HOUSE AMENDMENT Bill No. HB 177 CS
1	CHAMBER ACTION
2	Senate House
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12	Representative Garcia offered the following:
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14	Amendment (with directory and title amendments)
15	Remove line(s) 26-77, and insert:
16	(t)1. For the provision of adult open-heart services in a
17	hospital located within the boundaries of Palm Beach, Polk,
18	Martin, St. Lucie, or Indian River Counties or in a municipality
19	with a population of more than 240,000 if the following
20	conditions are met: the exemption must be based upon objective
21	criteria and address and solve the twin problems of geographic
22	and temporal access. A hospital shall be exempt from the
23	certificate-of-need review for the establishment of an open-
24	heart-surgery program when the application for exemption
25	submitted under this paragraph complies with the following
26	criteria:
27	a. The applicant must certify that it will meet and
28	continuously maintain the minimum licensure requirements adopted
29	by the agency governing adult open-heart programs, including the
30	most current guidelines of the American College of Cardiology
31	and American Heart Association Guidelines for Adult Open Heart
32	Programs.
33	b. The applicant must certify that it will maintain
34	sufficient appropriate equipment and health personnel to ensure
35	quality and safety.
36	c. The applicant must certify that it will maintain
37	appropriate times of operation and protocols to ensure
38	availability and appropriate referrals in the event of
39	emergencies.
40	d. The applicant can demonstrate that it is referring 300
41	or more patients per year from the hospital, including the
42	emergency room, for cardiac services at a hospital with cardiac
43	services, or that the average wait for transfer for 50 percent
44	or more of the cardiac patients exceeds 4 hours.
45	e. The applicant is a general acute care hospital that has
46	been in operation for 3 years or more.
47	f. The applicant is performing more than 300 diagnostic
48	cardiac catheterization procedures per year, combined inpatient
49	and outpatient.
50	g. The applicant's payor mix at a minimum reflects the
51	community average for Medicaid, charity care, and self-pay
52	patients or the applicant must certify that it will provide a
53	minimum of 5 percent of Medicaid, charity care, and self-pay to
54	open-heart-surgery patients.
55	h. If the applicant fails to meet the established criteria
56	for open-heart programs or fails to reach 300 surgeries per year
57	by the end of its third year of operation, it must show cause
58	why its exemption should not be revoked.
59	2. By December 31, 2004, and annually thereafter, the
60	Agency for Health Care Administration shall submit a report to
61	the Legislature providing information concerning the number of
62	requests for exemption received under this paragraph and the
63	number of exemptions granted or denied.
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65	================= T I T L E A M E N D M E N T =================
66	Remove line(s) 16-17, and insert:
67	report to the Legislature; providing an effective date.