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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to reducing fetal and infant 2
mortality; amending s. 381.84, F.S.; revising the 3
purpose and requirements for the Comprehensive 4
Statewide Tobacco Education and Use Prevention 5
Program; revising a provision relating to a certain 6
report to conform to changes made by the act; creating 7
s. 383.21625, F.S.; providing a definition; requiring 8
the Department of Health to contract with local 9
healthy start coalitions for the creation of fetal and 10
infant mortality review committees in all regions of 11
the state; providing requirements for such committees; 12
requiring local healthy start coalitions to report the 13
findings and recommendations developed by the 14
committees to the department annually; requiring the 15
department to compile such findings and 16
recommendations in a report and submit such report to 17
the Governor and Legislature by a specified date and 18
annually; authorizing the department to adopt rules; 19
amending s. 390.011, F.S.; revising and providing 20
definitions; amending s. 390.0111, F.S.; prohibiting a 21
physician from performing a termination of pregnancy 22
if the physician determines the gestational age of a 23
fetus is more than a specified number of weeks; 24
providing an exception; amending s. 390.0112, F.S.; 25
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revising a requirement that the directors of certain 26
medical facilities submit a monthly report to the 27
Agency for Health Care Administration; requiring 28
certain physicians to submit such report to the 29
agency; requiring the report to be submitted 30
electronically on a form adopted by the agency, the 31
Board of Medicine, and the Board of Osteopathic 32
Medicine; requiring the report to include certain 33
additional information; removing obsolete language; 34
creating s. 395.1054, F.S.; requiring that certain 35
hospitals participate in a minimum number of quality 36
improvement initiatives developed in collaboration 37
with the Florida Perinatal Quality Collaborative 38
within the University of South Florida College of 39
Public Health; providing an appropriation; providing 40
an effective date. 41
42
Be It Enacted by the Legislature of the Stat e of Florida: 43
44
Section 1. Subsections (2), (3), and (7) of section 45
381.84, Florida Statutes, are amended to read: 46
381.84 Comprehensive Statewide Tobacco Education and Use 47
Prevention Program.— 48
(2) PURPOSE, FINDINGS, AND INTENT. —It is the purpose of 49
this section to implement s. 27, Art. X of the State 50
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Constitution. The Legislature finds that s. 27, Art. X of the 51
State Constitution requires the funding of a statewide tobacco 52
education and use prevention program that focuses on tobacco use 53
by youth. The Legislature further finds that the primary goals 54
of the program are to reduce the prevalence of tobacco use among 55
youth, adults, and pregnant women, and women who may become 56
pregnant; reduce per capita tobacco consumption; and reduce 57
exposure to environme ntal tobacco smoke. Further, it is the 58
intent of the Legislature to base increases in funding for 59
individual components of the program on the results of 60
assessments and evaluations. Recognizing that some components 61
will need to grow faster than inflation, it is the intent of the 62
Legislature to fund portions of the program on a nonrecurring 63
basis in the early years so that those components that are most 64
effective can be supported as the program matures. 65
(3) PROGRAM COMPONENTS AND REQUIREMENTS. —The department 66
shall conduct a comprehensive, statewide tobacco education and 67
use prevention program consistent with the recommendations for 68
effective program components contained in the 1999 Best 69
Practices for Comprehensive Tobacco Control Programs of the CDC, 70
as amended by the CDC. The program shall include the following 71
components, each of which shall focus on educating people, 72
particularly pregnant women, women who may become pregnant, and 73
youth and their parents, about the health hazards of tobacco and 74
discouraging the use of tobacco: 75
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(a) Counter-marketing and advertising; Internet resource 76
center.—The counter-marketing and advertising campaign shall 77
include, at a minimum, Internet, print, radio, and television 78
advertising and shall be funded with a minimum of on e-third of 79
the total annual appropriation required by s. 27, Art. X of the 80
State Constitution. 81
1. The campaign shall include an Internet resource center 82
for copyrighted materials and information concerning tobacco 83
education and use prevention, including cessation. The Internet 84
resource center must be accessible to the public, including 85
parents, teachers, and students, at each level of public and 86
private schools, universities, and colleges in the state and 87
shall provide links to other relevant resources. T he Internet 88
address for the resource center must be incorporated in all 89
advertising. The information maintained in the resource center 90
shall be used by the other components of the program. 91
2. The campaign shall use innovative communication 92
strategies, such as targeting specific audiences who use 93
personal communication devices and frequent social networking 94
websites. 95
(b) Cessation programs, counseling, and treatment. —This 96
program component shall include two subcomponents: 97
1. A statewide toll -free cessation service, which may 98
include counseling, referrals to other local resources and 99
support services, and treatment to the extent funds are 100
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available for treatment services; and 101
2. A local community -based program to disseminate 102
information about tobacco -use cessation, how tobacco -use 103
cessation relates to prenatal care and obesity prevention, and 104
