Bill Text: FL S1144 | 2017 | Regular Session | Comm Sub


Bill Title: Laboratory Screening

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2017-05-03 - Laid on Table, companion bill(s) passed, see CS/HB 1041 (Ch. 2017-181) [S1144 Detail]

Download: Florida-2017-S1144-Comm_Sub.html
       Florida Senate - 2017                             CS for SB 1144
       
       
        
       By the Committee on Health Policy; and Senator Montford
       
       
       
       
       
       588-02964A-17                                         20171144c1
    1                        A bill to be entitled                      
    2         An act relating to laboratory screening; amending s.
    3         381.004, F.S.; clarifying that certain requirements
    4         related to the reporting of positive HIV test results
    5         to county health departments apply only to testing
    6         performed in a nonhealth care setting; amending s.
    7         381.0202, F.S.; authorizing the Department of Health
    8         to perform laboratory testing for other states;
    9         amending s. 381.983, F.S.; redefining the term
   10         “elevated blood-lead levels”; amending s. 381.984,
   11         F.S.; revising requirements of a public information
   12         initiative on lead-based-paint hazards; revising
   13         requirements on the distribution of information on
   14         childhood lead poisoning developed by the State
   15         Surgeon General or his or her designee; amending s.
   16         381.985, F.S.; revising requirements for the State
   17         Surgeon General’s program for early identification of
   18         persons at risk of having elevated blood-lead levels;
   19         requiring the department to maintain records showing
   20         elevated blood-lead levels; requiring that health care
   21         providers report to the individual who was screened
   22         the results that indicate elevated blood-lead levels;
   23         amending s. 383.14, F.S.; authorizing the State Public
   24         Health Laboratory to release the results of a
   25         newborn’s hearing and metabolic tests to certain
   26         individuals; requiring the department to promote the
   27         availability of services to promote detection of
   28         genetic conditions; clarifying that the membership of
   29         the Genetics and Newborn Screening Advisory Council
   30         must include one member each from four of the medical
   31         schools in this state; providing an effective date.
   32          
   33  Be It Enacted by the Legislature of the State of Florida:
   34  
   35         Section 1. Paragraph (a) of subsection (2) of section
   36  381.004, Florida Statutes, is amended to read:
   37         381.004 HIV testing.—
   38         (2) HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED CONSENT;
   39  RESULTS; COUNSELING; CONFIDENTIALITY.—
   40         (a) Before performing an HIV test:
   41         1. In a health care setting, the person to be tested shall
   42  be notified orally or in writing that the test is planned and
   43  that he or she has the right to decline the test. If the person
   44  to be tested declines the test, such decision shall be
   45  documented in the medical record. A person who has signed a
   46  general consent form for medical care is not required to sign or
   47  otherwise provide a separate consent for an HIV test during the
   48  period in which the general consent form is in effect.
   49         2. In a nonhealth care setting, a provider shall obtain the
   50  informed consent of the person upon whom the test is to be
   51  performed. Informed consent shall be preceded by an explanation
   52  of the right to confidential treatment of information
   53  identifying the subject of the test and the results of the test
   54  as provided by law. The provider shall also inform the test
   55  subject that a positive HIV test result will be reported to the
   56  county health department with sufficient information to identify
   57  the test subject and provide him or her with information on the
   58  availability and location of sites where anonymous testing is
   59  performed. As required in paragraph (3)(c), each county health
   60  department shall maintain a list of sites where anonymous
   61  testing is performed which includes site locations, telephone
   62  numbers, and hours of operation.
   63  
   64  The test subject shall also be informed that a positive HIV test
   65  result will be reported to the county health department with
   66  sufficient information to identify the test subject and of the
   67  availability and location of sites at which anonymous testing is
   68  performed. As required in paragraph (3)(c), each county health
