HB 1391 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1391-00
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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 certified nurse midwife out -of-2
hospital care plan; amending s. 464.0123, F.S.; 3
revising requirements for the autonomous practice of 4
nurse midwifery; requiring certified nurse midwives 5
engaged in autonomous practice to prescribe and use 6
emergency plan of care forms, report certain 7
information and provide certain patient records to 8
receiving providers when transferring patients; 9
requiring the Board of Nursing to establish transfer -10
of-care conditions, monitor for excessive transfers, 11
conduct reviews of adverse maternal and neonatal 12
outcomes, and monitor the licensure of certain 13
certified nurse midwives; providing an effective date. 14
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Be It Enacted by the Legislature of the State of Florida: 16
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Section 1. Paragraph (b) of subsection (3) of section 18
464.0123, Florida Statutes, is amended to read: 19
464.0123 Autonomous practice by an advanced practice 20
registered nurse.— 21
(3) PRACTICE REQUIREMEN TS.— 22
(b)1. A certified nurse midwife engaged in the autonomous 23
practice of nurse midwifery, to provide out -of-hospital 24
intrapartum care, must maintain a written policy for the 25
HB 1391 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1391-00
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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
transfer of patients needing a higher acuity of care or 26
emergency services. Th e policy must require the use of an 27
emergency plan of care form signed by the patient before 28
admission to intrapartum care. The emergency plan of care form 29
must include all of the following: 30
a. Name and address of the closest hospital with maternity 31
and newborn services. 32
b. Conditions for which transfer of care may be necessary. 33
Transfer-of-care conditions must follow board regulations. 34
c. Ambulance or other emergency medical services that may 35
be used to transport the patient in the event of an emerge ncy. 36
2. Once transfer of care is determined necessary by the 37
certified nurse midwife, he or she must document the following 38
information on the patient's emergency plan of care form: 39
a. Name, date of birth, and condition of the patient. 40
b. Gravidity or parity of the patient and gestational age 41
and condition of the fetus or newborn infant. 42
c. Reason for the transfer of care. 43
d. Description of the situation, relevant clinical 44
background, assessment, and recommendation. 45
e. Planned mode of transfer to the receiving facility. 46
f. Expected time of arrival at the receiving facility. 47
3.a. Before transfer of the patient, the certified nurse 48
midwife must provide the receiving provider with a verbal 49
summary of the information listed in subparagraph 2. 50
HB 1391 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1391-00
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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
b. Upon transfer of the patient to the receiving facility, 51
the certified nurse midwife must provide the receiving provider 52
with the patient's emergency plan of care form. 53
4. The certified nurse midwife shall provide the receiving 54
provider with the patien t's prenatal records, including patient 55
history, prenatal laboratory results, sonograms, prenatal care 56
flow sheets, maternal fetal medical reports, and labor flow 57
charting and current notations. 58
5. The board shall establish transfer -of-care conditions, 59
monitor for excessive transfers, conduct reviews of adverse 60
maternal and neonatal outcomes, and monitor the licensure of 61
certified nurse midwives engaged in autonomous practice must 62
have a written patient transfer agreement with a hospital and a 63
written referral agreement with a physician licensed under 64
chapter 458 or chapter 459 to engage in nurse midwifery . 65
Section 2. This act shall take effect July 1, 2023. 66