other chronic tobacco -related diseases. 105
(c) Surveillance and evaluation. —The program shall conduct 106
ongoing epidemiological surveillance and shall contract for 107
annual independent evaluations of the effectiveness of the 108
various components of the program in meeting the goals as set 109
forth in subsection (2). 110
(d) Youth school programs. —School and after-school 111
programs shall use current evidence -based curricula and pro grams 112
that involve youth to educate youth about the health hazards of 113
tobacco, help youth develop skills to refuse tobacco, and 114
demonstrate to youth how to stop using tobacco. 115
(e) Community programs and chronic disease prevention. —The 116
department shall promote and support local community -based 117
partnerships that emphasize programs involving youth, pregnant 118
women, and women who may become pregnant, including programs for 119
the prevention, detection, and early intervention of tobacco -120
related chronic diseases. 121
(f) Training.—The program shall include the training of 122
health care practitioners, tobacco -use cessation counselors, and 123
teachers by health professional students and other toba cco-use 124
prevention specialists who are trained in preventing tobacco use 125
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and health education. Tobacco -use cessation counselors shall be 126
trained by specialists who are certified in tobacco -use 127
cessation. 128
(g) Administration and management, statewide progr ams, and 129
county health departments. —The department shall administer the 130
program within the expenditure limit established in subsection 131
(8). Each county health department is eligible to receive a 132
portion of the annual appropriation, on a per capita basis, f or 133
coordinating tobacco education and use prevention programs 134
within that county. Appropriated funds may be used to improve 135
the infrastructure of the county health department to implement 136
the comprehensive, statewide tobacco education and use 137
prevention program. Each county health department shall 138
prominently display in all treatment rooms and waiting rooms 139
counter-marketing and advertisement materials in the form of 140
wall posters, brochures, television advertising if televisions 141
are used in the lobby or wai ting room, and screensavers and 142
Internet advertising if computer kiosks are available for use or 143
viewing by people at the county health department. 144
(h) Enforcement and awareness of related laws. —In 145
coordination with the Department of Business and Profess ional 146
Regulation, the program shall monitor the enforcement of laws, 147
rules, and policies prohibiting the sale or other provision of 148
tobacco to minors, as well as the continued enforcement of the 149
Clean Indoor Air Act prescribed in chapter 386. The 150
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advertisements produced in accordance with paragraph (a) may 151
also include information designed to make the public aware of 152
these related laws and rules. The departments may enter into 153
interagency agreements to carry out this program component. 154
(i) AHEC tobacco-use cessation initiative. —The AHEC 155
network may administer the AHEC tobacco -use cessation initiative 156
in each county within the state and perform other activities as 157
determined by the department. 158
(7) ANNUAL REPORT REQUIRED. —By January 31 of each year, 159
the department shall provide to the Governor, the President of 160
the Senate, and the Speaker of the House of Representatives a 161
report that evaluates the program's effectiveness in reducing 162
and preventing tobacco use and that recommends improvements to 163
enhance the program's effectiveness. The report must contain, at 164
a minimum, an annual survey of youth attitudes and behavior 165
toward tobacco, as well as a description of the progress in 166
reducing the prevalence of tobacco use among youth, adults, and 167
pregnant women, and women who may become pregnant ; reducing per 168
capita tobacco consumption; and reducing exposure to 169
environmental tobacco smoke. 170
Section 2. Section 383.21625, Florida Statutes, is created 171
to read: 172
383.21625 Fetal and infant mortality review committees. — 173
(1) As used in this section, the term "department" means 174
the Department of Health. 175
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(2) The department shall contract with local healthy start 176
coalitions for the creation of fetal and infant mortality review 177
committees in all regions of the state to i mprove fetal and 178
infant mortality and morbidity in each region. Each committee 179
shall: 180
(a) Review and analyze rates, trends, causes, and other 181
data related to fetal and infant mortality and morbidity in a 182
geographic area. 183
(b) Develop findings and recomm endations for interventions 184
and policy changes to reduce fetal and infant mortality and 185
morbidity rates. 186
(c) Engage with local communities and stakeholders to 187
implement recommended policies and procedures to reduce fetal 188
and infant mortality and morbidit y. 189
(3) Each local healthy start coalition shall report the 190
findings and recommendations developed by each fetal and infant 191
mortality review committee to the department annually. Beginning 192
October 1, 2023, the department shall compile such findings and 193
recommendations in an annual report, which must be submitted to 194
the Governor, the President of the Senate, and the Speaker of 195
the House of Representatives. 196
(4) The department may adopt rules necessary to implement 197
this section. 198
Section 3. Subsections ( 6) and (7) of section 390.011, 199
Florida Statutes, are renumbered as subsections (7) and (8), 200
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respectively, present subsections (8) through (13) are 201
renumbered as subsections (10) through (15), respectively, 202
present subsection (6) is amended, and new subsect ions (6) and 203
