Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. SB 1736
       
       
       
       
       
       
                                Barcode 863564                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/22/2011           .                                
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       The Committee on Health Regulation (Latvala) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 1708 - 1718
    4  and insert:
    5         Section 47. Paragraph (d) of subsection (1) and paragraph
    6  (m) of subsection (3) of section 408.036, Florida Statutes, are
    7  amended to read:
    8         408.036 Projects subject to review; exemptions.—
    9         (1) APPLICABILITY.—Unless exempt under subsection (3), all
   10  health-care-related projects, as described in paragraphs (a)
   11  (g), are subject to review and must file an application for a
   12  certificate of need with the agency. The agency is exclusively
   13  responsible for determining whether a health-care-related
   14  project is subject to review under ss. 408.031-408.045.
   15         (d) The establishment of a hospice or hospice inpatient
   16  facility, except as provided in s. 408.043.
   17         (3) EXEMPTIONS.—Upon request, the following projects are
   18  subject to exemption from the provisions of subsection (1):
   19         (m)1. For the provision of adult open-heart services in a
   20  hospital located within the boundaries of a health service
   21  planning district, as defined in s. 408.032(5), which has
   22  experienced an annual net out-migration of at least 600 open
   23  heart-surgery cases for 3 consecutive years according to the
   24  most recent data reported to the agency, and the district’s
   25  population per licensed and operational open-heart programs
   26  exceeds the state average of population per licensed and
   27  operational open-heart programs by at least 25 percent. All
   28  hospitals within a health service planning district which meet
   29  the criteria reference in sub-subparagraphs 2.a.-h. shall be
   30  eligible for this exemption on July 1, 2004, and shall receive
   31  the exemption upon filing for it and subject to the following:
   32         a. A hospital that has received a notice of intent to grant
   33  a certificate of need or a final order of the agency granting a
   34  certificate of need for the establishment of an open-heart
   35  surgery program is entitled to receive a letter of exemption for
   36  the establishment of an adult open-heart-surgery program upon
   37  filing a request for exemption and complying with the criteria
   38  enumerated in sub-subparagraphs 2.a.-h., and is entitled to
   39  immediately commence operation of the program.
   40         b. An otherwise eligible hospital that has not received a
   41  notice of intent to grant a certificate of need or a final order
   42  of the agency granting a certificate of need for the
   43  establishment of an open-heart-surgery program is entitled to
   44  immediately receive a letter of exemption for the establishment
   45  of an adult open-heart-surgery program upon filing a request for
   46  exemption and complying with the criteria enumerated in sub
   47  subparagraphs 2.a.-h., but is not entitled to commence operation
   48  of its program until December 31, 2006.
   49         2. A hospital shall be exempt from the certificate-of-need
   50  review for the establishment of an open-heart-surgery program
   51  when the application for exemption submitted under this
   52  paragraph complies with the following criteria:
   53         a. The applicant must certify that it will meet and
   54  continuously maintain the minimum licensure requirements adopted
   55  by the agency governing adult open-heart programs, including the
   56  most current guidelines of the American College of Cardiology
   57  and American Heart Association Guidelines for Adult Open Heart
   58  Programs.
   59         b. The applicant must certify that it will maintain
   60  sufficient appropriate equipment and health personnel to ensure
   61  quality and safety.
   62         c. The applicant must certify that it will maintain
   63  appropriate times of operation and protocols to ensure
   64  availability and appropriate referrals in the event of
   65  emergencies.
   66         d. The applicant can demonstrate that it has discharged at
   67  least 300 inpatients with a principal diagnosis of ischemic
   68  heart disease for the most recent 12-month period as reported to
   69  the agency.
   70         e. The applicant is a general acute care hospital that is
   71  in operation for 3 years or more.
   72         f. The applicant is performing more than 300 diagnostic
   73  cardiac catheterization procedures per year, combined inpatient
   74  and outpatient.
   75         g. The applicant’s payor mix at a minimum reflects the
   76  community average for Medicaid, charity care, and self-pay
   77  patients or the applicant must certify that it will provide a
   78  minimum of 5 percent of Medicaid, charity care, and self-pay to
   79  open-heart-surgery patients.
   80         h. If the applicant fails to meet the established criteria
   81  for open-heart programs or fails to reach 300 surgeries per year
   82  by the end of its third year of operation, it must show cause
   83  why its exemption should not be revoked.
   84         3. By December 31, 2004, and annually thereafter, the
   85  agency shall submit a report to the Legislature providing
   86  information concerning the number of requests for exemption it
   87  has received under this paragraph during the calendar year and
   88  the number of exemptions it has granted or denied during the
   89  calendar year.
   90  
   91  ================= T I T L E  A M E N D M E N T ================
   92         And the title is amended as follows:
   93         Delete line 145
   94  and insert:
   95         facility; deleting a requirement that the agency
   96         submit a report to the Legislature providing
   97         information concerning the number of requests it
   98         receives for an exemption from certificate-of-need
   99         review; amending s. 408.043, F.S.; revising