HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 133 Surrendered Newborn Infants
SPONSOR(S): Health & Human Services Committee, Harding and others
TIED BILLS: IDEN./SIM. BILLS: SB 122
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 16 Y, 1 N Woodruff Brazzell
2) Health & Human Services Committee 18 Y, 0 N, As CS Woodruff Calamas
SUMMARY ANALYSIS
Florida law allows parents who are unwilling or unable to care for their infants to safely relinquish them at
hospitals, fire stations, and emergency medical services stations. This ‘safe haven law’ allows parents to
anonymously surrender infants up to seven days old and grants the parents immunity from criminal
prosecution unless there is actual or suspected child abuse or neglect.
A newborn safety device, or baby box, provides a place for a parent in crisis to safely, securely, and
anonymously surrender an unwanted newborn. The concept of a baby box has existed for centuries throughout
Europe, and over 20 countries still utilize some form of a baby box today.
HB 133 increases the age that an infant may be surrendered from seven days old to 30 days old. The bill
authorizes hospitals, emergency medical service stations, and fire stations that are staffed 24 hours a day to
opt to utilize newborn safety devices, and specifies the requirements for such devices.
The bill also requires DOH to approve the newborn infant safety devices used at a hospital, fire station or
emergency medical services station and grants DOH rulemaking authority to implement the review and
approval process.
The bill has an insignificant fiscal impact on DOH, absorbable within existing resources. The bill has no fiscal
impact on local government.
The bill provides an effective date of July 1, 2021.
FULL ANALYSIS
This document does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h0133c.HHS
DATE: 3/10/2021
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Safe Haven Laws
Safe haven laws allow parents or agents of the parents to safely relinquish babies at designated
locations while remaining anonymous, and confer immunity from criminal liability and prosecution for
child endangerment, abandonment, or neglect.1 The purpose of safe haven laws is to ensure that
abandoned infants are left with those who can provide immediate care necessary for the children’s
safety and wellbeing.2
In 1999, Texas was the first state to enact safe haven legislation.3 Now all 50 states, the District of
Columbia, and Puerto Rico have variations of safe haven laws.4 In 11 states and Puerto Rico, only
infants who are up to 72 hours old may be relinquished to a designated site, and in 19 states infants
are accepted up to one month old.5 Additionally, 16 states and Puerto Rico require parents to surrender
their infants only to a hospital, emergency medical services provider, or healthcare facility. 6 In 27
states, fire stations are also designated as safe haven providers.7 Personnel at police stations or other
law enforcement agencies may accept infants in 25 states.8
Thirty-five states and the District of Columbia expressly preserve the anonymity of the person
relinquishing an infant.9
Florida Safe Haven Law
Florida enacted safe haven legislation in 2000 in response to tragedies of newborn abandonment at
unsafe locations, such as public restrooms or trash receptacles.10 The law authorizes parents to
surrender a newborn infant up to seven days old at a hospital, fire station, or emergency medical
service station. It creates a presumption that the parent consents to the termination of their parental
rights11 and for the transport and medical treatment for the child.12 The law expressly grants the parents
a right to anonymity and to not be pursued, unless the parent seeks to reclaim the newborn infant.13 If
the newborn infant is born in a hospital, the hospital registrars must complete the infant’s birth
certificate without naming the mother, if she requests it and expresses an intent to leave without the
infant and not return.14 The law also grants the parents immunity from criminal prosecution unless there
is actual or suspected abuse or neglect of the infant.15
The Florida safe haven law requires hospitals, fire stations, and emergency medical services stations
that are staffed with full-time firefighters or emergency medical technicians to accept any newborn
infant left with a firefighter or emergency medical technician. The law does not specify any training
required for personnel who might receive infants at these facilities, nor does it direct them on how to
interact with individuals surrendering infants other than specifying that those relinquishing infants have
a right to remain anonymous and not be pursued or followed unless the parent seeks to reclaim the
1 Infant Safe Haven Laws, Child Welfare Information Gateway (Dec. 2016), https://www.childwelfare.gov/pubPDFs/safehaven.pdf
2 Id.
3 NY Legislative Counsel Bureau, A Study of Infant Abandonment Legislation,
https://www.leg.state.nv.us/Division/Research/Publications/Bkground/BP01-03.pdf (last visited Feb. 4, 2021).
4 Id.
5 Id.
6 Supra note 1.
7 Id.
8 Id.
9 Infant Abandonment, Guttmacher Institute (Feb. 2021), https://www.guttmacher.org/state-policy/explore/infant-abandonment.
