Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. SB 1518
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/09/2016           .                                

       The Committee on Health Policy (Grimsley) recommended the
    1         Senate Amendment to Amendment (740310) (with title
    2  amendment)
    4         Between lines 4 and 5
    5  insert:
    6         Section 1. Section 391.224, Florida Statutes, is created to
    7  read:
    8         391.224 Pediatric Cardiac Advisory Council.—
   10         (a) The Legislature finds significant benefits in the
   11  continued coordination of activities by several state agencies
   12  regarding access to pediatric cardiac care in this state. It is
   13  the intent of the Legislature that the Department of Health, the
   14  department’s cardiac consultants, and the Agency for Health Care
   15  Administration maintain their long-standing interagency teams
   16  and agreements for the development and adoption of guidelines,
   17  standards, and rules for those portions of the state cardiac
   18  care system within the statutory authority of each agency. This
   19  coordinated approach will continue to ensure the necessary
   20  continuum of care for the pediatric cardiac patient. The
   21  department has the leadership responsibility for this activity.
   22         (b) It is further the intent of the Legislature to
   23  establish the Pediatric Cardiac Advisory Council, a statewide,
   24  inclusive council within the department.
   26         (a) The State Surgeon General shall appoint the Pediatric
   27  Cardiac Advisory Council for the purpose of advising the
   28  department on the delivery of cardiac services to children.
   29         (b) The chair of the council shall be elected from among
   30  the council members every 2 years and may not serve more than
   31  two consecutive terms.
   32         (c) The council shall meet upon the call of the chair or
   33  two or more voting members or upon the call of the State Surgeon
   34  General, but must meet at least quarterly. Council meetings must
   35  be conducted by teleconference or through other electronic means
   36  when feasible.
   37         (d) The council shall be composed of no more than 13 voting
   38  members with technical expertise in cardiac medicine. Members
   39  shall be appointed by the State Surgeon General for staggered
   40  terms of 4 years. An employee of the department or a contracted
   41  consultant paid by the department may not serve as an appointed
   42  member or ex officio member of the council. Council members
   43  shall include the following voting members:
   44         1. Pediatric cardiologists or pediatric cardiovascular
   45  surgeons who have been nominated by their respective chief
   46  executive officers and approved by the State Surgeon General
   47  from the following facilities for as long as such facilities
   48  maintain their pediatric certificates of need:
   49         a. All Children’s Hospital in St. Petersburg;
   50         b. Arnold Palmer Hospital for Children in Orlando;
   51         c. Joe DiMaggio Children’s Hospital in Hollywood;
   52         d. Nicklaus Children’s Hospital in Miami;
   53         e. St. Joseph’s Children’s Hospital in Tampa;
   54         f. University of Florida Health Shands Hospital in
   55  Gainesville;
   56         g. University of Miami Holtz Children’s Hospital in Miami;
   57  and
   58         h. Wolfson Children’s Hospital in Jacksonville.
   60  A hospital with a certificate of need for a pediatric cardiac
   61  program that meets state and national standards as determined by
   62  the council following an onsite visit by a panel from the
   63  council shall have one of its pediatric cardiologists or
   64  pediatric cardiovascular surgeons who has been nominated by its
   65  chief executive officer and approved by the State Surgeon
   66  General appointed to the council as a new voting member. The
   67  voting privilege of a voting member of the council appointed
   68  pursuant to this subparagraph shall be suspended if the facility
   69  he or she represents no longer meets state and national
   70  standards as adopted by the council. Such individual may remain
   71  a member of the council in an advisory capacity but shall
   72  relinquish voting privileges until his or her facility meets
   73  such standards.
   74         2. Two physicians at large, not associated with a facility
   75  that has a representative appointed as a voting member of the
   76  council, who are pediatric cardiologists or subspecialists with
   77  special expertise or experience in dealing with children or
   78  adults with congenital heart disease. These physicians shall be
   79  selected by the State Surgeon General in consultation with the
   80  Deputy Secretary for Children’s Medical Services and the
   81  Director of Children’s Medical Services.
   82         3. One community physician who has ongoing involvement with
   83  and special interest in children with heart disease and who is
   84  not associated with a facility represented in subparagraph 1. or
   85  one community-based medical internist having experience with
   86  adults with congenital heart disease. The community physician
   87  shall be selected by the State Surgeon General in consultation
   88  with the Deputy Secretary of Children’s Medical Services and the
   89  Director of the Division of Children’s Medical Services.
   90         (e) The State Surgeon General may appoint nonvoting
   91  advisory members to the council in consultation with the Deputy
   92  Secretary for Children’s Medical Services and the Director of
   93  Children’s Medical Services. Among such nonvoting advisory
   94  members appointed to the council shall be one representative
   95  from a pediatric health advocacy group. Such members may
   96  participate in council discussions and subcommittees created by
   97  the council, but may not vote.
   98         (f) The duties of the council include, but are not limited
   99  to:
  100         1. Recommending standards for personnel, diagnoses,
  101  clinics, and facilities rendering cardiac services to the
  102  department and the Division of Children’s Medical Services.