(9) are added to that section, to read: 204
390.011 Definitions. —As used in this chapter, the term: 205
(6) "Fatal fetal abnormality" means a terminal condition 206
that, in reasonable medical judgment, regardless of the 207
provision of life-saving medical treatment, is incompatible with 208
life outside the womb and will result in death upon birth or 209
imminently thereafter. 210
(7)(6) "Gestation" means the development of a human embryo 211
or fetus as calculated from the first day of the pregnant 212
woman's last menstrual period between fertilization and birth . 213
(9) "Medical abortion" means the administration or use of 214
an abortion-inducing drug to induce an abortion. 215
Section 4. Subsection (1) of section 390.0111, Florida 216
Statutes, is amended to read: 217
390.0111 Termination of pregnancies. — 218
(1) TERMINATION AFTER GESTATIONAL AGE OF 15 WEEKS IN THIRD 219
TRIMESTER; WHEN ALLOWED.—A physician may not perform a No 220
termination of pregnancy if the physician determines the 221
gestational age of the fetus is more than 15 weeks shall be 222
performed on any human being in the third trimester of pregnancy 223
unless one of the following conditions is met: 224
(a) Two physicians certify in writing that, in reasonable 225
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medical judgment, the termination of the pregnancy is necessary 226
to save the pregnant woman's life or avert a serious risk of 227
substantial and irreversible physical impairment of a major 228
bodily function of the pregnant woman other than a psychological 229
condition. 230
(b) The physician certifies in writing that, in reasonable 231
medical judgment, there is a medical necessity for legitimate 232
emergency medical procedures for termination of the pregnancy to 233
save the pregnant woman's life or avert a serious risk of 234
imminent substantial and irreversible physical impairment of a 235
major bodily function of the pregnant woman other than a 236
psychological condition, and another physician is not available 237
for consultation. 238
(c) The fetus has not achieved viability under s. 239
390.01112 and two physicians certify in writing that, in 240
reasonable medical judgemen t, the fetus has a fatal fetal 241
abnormality. 242
Section 5. Section 390.0112, Florida Statutes, is amended 243
to read: 244
390.0112 Termination of pregnancies; reporting. — 245
(1) The director of any medical facility in which 246
abortions are performed , including surgical procedures and 247
medical abortions, including a physician's office, shall submit 248
a report each month to the agency. If the abortion is not 249
performed in a medical facility, the physician performing the 250
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abortion shall submit the monthly report. The report must may be 251
submitted electronically on a form adopted by the agency, the 252
Board of Medicine, and the Board of Osteopathic Medicine which , 253
may not include personal identifying information , and must 254
include: 255
(a) Until the agency begins collecting data under 256
paragraph (e), The number of abortions performed. 257
(b) The reasons such abortions were performed. If a woman 258
upon whom an abortion is performed has provided evidence that 259
she is a victim of human trafficking pursuant to s. 260
390.0111(3)(a)1.b.(IV), su ch reason must be included in the 261
information reported under this section. 262
(c) For each abortion, the period of gestation at the time 263
the abortion was performed. 264
(d) The number of infants born alive or alive immediately 265
after an attempted abortion. 266
(e) Beginning no later than January 1, 2017, Information 267
consistent with the United States Standard Report of Induced 268
Termination of Pregnancy adopted by the Centers for Disease 269
Control and Prevention. 270
(f) The number of medication abortion regimens prescribed 271
or dispensed. 272
(2) The agency shall keep such reports in a central 273
location for the purpose of compiling and analyzing statistical 274
data and shall submit data reported pursuant to paragraph (1)(e) 275
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to the Division of Reproductive Health within th e Centers for 276
Disease Control and Prevention, as requested by the Centers for 277
Disease Control and Prevention. 278
(3) If the termination of pregnancy is not performed in a 279
medical facility, the physician performing the procedure shall 280
be responsible for repo rting such information as required in 281
subsection (1). 282
(3)(4) Reports submitted pursuant to this section shall be 283
confidential and exempt from the provisions of s. 119.07(1) and 284
shall not be revealed except upon the order of a court of 285
competent jurisdiction in a civil or criminal proceeding. 286
(4)(5) Any person required under this section to file a 287
report or keep any records who willfully fails to file such 288
report or keep such records may be subject to a $200 fine for 289
each violation. The agency shall be r equired to impose such 290
fines when reports or records required under this section have 291
not been timely received. For purposes of this section, timely 292
received is defined as 30 days following the preceding month. 293
Section 6. Section 395.1054, Florida Stat utes, is created 294
to read: 295
395.1054 Birthing quality improvement initiatives. —A 296
hospital that provides birthing services shall at all times 297
participate in at least two quality improvement initiatives 298
developed in collaboration with the Florida Perinatal Q uality 299
Collaborative within the University of South Florida College of 300
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Public Health. 301
Section 7. For the 2022-2023 fiscal year, the sum of 302
$1,602,000 in recurring funds from the General Revenue Fund is 303
appropriated to the Department of Health for the p urpose of 304
establishing fetal and infant mortality review committees under 305
s. 383.21625, Florida Statutes. 306
Section 8. This act shall take effect July 1, 2022. 307