10 S. 383.50, F.S.; see Ch. 2000-188, Laws of Fla.
11 S. 63.0423, F.S.
12 S. 383.50, F.S.
13 S. 383.50(5), F.S.
14 Id.
15 S. 383.50(10), F.S.
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infant. The law grants emergency medical technicians, paramedics, and fire department staff immunity
from criminal and civil liability, except in situations of negligence, when acting in good faith for a
surrendered infant.16
Since 2000, approximately 324 newborns have been surrendered at a safe haven in Florida. In that
time, 62 infants are known to have been unsafely abandoned, of which 32 died.17
Newborn Safety Devices
For centuries, mothers throughout Europe have surrendered their babies in hatches or crib structures,
commonly referred to as “foundling wheels” or “baby boxes,” at the entrance of a place of worship, a
charity organization, or hospital.18 The modern-day newborn safety device was created in South Africa
in 1999, in which mothers placed their child in a hatch in a church wall and the door automatically
locked, sending a signal to care workers inside.19
Over 20 countries currently have some form of baby boxes, including Austria, Germany, Italy, Poland,
Portugal, and Slovakia.20 Approximately 200 baby boxes have been installed across Europe in the past
decade.21
Safe Haven Baby Boxes
Safe Haven Baby Boxes, Inc. is a nonprofit corporation in Indiana.22 The nonprofit has patented a
device for receiving a surrendered baby,23 trademarked as a “Safe Haven Baby Box”.24 The federal
Food and Drug Administration has determined that a “Safe Haven Baby Box” is not a medical “device”
under the federal Food, Drug, and Cosmetic Act, and therefore is not required to comply with the
requirements of the Act.25
There are currently 56 Safe Haven Baby Boxes across five states.26
In December, an Ocala fire department unveiled the first baby box installed in Florida.27 The fire
department utilizes the Safe Haven Baby Box. It is electronically monitored and equipped to notify 911
as soon as the outer door is open. Once a parent has placed the baby in the padded box, the door will
automatically lock and a silent alarm is triggered alerting personnel that a baby needs to be picked
16 S. 383.50(3), F.S.
17 A Safe Haven for Newborns, Safe Haven Statistics, https://asafehavenfornewborns.com/what-we-do/safe-haven-statistics/ (last
visited Feb. 4, 2021).
18 Atsushi Asai, Should We Maintain Baby Hatches in Our Society?, BMC Med. Ethics (Feb. 22, 2013),
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586365/#B1
19 Baby Boxes Allow Mothers to Drop-off Unwanted Children, Apolitical (Aug. 22, 2019),
https://apolitical.co/solution_article/baby-boxes-allow-mothers-to-drop-off-unwanted-children
20 European Commission, Child Abandonment and Its Prevention,
http://ec.europa.eu/justice/grants/results/daphne-toolkit/content/child-abandonment-and-its-prevention_en (last visited Feb. 4, 2021).
21 Amber Hildebrandt, The Revival of 'Baby Boxes' for Unwanted Infants, CBC NEWS (May 07, 2013),
https://www.cbc.ca/news/canada/the-revival-of-baby-boxes-for-unwanted-infants-1.1357615
22 United States Patent (dated Apr. 29, 2020), https://img1.wsimg.com/blobby/go/0e1dea24-4aa4-477a-b7dd-
0e668b1de6d1/downloads/Patent%20.pdf?ver=1610398180477 (last visited Feb. 9, 2021).
23 Id.
24 Trademark Certificate (registered Oct. 15, 2019), https://img1.wsimg.com/blobby/go/0e1dea24-4aa4-477a-b7dd-
0e668b1de6d1/downloads/Tradmark%20Certificate.pdf?ver=1610398180478 (last visited Feb 9, 2021).
25 Letter from U.S. Food and Drug Administration to Safe Haven Baby Boxes, Inc. (dated Feb. 15, 2019)
https://img1.wsimg.com/blobby/go/0e1dea24-4aa4-477a-b7dd-0e668b1de6d1/downloads/C180100.Letter.pdf?ver=1610398180478
(last visited Feb. 9, 2021).
26 Safe Haven Baby Boxes, Baby Box Locations, https://shbb.org/locations (last visited Feb. 4, 2021).
27 Ocala Fire Rescue Unveils Florida’s First Haven Baby Box (Dec. 15, 2020),
https://www.ocalafl.org/Home/Components/News/News/13495/577?npage=3
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up.28 The box is similar to an incubator, with heating and cooling functions to keep the baby safe until
help arrives.29 The baby box cost approximately $15,000 to install.30
Florida Department of Health
The purpose of the Department of Health (DOH) is to protect and promote the health of all residents
and visitors in Florida.31 Under current law, the DOH must:
Identify, diagnose, and conduct surveillance of diseases and health conditions in the state and
accumulate the health statistics necessary to establish trends.
Implement interventions that prevent or limit the impact or spread of diseases and health
conditions.
Collect, manage, and analyze vital statistics and other health data to inform the public and
formulate public health policy and planning.
Maintain and coordinate preparedness for and responses to public health emergencies in the
state.
Provide or ensure the provision of quality health care and related services to identified
populations in the state.
