HB 0177 2003
1	CHAMBER ACTION
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6	The Committee on Health Care recommends the following:
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8	Committee Substitute
9	Remove the entire bill and insert:
10	A bill to be entitled
11	An act relating to health care; amending s. 408.036, F.S.;
12	providing an exemption from certificate-of-need
13	requirements for certain open-heart-surgery programs;
14	providing criteria for qualifying for the exemption;
15	requiring the Agency for Health Care Administration to
16	report to the Legislature annually; providing for
17	expiration of the exemption; providing an effective date.
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19	Be It Enacted by the Legislature of the State of Florida:
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21	Section 1. Paragraph (t) is added to subsection (3) of
22	section 408.036, Florida Statutes, to read:
23	408.036 Projects subject to review; exemptions.--
24	(3) EXEMPTIONS.--Upon request, the following projects are
25	subject to exemption from the provisions of subsection (1):
26	(t)1. For an adult open-heart surgery program to be
27	located in a new hospital, provided the new hospital is being
28	established in the location of an existing hospital with an
29	adult open-heart surgery program, the existing hospital and the
30	existing adult-open heart surgery program are being relocated to
31	the replacement hospital, and the replacement hospital will
32	utilize a closed-staff model. A hospital is exempt from the
33	certificate-of-need review for the establishment of an open-
34	heart-surgery program if the application for exemption submitted
35	under this paragraph complies with the following criteria:
36	a. The applicant must certify that it will meet and
37	continuously maintain the minimum Florida Administrative Code
38	and any future licensure requirements governing open-heart
39	programs adopted by the agency, including the most current
40	guidelines of the American College of Cardiology and American
41	Heart Association Guidelines for Adult Open Heart Programs.
42	b. The applicant must certify that it will maintain
43	sufficient appropriate equipment and health personnel to ensure
44	quality and safety.
45	c. The applicant must certify that it will maintain
46	appropriate times of operation and protocols to ensure
47	availability and appropriate referrals in the event of
48	emergencies.
49	d. The applicant is a newly licensed hospital in a
50	physical location previously owned and licensed to a hospital
51	performing more than 300 open-heart procedures each year,
52	including heart transplant.
53	e. The applicant must certify that it can perform more
54	than 300 diagnostic cardiac catheterization procedures per year,
55	combined inpatient and outpatient, by the end of its third year
56	of operation.
57	f. The applicant's payor mix at a minimum reflects the
58	community average for Medicaid, charity care, and self-pay
59	patients or the applicant must certify that it will provide a
60	minimum of 5 percent of Medicaid, charity care, and self-pay to
61	open-heart-surgery patients.
62	g. If the applicant fails to meet the established criteria
63	for open-heart programs or fails to reach 300 surgeries per year
64	by the end of its third year of operation, it must show cause
65	why its exemption should not be revoked.
66	h. In order to ensure continuity of available services,
67	the applicant of the newly licensed hospital may apply for this
68	certificate of need prior to taking possession of the physical
69	facilities. The effective date of the certificate of need will
70	be concurrent with the effective date of the newly issued
71	hospital license.
72	2. By December 31, 2004, and annually thereafter, the
73	agency shall submit a report to the Legislature providing
74	information concerning the number of requests for exemption
75	received under this paragraph and the number of exemptions
76	granted or denied.
77	3. This paragraph is repealed effective January 1, 2008.
78	Section 2. This act shall take effect upon becoming a law.