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
HB 1391 2023
1 A bill to be entitled
2 An act relating to certified nurse midwife out-of-
3 hospital care plan; amending s. 464.0123, F.S.;
4 revising requirements for the autonomous practice of
5 nurse midwifery; requiring certified nurse midwives
6 engaged in autonomous practice to prescribe and use
7 emergency plan of care forms, report certain
8 information and provide certain patient records to
9 receiving providers when transferring patients;
10 requiring the Board of Nursing to establish transfer-
11 of-care conditions, monitor for excessive transfers,
12 conduct reviews of adverse maternal and neonatal
13 outcomes, and monitor the licensure of certain
14 certified nurse midwives; providing an effective date.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1. Paragraph (b) of subsection (3) of section
19 464.0123, Florida Statutes, is amended to read:
20 464.0123 Autonomous practice by an advanced practice
21 registered nurse.—
22 (3) PRACTICE REQUIREMENTS.—
23 (b)1. A certified nurse midwife engaged in the autonomous
24 practice of nurse midwifery, to provide out-of-hospital
25 intrapartum care, must maintain a written policy for the
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26 transfer of patients needing a higher acuity of care or
27 emergency services. The policy must require the use of an
28 emergency plan of care form signed by the patient before
29 admission to intrapartum care. The emergency plan of care form
30 must include all of the following:
31 a. Name and address of the closest hospital with maternity
32 and newborn services.
33 b. Conditions for which transfer of care may be necessary.
34 Transfer-of-care conditions must follow board regulations.
35 c. Ambulance or other emergency medical services that may
36 be used to transport the patient in the event of an emerge ncy.
37 2. Once transfer of care is determined necessary by the
38 certified nurse midwife, he or she must document the following
39 information on the patient's emergency plan of care form:
40 a. Name, date of birth, and condition of the patient.
41 b. Gravidity or parity of the patient and gestational age
42 and condition of the fetus or newborn infant.
43 c. Reason for the transfer of care.
44 d. Description of the situation, relevant clinical
45 background, assessment, and recommendation.
46 e. Planned mode of transfer to the receiving facility.
47 f. Expected time of arrival at the receiving facility.
48 3.a. Before transfer of the patient, the certified nurse
49 midwife must provide the receiving provider with a verbal
50 summary of the information listed in subparagraph 2.
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51 b. Upon transfer of the patient to the receiving facility,
52 the certified nurse midwife must provide the receiving provider
53 with the patient's emergency plan of care form.
54 4. The certified nurse midwife shall provide the receiving
55 provider with the patient's prenatal records, including patient
56 history, prenatal laboratory results, sonograms, prenatal care
57 flow sheets, maternal fetal medical reports, and labor flow
58 charting and current notations.
59 5. The board shall establish transfer-of-care conditions,
60 monitor for excessive transfers, conduct reviews of adverse
61 maternal and neonatal outcomes, and monitor the licensure of
62 certified nurse midwives engaged in autonomous practice must
63 have a written patient transfer agreement with a hospital and a
64 written referral agreement with a physician licensed under
65 chapter 458 or chapter 459 to engage in nurse midwifery .
66 Section 2. This act shall take effect July 1, 2023.
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Statutes affected:
H 1391 Filed: 464.0123