Regulate health practitioners for the preservation of the health, safety, and welfare of the public.
When Florida’s safe haven law was first passed in 2000, it required DOH to work in conjunction with the
Department of Children and Families to produce a media campaign. This campaign promotes safe
placement alternatives for newborn infants, informs the public of the confidentiality and limited immunity
from criminal prosecution offered to a parent, educates parents of their rights to reclaim their newborn
infant within specified time periods, and publicizes adoption procedures.32 In accordance with specific
appropriation, line 529, of the 2020-21 General Appropriations Act, DOH currently has a contract with
the non-profit organization A Safe Haven for Newborns to provide statewide community outreach and
awareness to prevent the loss of infant life by educating the public of safe venues for parents
considering abandoning their infants.33
Effect of Proposed Changes
HB 133 amends Florida’s safe haven law to increase the infant age limit for a parent to surrender a
newborn infant at a safe haven location from seven days old to 30 days old. This gives parents more
time to make a decision, possibly preventing the unsafe abandonment of infants older than seven days.
The bill also authorizes the use of newborn safety devices, or baby boxes, at the designated safe
haven sites, if they are staffed 24 hours a day.
The bill requires the boxes to be physically part of the hospital, fire station, or emergency medical
services station, and installed in an exterior wall. The boxes must have an exterior point of access that
locks. The boxes must have an interior point of access in an area that is conspicuous and visible to
facility employees. Placing an infant inside the box must automatically trigger an alarm inside the
building to alert individuals inside the building to safely retrieve the newborn infant.
The bill requires facilities that use a newborn safety device to check the device at least twice daily and
test the device at least once weekly to ensure that the alarm system is in working order.
28 Safe Haven Baby Boxes, How Does It Work, https://shbb.org/resources (last visited Feb. 4, 2021).
29 Jennie Runevitch, Safe Haven Baby Boxes: Here's How They Work, WTHR-TV CHANNEL 13 (Oct. 18, 2019),
https://www.wthr.com/article/safe-haven-baby-boxes-heres-how-they-work
30 Austin L. Miller, Ocala gets Florida’s Fist Baby Box, A Safe Drop-Off When Parents Can’t Care for Baby, Ocala Star Banner (Dec. 16,
2020), https://www.ocala.com/story/news/2020/12/16/baby-box-safe-haven-ocala-florida/3912696001/.
31 S. 20.43, F.S.
32 Ch. 2000-188, Laws of Fla.
33 Florida Department of Health, 2021 Agency Bill Analysis for HB 133 (Jan. 29, 2021); See also 2019, HB 5001, General
Appropriations Act in specific appropriations 529.
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The bill makes all the provisions in the current safe haven law applicable to surrendering an infant
using a baby box, including parental consent for the child’s transport and medical treatment, consent to
termination of parental rights, the right to anonymity and non-pursuit, and the immunities for both the
parents and the receiving facility’s staff.
The bill also requires DOH to approve the newborn infant safety devices used at a hospital, fire station
or emergency medical services station and grants DOH rulemaking authority to implement the review
and approval process.
The bill’s effective date is July 1, 2021.
B. SECTION DIRECTORY:
Section 1: Amends s. 383.50, F.S., relating to the treatment of a surrendered newborn infant.
Section 2: Amends s. 63.0423, F.S., relating to procedures with respect to surrendered newborn
infants.
Section 3: Provides an effective date.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
The bill has an insignificant, absorbable fiscal impact on DOH associated with rulemaking authority
for the review and approval of newborn infant safety devices.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
Local government facilities that opt to use a newborn safety device as a means for the
relinquishment of a newborn will incur the cost of acquisition and installation of the new device.
Costs may vary by the newborn safety device used. For example, the use of the Safe Haven Safety
Box costs approximately $15,000 to install.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
Private sector facilities that opt to use a newborn safety device as a means for the relinquishment of a
newborn will incur the cost of acquisition and installation of the new device. Costs may vary by the
newborn safety device used. For example, the use of the Safe Haven Safety Box costs approximately
$15,000 to install.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
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DATE: 3/10/2021
1. Applicability of Municipality/County Mandates Provision:
This bill does not appear to require counties or municipalities to take an action requiring the
expenditure of funds, reduce the authority that counties or municipalities have to raise revenue in the
aggregate, nor reduce the percentage of state tax shared with counties or municipalities.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
DOH has sufficient rulemaking authority to implement the bill’s provisions.
C. DRAFTING ISSUES OR OTHER COMMENTS:
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
On March 9, 2021, the Health and Human Services Committee adopted an amendment and reported the
bill favorably as a committee substitute. The amendment requires the Department of Health (DOH) to
review and approve newborn infant safety devices for use by hospitals, emergency medical services
stations, or fire stations and grants DOH rulemaking authority to implement the review and approval
process.
The analysis is drafted to the c