   69  department shall maintain a list of sites at which anonymous
   70  testing is performed, including the locations, telephone
   71  numbers, and hours of operation of the sites.
   72         Section 2. Section 381.0202, Florida Statutes, is amended
   73  to read:
   74         381.0202 Laboratory services.—
   75         (1) The department shall establish and maintain, in
   76  suitable and convenient places in the state, laboratories for
   77  microbiological and chemical analyses and any other purposes it
   78  determines necessary for the protection of the public health.
   79         (2) The department may contract or agree with any person or
   80  public or private agency to provide laboratory services relating
   81  to or having potential impact on the public health or relating
   82  to the health of clients directly under the care of the state.
   83         (3) The department is authorized to establish and collect
   84  reasonable fees and charges for laboratory services provided.
   85  Such fees and charges shall be deposited in a trust fund
   86  administered by the department and shall be used solely for this
   87  purpose.
   88         (4) The department may perform laboratory testing related
   89  to public health for other states on a fee-for-service basis.
   90         Section 3. Subsection (3) of section 381.983, Florida
   91  Statutes, is amended to read:
   92         381.983 Definitions.—As used in this act, the term:
   93         (3) “Elevated blood-lead level” means a quantity of lead in
   94  the whole venous blood, measured from a venous or capillary draw
   95  expressed in micrograms per deciliter (ug/dL), which exceeds the
   96  cutpoint specified in department rule. The determination of
   97  elevated blood-lead level must be based on national
   98  recommendations developed by the Council of State and
   99  Territorial Epidemiologists and the Centers for Disease Control
  100  and Prevention. 10 ug/dL or such other level as specifically
  101  provided in this act.
  102         Section 4. Subsections (2) and (3) of section 381.984,
  103  Florida Statutes, are amended to read:
  104         381.984 Educational programs.—
  105         (2) PUBLIC INFORMATION INITIATIVE.—The Governor, in
  106  conjunction with the State Surgeon General and his or her
  107  designee, shall sponsor a series of public service announcements
  108  on radio, television, or the Internet, or in and print media
  109  about the nature of lead-based-paint hazards, the importance of
  110  standards for lead poisoning prevention in properties, and the
  111  purposes and responsibilities set forth in this act. In
  112  developing and coordinating this public information initiative,
  113  the sponsors shall seek the participation and involvement of
  114  private industry organizations, including those involved in real
  115  estate, insurance, mortgage banking, or and pediatrics.
  116         (3) DISTRIBUTION OF INFORMATION LITERATURE ABOUT CHILDHOOD
  117  LEAD POISONING.—By January 1, 2007, The State Surgeon General or
  118  his or her designee shall develop culturally and linguistically
  119  appropriate information and distribution methods pamphlets
  120  regarding childhood lead poisoning, the importance of testing
  121  for elevated blood-lead levels, prevention of childhood lead
  122  poisoning, treatment of childhood lead poisoning, and, as where
  123  appropriate, the requirements of this act. This These
  124  information pamphlets shall be distributed to parents or the
  125  other legal guardians of children 6 years of age or younger on
  126  the following occasions:
  127         (a) By a health care provider at the time of a child’s
  128  birth and at the time of any childhood immunization or
  129  vaccination unless it is established that such information
  130  pamphlet has been provided previously to the parent or legal
  131  guardian by the health care provider within the prior 12 months.
  132         (b) By the owner or operator of any child care facility or
  133  preschool or kindergarten class on or before each October 15 of
  134  the calendar year.
  135         Section 5. Section 381.985, Florida Statutes, is amended to
  136  read:
  137         381.985 Screening program.—
  138         (1) The State Surgeon General shall establish guidelines a
  139  program for early identification of persons at risk of having
  140  elevated blood-lead levels and for the systematic screening of .
  141  Such program shall systematically screen children under 6 years
  142  of age in the target populations identified in subsection (2)
  143  for the presence of elevated blood-lead levels. Children within
  144  the specified target populations shall be screened with a blood