  103         2. Analyzing reports on the periodic review of cardiac
  104  personnel, diagnoses, clinics, and facilities to determine if
  105  established state and national standards for cardiac services
  106  are met.
  107         3. Making recommendations to the Director of Children’s
  108  Medical Services as to the approval or disapproval of reviewed
  109  cardiac care personnel, diagnoses, clinics, and facilities.
  110         4. Making recommendations as to the intervals for
  111  reinspection of approved personnel, diagnoses, clinics, and
  112  facilities for cardiac care.
  113         5. Reviewing and inspecting hospitals upon the request of
  114  the hospitals, the department, or the Agency for Health Care
  115  Administration to determine if established state and national
  116  standards for cardiac services are met.
  117         6. Providing input on all aspects of the state’s Children’s
  118  Medical Services cardiac programs, including rulemaking.
  119         7. Addressing all components of the care of adults and
  120  children with congenital heart disease and children with
  121  acquired heart disease, as indicated and appropriate.
  122         8. Abiding by the recognized state and national
  123  professional standards of care for children with heart disease.
  124         9. Making recommendations to the State Surgeon General for
  125  legislation and appropriations for children’s cardiac services.
  126         10. Providing advisory opinions to the Agency for Health
  127  Care Administration before the agency approves a certificate of
  128  need for children’s cardiac services.
  129         (g) A council member shall serve without compensation, but
  130  is entitled to reimbursement for per diem and travel expenses in
  131  accordance with s. 112.061.
  132         (h) At the recommendation of the Pediatric Cardiac Advisory
  133  Council and with the approval of the Director of Children’s
  134  Medical Services, the State Surgeon General shall designate
  135  facilities meeting the council’s approved state and national
  136  professional standards of care for children with heart disease
  137  as “Pediatric and Congenital Cardiovascular Centers of
  138  Excellence.” The designation is withdrawn automatically if a
  139  particular center no longer meets such standards.
  140         1. The council shall develop and recommend to the State
  141  Surgeon General measurable performance standards and goals for
  142  determining whether a facility meets the requirements for
  143  designation as a “Pediatric and Congenital Cardiovascular Center
  144  of Excellence.”
  145         2. The council shall develop and recommend to the State
  146  Surgeon General evaluation tools for measuring the goals and
  147  performance standards of the facilities seeking and receiving
  148  the “Pediatric and Congenital Cardiovascular Center of
  149  Excellence” designation.
  150         (3) ANNUAL REPORT.—The council shall submit an annual
  151  report to the Governor, the President of the Senate, the Speaker
  152  of the House of Representatives, and the State Surgeon General
  153  by January 1 of each year, beginning in 2017. The report must
  154  summarize the council’s activities for the preceding fiscal year
  155  and include data and performance measures for all pediatric
  156  cardiac facilities that participate in the Children’s Medical
  157  Services Network relating to surgical morbidity and mortality.
  158  The report must also recommend any policy or procedural changes
  159  that would increase the council’s effectiveness in monitoring
  160  the pediatric cardiovascular programs in the state.
  161         (4)RULEMAKING.—The department, in coordination with the
  162  Agency for Health Care Administration, shall develop rules
  163  related to pediatric cardiac facilities that participate in the
  164  Children’s Medical Services Network. The rules may establish
  165  standards relating to the training and credentialing of medical
  166  and surgical personnel, facility and physician minimum case
  167  volumes, and data reporting requirements for monitoring and
  168  enhancing quality assurance. The department may adopt rules
  169  relating to the establishment, operations, and authority of the
  170  Pediatric Cardiac Advisory Council and the establishment, goals,
  171  performance standards, and evaluation tools for designating
  172  facilities as Pediatric and Congenital Cardiovascular Centers of
  173  Excellence. The rules relating to pediatric cardiac services and
  174  facilities in effect on October 1, 2016, are authorized pursuant
  175  to this subsection and shall remain in effect until amended
  176  pursuant to this subsection.
  178  ================= T I T L E  A M E N D M E N T ================
  179  And the title is amended as follows:
  180         Delete line 57
  181  and insert:
  182         An act relating to cardiovascular services; creating
  183         s. 391.224, F.S.; providing legislative findings and
  184         intent; creating the Pediatric Cardiac Advisory
  185         Council; determining the chair of the advisory
  186         council; establishing the membership of the advisory
  187         council; identifying the duties of the advisory
  188         council; setting the minimum qualifications for the
  189         designation of a facility as a Pediatric and
  190         Congenital Cardiovascular Center of Excellence;
  191         requiring a report to the Governor, the Legislature,
  192         and the State Surgeon General; requiring the
  193         Department of Health to develop rules relating to
  194         pediatric cardiac services and facilities in the
  195         Children’s Medical Services Network; authorizing the
  196         department to adopt rules relating to the council and
  197         the designation of facilities as Pediatric and
  198         Congenital Cardiovascular Centers of Excellence;
  199         authorizing and preserving until amended specified
  200         rules relating to pediatric cardiac services and
  201         facilities;