HOUSE AMENDMENT Bill No. CS/SB 56
1	CHAMBER ACTION
2	Senate House
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12	Representative Garcia offered the following:
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14	Amendment (with title amendment)
15	On page 1, line 19, through page 3, line 11,
16	remove: all of said lines
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18	and insert:
19	(t)1. For the provision of adult open-heart services in a
20	hospital located within the boundaries of Palm Beach, Polk,
21	Martin, St. Lucie, or Indian River Counties or in a municipality
22	with a population of more than 240,000 if the following
23	conditions are met: the exemption must be based upon objective
24	criteria and address and solve the twin problems of geographic
25	and temporal access. A hospital shall be exempt from the
26	certificate-of-need review for the establishment of an open-
27	heart-surgery program when the application for exemption
28	submitted under this paragraph complies with the following
29	criteria:
30	a. The applicant must certify that it will meet and
31	continuously maintain the minimum licensure requirements adopted
32	by the agency governing adult open-heart programs, including the
33	most current guidelines of the American College of Cardiology
34	and American Heart Association Guidelines for Adult Open Heart
35	Programs.
36	b. The applicant must certify that it will maintain
37	sufficient appropriate equipment and health personnel to ensure
38	quality and safety.
39	c. The applicant must certify that it will maintain
40	appropriate times of operation and protocols to ensure
41	availability and appropriate referrals in the event of
42	emergencies.
43	d. The applicant can demonstrate that it is referring 300
44	or more patients per year from the hospital, including the
45	emergency room, for cardiac services at a hospital with cardiac
46	services, or that the average wait for transfer for 50 percent
47	or more of the cardiac patients exceeds 4 hours.
48	e. The applicant is a general acute care hospital that has
49	been in operation for 3 years or more.
50	f. The applicant is performing more than 300 diagnostic
51	cardiac catheterization procedures per year, combined inpatient
52	and outpatient.
53	g. The applicant's payor mix at a minimum reflects the
54	community average for Medicaid, charity care, and self-pay
55	patients or the applicant must certify that it will provide a
56	minimum of 5 percent of Medicaid, charity care, and self-pay to
57	open-heart-surgery patients.
58	h. If the applicant fails to meet the established criteria
59	for open-heart programs or fails to reach 300 surgeries per year
60	by the end of its third year of operation, it must show cause
61	why its exemption should not be revoked.
62	2. By December 31, 2004, and annually thereafter, the
63	Agency for Health Care Administration shall submit a report to
64	the Legislature providing information concerning the number of
65	requests for exemption received under this paragraph and the
66	number of exemptions granted or denied.
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68	================= T I T L E A M E N D M E N T =================
69	On page 1, line(s) 8-9,
70	remove: all of said lines
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72	and insert: to the Legislature; providing an effective date.