Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. CS for SB 378
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  11/17/2015           .                                

       The Committee on Governmental Oversight and Accountability
       (Hays) recommended the following:
    1         Senate Amendment (with title amendment)
    3         Delete lines 52 - 159
    4  and insert:
    5         (d) The council shall be composed of no more than 13 voting
    6  members with technical expertise in cardiac medicine. Members
    7  shall be appointed by the State Surgeon General for staggered
    8  terms of 4 years. An employee of the department or a contracted
    9  consultant paid by the department may not serve as an appointed
   10  member or ex officio member of the council. Council members
   11  shall include the following voting members:
   12         1. Pediatric cardiologists or pediatric cardiovascular
   13  surgeons who have been nominated by their respective chief
   14  executive officers and approved by the State Surgeon General
   15  from the following facilities for as long as such facilities
   16  maintain their pediatric certificates of need:
   17         a. All Children’s Hospital in St. Petersburg;
   18         b. Arnold Palmer Hospital for Children in Orlando;
   19         c. Joe DiMaggio Children’s Hospital in Hollywood;
   20         d. Nicklaus Children’s Hospital in Miami;
   21         e. St. Joseph’s Children’s Hospital in Tampa;
   22         f. University of Florida Health Shands Hospital in
   23  Gainesville;
   24         g. University of Miami Holtz Children’s Hospital in Miami;
   25  and
   26         h. Wolfson Children’s Hospital in Jacksonville.
   28  A hospital with a certificate of need for a pediatric cardiac
   29  program that meets state and national standards as determined by
   30  the council following an onsite visit by a panel from the
   31  council shall have one of its pediatric cardiologists or
   32  pediatric cardiovascular surgeons who has been nominated by its
   33  chief executive officer and approved by the State Surgeon
   34  General appointed to the council as a new voting member. The
   35  voting privilege of a voting member of the council appointed
   36  pursuant to this subparagraph shall be suspended if the facility
   37  he or she represents no longer meets state and national
   38  standards as adopted by the council. Such individual may remain
   39  a member of the council in an advisory capacity but shall
   40  relinquish voting privileges until his or her facility meets
   41  such standards.
   42         2. Two physicians at large, not associated with a facility
   43  that has a representative appointed as a voting member of the
   44  council, who are pediatric cardiologists or subspecialists with
   45  special expertise or experience in dealing with children or
   46  adults with congenital heart disease. These physicians shall be
   47  selected by the State Surgeon General in consultation with the
   48  Deputy Secretary for Children’s Medical Services and the
   49  Director of Children’s Medical Services.
   50         3. One community physician who has ongoing involvement with
   51  and special interest in children with heart disease and who is
   52  not associated with a facility represented in subparagraph 1. or
   53  one community-based medical internist having experience with
   54  adults with congenital heart disease. The community physician
   55  shall be selected by the State Surgeon General in consultation
   56  with the Deputy Secretary of Children’s Medical Services and the
   57  Director of the Division of Children’s Medical Services.
   58         (e) The State Surgeon General may appoint nonvoting
   59  advisory members to the council in consultation with the Deputy
   60  Secretary for Children’s Medical Services and the Director of
   61  Children’s Medical Services. Such members may participate in
   62  council discussions and subcommittees created by the council,
   63  but may not vote.
   64         (f) The duties of the council include, but are not limited
   65  to:
   66         1. Recommending standards for personnel, diagnoses,
   67  clinics, and facilities rendering cardiac services to the
   68  department and the Division of Children’s Medical Services.
   69         2. Analyzing reports on the periodic review of cardiac
   70  personnel, diagnoses, clinics, and facilities to determine if
   71  established state and national standards for cardiac services
   72  are met.
   73         3. Making recommendations to the Director of Children’s
   74  Medical Services as to the approval or disapproval of reviewed
   75  cardiac care personnel, diagnoses, clinics, and facilities.
   76         4. Making recommendations as to the intervals for
   77  reinspection of approved personnel, diagnoses, clinics, and
   78  facilities for cardiac care.
   79         5. Reviewing and inspecting hospitals upon the request of
   80  the hospitals, the department, or the Agency for Health Care
   81  Administration to determine if established state and national
   82  standards for cardiac services are met.