  145  lead test at age 12 months and age 24 months, or between the
  146  ages of 36 months and 72 months if they have not previously been
  147  screened. The State Surgeon General shall, after consultation
  148  with recognized professional medical groups and such other
  149  sources as the State Surgeon General deems appropriate, adopt
  150  rules to follow established national guidelines or
  151  recommendations such as those issued by the Council of State and
  152  Territorial Epidemiologists and the Centers for Disease Control
  153  and Prevention related to reporting elevated blood-lead levels
  154  and screening results to the department pursuant to this
  155  section. promulgate rules establishing:
  156         (a) The means by which and the intervals at which such
  157  children under 6 years of age shall be screened for lead
  158  poisoning and elevated blood-lead levels.
  159         (b) Guidelines for the medical followup on children found
  160  to have elevated blood-lead levels.
  161         (2) In developing screening programs to identify persons at
  162  risk with elevated blood-lead levels, priority shall be given to
  163  persons within the following categories:
  164         (a) All children enrolled in the Medicaid program at ages
  165  12 months and 24 months, or between the ages of 36 months and 72
  166  months if they have not previously been screened.
  167         (b) Children under the age of 6 years exhibiting delayed
  168  cognitive development or other symptoms of childhood lead
  169  poisoning.
  170         (c) Persons at risk residing in the same household, or
  171  recently residing in the same household, as another person at
  172  risk with an elevated a blood-lead level of 10 ug/dL or greater.
  173         (d) Persons at risk residing, or who have recently resided,
  174  in buildings or geographical areas in which significant numbers
  175  of cases of lead poisoning or elevated blood-lead levels have
  176  recently been reported.
  177         (e) Persons at risk residing, or who have recently resided,
  178  in an affected property contained in a building that during the
  179  preceding 3 years has been subject to enforcement for violations
  180  of lead-poisoning-prevention statutes, ordinances, rules, or
  181  regulations as specified by the State Surgeon General.
  182         (f) Persons at risk residing, or who have recently resided,
  183  in a room or group of rooms contained in a building whose owner
  184  also owns a building containing affected properties which,
  185  during the preceding 3 years, has been subject to an enforcement
  186  action for a violation of lead-poisoning-prevention statutes,
  187  ordinances, rules, or regulations.
  188         (g) Persons at risk residing in other buildings or
  189  geographical areas in which the State Surgeon General reasonably
  190  determines there is to be a significant risk of affected
  191  individuals having an elevated blood-lead level. a blood-lead
  192  level of 10 ug/dL or greater.
  193         (3) The department State Surgeon General shall maintain
  194  comprehensive records of all screenings indicating an elevated
  195  blood-lead level. conducted pursuant to this section. Such
  196  records shall be indexed geographically and by owner in order to
  197  determine the location of areas of relatively high incidence of
  198  lead poisoning and other elevated blood-lead levels.
  199  
  200  All cases or probable cases of lead poisoning found in the
  201  course of screenings conducted pursuant to this section shall be
  202  reported to the affected individual, to his or her parent or
  203  legal guardian if he or she is a minor, and to the State Surgeon
  204  General.
  205         (4)The results of screenings conducted pursuant to this
  206  section shall be reported by the health care provider who
  207  conducted or ordered the screening to the individual who was
  208  screened, or to the individual’s parent or legal guardian if he
  209  or she is a minor.
  210         Section 6. Paragraph (c) of subsection (1), paragraph (f)
  211  of subsection (3), and subsection (5) of section 383.14, Florida
  212  Statutes, are amended to read:
  213         383.14 Screening for metabolic disorders, other hereditary
  214  and congenital disorders, and environmental risk factors.—
  215         (1) SCREENING REQUIREMENTS.—To help ensure access to the
  216  maternal and child health care system, the Department of Health
  217  shall promote the screening of all newborns born in Florida for
  218  metabolic, hereditary, and congenital disorders known to result
  219  in significant impairment of health or intellect, as screening
  220  programs accepted by current medical practice become available
  221  and practical in the judgment of the department. The department
