract with health care providers in establishing and maintaining centers in accordance with ss. 383.15-383.19. The cost of administering the regional perinatal intensive care centers program shall be paid by the department from funds appropriated for this purpose. History. — s. 3, ch. 76-54; s. 1, ch. 77-171; s. 1, ch. 82-209; s. 2, ch. 85-225; s. 3, ch. 94-140; s. 86, ch. 2014-17. 383.18 Contracts; conditions. Participation in the regional perinatal intensive care centers program under ss. 383.15-383.19 is contingent upon the department entering into a contract with a provider. The contract shall provide that patients will receive services from the center and that parents or guardians of patients who participate in the program and who are in compliance with Medicaid eligibility requirements as determined by the department are not additionally charged for treatment and care which has been contracted for by the department. Financial eligibility for the program is based on the Medicaid income guidelines for pregnant women and for children under 1 year of age. Funding shall be provided in accordance with ss. 383.19 and 409.908. History. — s. 4, ch. 76-54; s. 1, ch. 77-174; s. 4, ch. 80-177; s. 3, ch. 82-209; s. 4, ch. 85-225; s. 32, ch. 87-225; s. 4, ch. 94-140; s. 87, ch. 2014-17; s. 3, ch. 2015-225. 383.19 Standards; funding; ineligibility. (1) The department shall adopt rules that specify standards for development and operation of a center which include, but are not limited to: (a) The need to provide services through a regional perinatal intensive care center and the requirements of the population to be served. (b) Equipment. (c) Facilities. (d) Staffing and qualifications of personnel. (e) Transportation services. (f) Data collection. (g) Definitions of terms. (2) The department shall designate at least one center to serve a geographic area representing each region of the state in which at least 10,000 live births occur per year, but in no case may there be more than 11 regional perinatal intensive care centers established unless specifically authorized in the appropriations act or in this subsection. Medicaid reimbursement shall be made for services provided to patients who are Medicaid recipients. Medicaid reimbursement for in-center obstetrical physician services shall be based upon the obstetrical care group payment system. Medicaid reimbursement for in-center neonatal physician services shall be based upon the neonatal care group payment system. These prospective payment systems, developed by the department, must place patients into homogeneous groups based on clinical factors, severity of illness, and intensity of care. Outpatient obstetrical services and other related services, such as consultations, shall be reimbursed based on the usual Medicaid method of payment for outpatient medical services. (3) Failure to comply with the standards established under this section constitutes grounds for terminating the contract. (4) The department shall give priority to establishing centers in hospitals that demonstrate an interest in perinatal intensive care by meeting program standards. (5) A private, for-profit hospital that does not accept county, state, or federal funds or indigent patients is not eligible to participate under ss. 383.15-383.19. (6) Each hospital that contracts with the department to provide services under the terms of ss. 383.15-383.19 shall prepare and submit to the department an annual report that includes, but is not limited to, the number of clients served and the costs of services in the center. The department shall annually conduct a programmatic and financial evaluation of each center. History. — s. 5, ch. 76-54; s. 1, ch. 77-171; s. 1, ch. 77-174; s. 2, ch. 79-351; s. 152, ch. 79-400; s. 5, ch. 80-177; s. 2, ch. 82-209; s. 5, ch. 85-225; s. 5, ch. 94-140; s. 19, ch. 2000-242; s. 97, ch. 2010-102; s. 88, ch. 2014-17. 383.216 Community-based prenatal and infant health care. (1) The Department of Health shall cooperate with localities which wish to establish prenatal and infant health care coalitions, and shall acknowledge and incorporate, if appropriate, existing community children’s services organizations, pursuant to this section within the resources allocated. The purpose of this program is to establish a partnership among the private sector, the public sector, state government, local government, community alliances, and maternal and child health care providers, for the provision of coordinated community-based prenatal and infant health care. The prenatal and infant health care coalitions must work in a coordinated, nonduplicative manner with local health planning councils established pursuant to s. 408.033. (2) Each prenatal and infant health care coalition shall develop, in coordination with the Department of Health, a plan which shall include at a minimum provision to: (a) Perform community assessments, using the Planned Approach to Community Health (PATCH) process, to identify the local need for comprehensive preventive and primary prenatal and infant health care. These assessments shall be used to: 1. Determine the priority target groups for receipt of care. 2. Determine outcome performance objectives jointly with the department. 3. Identify potential local providers of services. 4. Determine the type of services required to serve the identified priority target groups. 5. Identify the unmet need for services for the identified priority target groups. (b) Design a prenatal and infant health care services delivery plan which is consistent with local community objectives and this section. (c) Solicit and select local service providers based on reliability and availability, and define the role of each in the services delivery plan. (d) Determine the allocation of available federal, state, and local resources to prenatal and infant health care providers. (e) Review, monitor, and advise the department concerning the performance of the services delivery system, and make any necessary annual adjustments in the design of the delivery system, the provider composition, the targeting of services, and other factors necessary for achieving projected outcomes. (f) Build broad-based community support. (3) Supervision of the prenatal and infant health care coalitions is the responsibility of the department. The department shall: (a) Assist in the formation and development of the coalitions. (b) Define the core services package so that it is consistent with the prenatal and infant health care services delivery plan. (c) Provide data and technical assistance. (d) Assure implementation of a quality management system within the provider coalition. (e) Define statewide, uniform eligibility and fee schedules. (f) Evaluate provider performance based on outcome measures established by the pren