   83         6. Providing input on all aspects of the state’s Children’s
   84  Medical Services cardiac programs, including rulemaking.
   85         7. Addressing all components of the care of adults and
   86  children with congenital heart disease and children with
   87  acquired heart disease, as indicated and appropriate.
   88         8. Abiding by the recognized state and national
   89  professional standards of care for children with heart disease.
   90         9. Making recommendations to the State Surgeon General for
   91  legislation and appropriations for children’s cardiac services.
   92         10. Providing advisory opinions to the Agency for Health
   93  Care Administration before the agency approves a certificate of
   94  need for children’s cardiac services.
   95         (g) A council member shall serve without compensation, but
   96  is entitled to reimbursement for per diem and travel expenses in
   97  accordance with s. 112.061.
   98         (h) At the recommendation of the Pediatric Cardiac Advisory
   99  Council and with the approval of the Director of Children’s
  100  Medical Services, the State Surgeon General shall designate
  101  facilities meeting the council’s approved state and national
  102  professional standards of care for children with heart disease
  103  as “Pediatric and Congenital Cardiovascular Centers of
  104  Excellence.” The designation is withdrawn automatically if a
  105  particular center no longer meets such standards.
  106         1. The council shall develop and recommend to the State
  107  Surgeon General measurable performance standards and goals for
  108  determining whether a facility meets the requirements for
  109  designation as a “Pediatric and Congenital Cardiovascular Center
  110  of Excellence.”
  111         2. The council shall develop and recommend to the State
  112  Surgeon General evaluation tools for measuring the goals and
  113  performance standards of the facilities seeking and receiving
  114  the “Pediatric and Congenital Cardiovascular Center of
  115  Excellence” designation.
  116         (3) ANNUAL REPORT.—The council shall submit an annual
  117  report to the Governor, the President of the Senate, the Speaker
  118  of the House of Representatives, and the State Surgeon General
  119  by January 1 of each year, beginning in 2017. The report must
  120  summarize the council’s activities for the preceding fiscal year
  121  and include data and performance measures for all pediatric
  122  cardiac facilities that participate in the Children’s Medical
  123  Services Network relating to surgical morbidity and mortality.
  124  The report must also recommend any policy or procedural changes
  125  that would increase the council’s effectiveness in monitoring
  126  the pediatric cardiovascular programs in the state.
  127         (4) RULEMAKING.—The department, in coordination with the
  128  Agency for Health Care Administration, shall develop rules
  129  related to pediatric cardiac facilities that participate in the
  130  Children’s Medical Services Network. The rules may establish
  131  standards relating to the training and credentialing of medical
  132  and surgical personnel, facility and physician minimum case
  133  volumes, and data reporting requirements for monitoring and
  134  enhancing quality assurance. The department may adopt rules
  135  relating to the establishment, operations, and authority of the
  136  Pediatric Cardiac Advisory Council and the establishment, goals,
  137  performance standards, and evaluation tools for designating
  138  facilities as Pediatric and Congenital Cardiovascular Centers of
  139  Excellence. The rules relating to pediatric cardiac services and
  140  facilities in effect on October 1, 2015, are authorized pursuant
  141  to this subsection and shall remain in effect until amended
  142  pursuant to this subsection.
  143         Section 2. This act shall take effect upon becoming a law.
  145  ================= T I T L E  A M E N D M E N T ================
  146  And the title is amended as follows:
  147         Delete lines 2 - 17
  148  and insert:
  149         An act relating to pediatric cardiac care in the
  150         Children’s Medical Services Network; creating s.
  151         391.224, F.S.; providing legislative findings and
  152         intent; creating the Pediatric Cardiac Advisory
  153         Council; determining the chair of the advisory
  154         council; establishing the membership of the advisory
  155         council; identifying the duties of the advisory
  156         council; setting the minimum qualifications for the
  157         designation of a facility as a Pediatric and
  158         Congenital Cardiovascular Center of Excellence;
  159         requiring a report to the Governor, the Legislature,
  160         and the State Surgeon General; requiring the
  161         Department of Health to develop rules relating to
  162         pediatric cardiac services and facilities in the
  163         Children’s Medical Services Network; authorizing the
  164         department to adopt rules relating to the council and
  165         the designation of facilities as Pediatric and
  166         Congenital Cardiovascular Centers of Excellence;
  167         authorizing and preserving until amended specified
  168         rules relating to pediatric cardiac services and
  169         facilities; providing an effective date.