  222  shall also promote the identification and screening of all
  223  newborns in this state and their families for environmental risk
  224  factors such as low income, poor education, maternal and family
  225  stress, emotional instability, substance abuse, and other high
  226  risk conditions associated with increased risk of infant
  227  mortality and morbidity to provide early intervention,
  228  remediation, and prevention services, including, but not limited
  229  to, parent support and training programs, home visitation, and
  230  case management. Identification, perinatal screening, and
  231  intervention efforts shall begin prior to and immediately
  232  following the birth of the child by the attending health care
  233  provider. Such efforts shall be conducted in hospitals,
  234  perinatal centers, county health departments, school health
  235  programs that provide prenatal care, and birthing centers, and
  236  reported to the Office of Vital Statistics.
  237         (c) Release of screening results.—Notwithstanding any law
  238  to the contrary, the State Public Health Laboratory may release,
  239  directly or through the Children’s Medical Services program, the
  240  results of a newborn’s hearing and metabolic tests or screenings
  241  to the newborn’s health care practitioner, the newborn’s parent
  242  or legal guardian, the newborn’s personal representative, or a
  243  person designated by the newborn’s parent or legal guardian. As
  244  used in this paragraph, the term “health care practitioner”
  245  means a physician or physician assistant licensed under chapter
  246  458; an osteopathic physician or physician assistant licensed
  247  under chapter 459; an advanced registered nurse practitioner,
  248  registered nurse, or licensed practical nurse licensed under
  249  part I of chapter 464; a midwife licensed under chapter 467; a
  250  speech-language pathologist or audiologist licensed under part I
  251  of chapter 468; or a dietician or nutritionist licensed under
  252  part X of chapter 468.
  253         (3) DEPARTMENT OF HEALTH; POWERS AND DUTIES.—The department
  254  shall administer and provide certain services to implement the
  255  provisions of this section and shall:
  256         (f) Promote the availability of genetic studies, services,
  257  and counseling in order that the parents, siblings, and affected
  258  newborns may benefit from detection and available knowledge of
  259  the condition.
  260  
  261  All provisions of this subsection must be coordinated with the
  262  provisions and plans established under this chapter, chapter
  263  411, and Pub. L. No. 99-457.
  264         (5) ADVISORY COUNCIL.—There is established a Genetics and
  265  Newborn Screening Advisory Council made up of 15 members
  266  appointed by the State Surgeon General. The council shall be
  267  composed of two consumer members, three practicing
  268  pediatricians, at least one of whom must be a pediatric
  269  hematologist, one member representative from each from of the
  270  four of the medical schools in this the state, the State Surgeon
  271  General or his or her designee, one representative from the
  272  Department of Health representing Children’s Medical Services,
  273  one representative from the Florida Hospital Association, one
  274  individual with experience in newborn screening programs, one
  275  individual representing audiologists, and one representative
  276  from the Agency for Persons with Disabilities. All appointments
  277  shall be for a term of 4 years. The chairperson of the council
  278  shall be elected from the membership of the council and shall
  279  serve for a period of 2 years. The council shall meet at least
  280  semiannually or upon the call of the chairperson. The council
  281  may establish ad hoc or temporary technical advisory groups to
  282  assist the council with specific topics which come before the
  283  council. Council members shall serve without pay. Pursuant to
  284  the provisions of s. 112.061, the council members are entitled
  285  to be reimbursed for per diem and travel expenses. It is the
  286  purpose of the council to advise the department about:
  287         (a) Conditions for which testing should be included under
  288  the screening program and the genetics program.
  289         (b) Procedures for collection and transmission of specimens
  290  and recording of results.
  291         (c) Methods whereby screening programs and genetics
  292  services for children now provided or proposed to be offered in
  293  the state may be more effectively evaluated, coordinated, and
  294  consolidated.
  295         Section 7. This act shall take effect July 1, 2017.

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