Senate Bill sb0460c1

    Florida Senate - 2003                            CS for SB 460

    By the Committee on Health, Aging, and Long-Term Care; and
    Senators Pruitt and Klein




    317-1834-03

  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         408.036, F.S.; providing an exemption from

  4         certificate-of-need requirements for certain

  5         open-heart-surgery programs; providing criteria

  6         for qualifying for the exemption; requiring the

  7         Agency for Health Care Administration to report

  8         to the Legislature; providing for expiration of

  9         the exemption; providing an effective date.

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11  Be It Enacted by the Legislature of the State of Florida:

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13         Section 1.  Paragraph (t) is added to subsection (3) of

14  section 408.036, Florida Statutes, to read:

15         408.036  Projects subject to review.--

16         (3)  EXEMPTIONS.--Upon request, the following projects

17  are subject to exemption from the provisions of subsection

18  (1):

19         (t)1.  For the provision of adult open-heart services

20  in a hospital located within the boundaries of Palm Beach,

21  Polk, Martin, St. Lucie, and Indian River Counties if the

22  following conditions are met: The exemption must be based upon

23  objective criteria and address and solve the twin problems of

24  geographic and temporal access. A hospital shall be exempt

25  from the certificate-of-need review for the establishment of

26  an open-heart-surgery program when the application for

27  exemption submitted under this paragraph complies with the

28  following criteria:

29         a.  The applicant must certify that it will meet and

30  continuously maintain the minimum licensure requirements

31  adopted by the agency governing adult open-heart programs,

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    Florida Senate - 2003                            CS for SB 460
    317-1834-03




  1  including the most current guidelines of the American College

  2  of Cardiology and American Heart Association Guidelines for

  3  Adult Open Heart Programs.

  4         b.  The applicant must certify that it will maintain

  5  sufficient appropriate equipment and health personnel to

  6  ensure quality and safety.

  7         c.  The applicant must certify that it will maintain

  8  appropriate times of operation and protocols to ensure

  9  availability and appropriate referrals in the event of

10  emergencies.

11         d.  The applicant can demonstrate that it is referring

12  300 or more patients per year from the hospital, including the

13  emergency room, for cardiac services at a hospital with

14  cardiac services, or that the average wait for transfer for 50

15  percent or more of the cardiac patients exceeds 4 hours.

16         e.  The applicant is a general acute care hospital that

17  is in operation for 3 years or more.

18         f.  The applicant is performing more than 300

19  diagnostic cardiac catheterization procedures per year,

20  combined inpatient and outpatient.

21         g.  The applicant's payor mix at a minimum reflects the

22  community average for Medicaid, charity care, and self-pay

23  patients or the applicant must certify that it will provide a

24  minimum of 5 percent of Medicaid, charity care, and self-pay

25  to open-heart-surgery patients.

26         h.  If the applicant fails to meet the established

27  criteria for open-heart programs or fails to reach 300

28  surgeries per year by the end of its third year of operation,

29  it must show cause why its exemption should not be revoked.

30         2.  By December 31, 2004, and annually thereafter, the

31  Agency for Health Care Administration shall submit a report to

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    Florida Senate - 2003                            CS for SB 460
    317-1834-03




  1  the Legislature providing information concerning the number of

  2  requests for exemption received under this paragraph and the

  3  number of exemptions granted or denied.

  4         3.  This paragraph is repealed effective July 1, 2006.

  5         Section 2.  This act shall take effect upon becoming a

  6  law.

  7

  8          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  9                         Senate Bill 460

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11  The committee substitute differs from SB 460 in the following
    ways:
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    1. The committee substitute does not authorize an exemption
13  from certificate-of-need review for open-heart surgery in
    service districts 1, 6, and 9, but, rather, authorizes such an
14  exemption in Palm Beach, Polk, Martin, St. Lucie, and Indian
    River Counties.
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    2. The committee substitute omits two introductory sentences
16  regarding when consideration must be given to creating an
    exemption and why changing the specific need criteria would
17  not solve the problem of protracted appeals.

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CODING: Words stricken are deletions; words underlined are additions.