Florida Senate - 2016                       CS for CS for SB 378
       By the Committees on Governmental Oversight and Accountability;
       and Health Policy; and Senator Bean
       585-01305-16                                           2016378c2
    1                        A bill to be entitled                      
    2         An act relating to pediatric cardiac care in the
    3         Children’s Medical Services Network; creating s.
    4         391.224, F.S.; providing legislative findings and
    5         intent; creating the Pediatric Cardiac Advisory
    6         Council; determining the chair of the advisory
    7         council; establishing the membership of the advisory
    8         council; identifying the duties of the advisory
    9         council; setting the minimum qualifications for the
   10         designation of a facility as a Pediatric and
   11         Congenital Cardiovascular Center of Excellence;
   12         requiring a report to the Governor, the Legislature,
   13         and the State Surgeon General; requiring the
   14         Department of Health to develop rules relating to
   15         pediatric cardiac services and facilities in the
   16         Children’s Medical Services Network; authorizing the
   17         department to adopt rules relating to the council and
   18         the designation of facilities as Pediatric and
   19         Congenital Cardiovascular Centers of Excellence;
   20         authorizing and preserving until amended specified
   21         rules relating to pediatric cardiac services and
   22         facilities; providing an effective date.
   24  Be It Enacted by the Legislature of the State of Florida:
   26         Section 1. Section 391.224, Florida Statutes, is created to
   27  read:
   28         391.224 Pediatric Cardiac Advisory Council.—
   30         (a) The Legislature finds significant benefits in the
   31  continued coordination of activities by several state agencies
   32  regarding access to pediatric cardiac care in this state. It is
   33  the intent of the Legislature that the Department of Health, the
   34  department’s cardiac consultants, and the Agency for Health Care
   35  Administration maintain their long-standing interagency teams
   36  and agreements for the development and adoption of guidelines,
   37  standards, and rules for those portions of the state cardiac
   38  care system within the statutory authority of each agency. This
   39  coordinated approach will continue to ensure the necessary
   40  continuum of care for the pediatric cardiac patient. The
   41  department has the leadership responsibility for this activity.
   42         (b) It is further the intent of the Legislature to
   43  establish the Pediatric Cardiac Advisory Council, a statewide,
   44  inclusive council within the department.
   46         (a) The State Surgeon General shall appoint the Pediatric
   47  Cardiac Advisory Council for the purpose of advising the
   48  department on the delivery of cardiac services to children.
   49         (b) The chair of the council shall be elected from among
   50  the council members every 2 years and may not serve more than
   51  two consecutive terms.
   52         (c) The council shall meet upon the call of the chair or
   53  two or more voting members or upon the call of the State Surgeon
   54  General, but must meet at least quarterly. Council meetings must
   55  be conducted by teleconference or through other electronic means
   56  when feasible.
   57         (d) The council shall be composed of no more than 13 voting
   58  members with technical expertise in cardiac medicine. Members
   59  shall be appointed by the State Surgeon General for staggered
   60  terms of 4 years. An employee of the department or a contracted
   61  consultant paid by the department may not serve as an appointed
   62  member or ex officio member of the council. Council members
   63  shall include the following voting members:
   64         1. Pediatric cardiologists or pediatric cardiovascular
   65  surgeons who have been nominated by their respective chief
   66  executive officers and approved by the State Surgeon General
   67  from the following facilities for as long as such facilities
   68  maintain their pediatric certificates of need:
   69         a. All Children’s Hospital in St. Petersburg;
   70         b. Arnold Palmer Hospital for Children in Orlando;
   71         c. Joe DiMaggio Children’s Hospital in Hollywood;
   72         d. Nicklaus Children’s Hospital in Miami;
   73         e. St. Joseph’s Children’s Hospital in Tampa;
   74         f. University of Florida Health Shands Hospital in
   75  Gainesville;
   76         g. University of Miami Holtz Children’s Hospital in Miami;
   77  and
   78         h. Wolfson Children’s Hospital in Jacksonville.
   80  A hospital with a certificate of need for a pediatric cardiac
   81  program that meets state and national standards as determined by
   82  the council following an onsite visit by a panel from the
   83  council shall have one of its pediatric cardiologists or
   84  pediatric cardiovascular surgeons who has been nominated by its
   85  chief executive officer and approved by the State Surgeon
   86  General appointed to the council as a new voting member. The
   87  voting privilege of a voting member of the council appointed
   88  pursuant to this subparagraph shall be suspended if the facility
   89  he or she represents no longer meets state and national
   90  standards as adopted by the council. Such individual may remain
   91  a member of the council in an advisory capacity but shall
   92  relinquish voting privileges until his or her facility meets
   93  such standards.
   94         2. Two physicians at large, not associated with a facility
   95  that has a representative appointed as a voting member of the
   96  council, who are pediatric cardiologists or subspecialists with
   97  special expertise or experience in dealing with children or
   98  adults with congenital heart disease. These physicians shall be
   99  selected by the State Surgeon General in consultation with the
  100  Deputy Secretary for Children’s Medical Services and the
  101  Director of Children’s Medical Services.
  102         3. One community physician who has ongoing involvement with
  103  and special interest in children with heart disease and who is
  104  not associated with a facility represented in subparagraph 1. or
  105  one community-based medical internist having experience with
  106  adults with congenital heart disease. The community physician
  107  shall be selected by the State Surgeon General in consultation
  108  with the Deputy Secretary of Children’s Medical Services and the
  109  Director of the Division of Children’s Medical Services.
  110         (e) The State Surgeon General may appoint nonvoting
  111  advisory members to the council in consultation with the Deputy
  112  Secretary for Children’s Medical Services and the Director of
  113  Children’s Medical Services. Such members may participate in
  114  council discussions and subcommittees created by the council,
  115  but may not vote.
  116         (f) The duties of the council include, but are not limited
  117  to:
  118         1. Recommending standards for personnel, diagnoses,
  119  clinics, and facilities rendering cardiac services to the
  120  department and the Division of Children’s Medical Services.
  121         2. Analyzing reports on the periodic review of cardiac
  122  personnel, diagnoses, clinics, and facilities to determine if
  123  established state and national standards for cardiac services
  124  are met.
  125         3. Making recommendations to the Director of Children’s
  126  Medical Services as to the approval or disapproval of reviewed
  127  cardiac care personnel, diagnoses, clinics, and facilities.
  128         4. Making recommendations as to the intervals for
  129  reinspection of approved personnel, diagnoses, clinics, and
  130  facilities for cardiac care.
  131         5. Reviewing and inspecting hospitals upon the request of
  132  the hospitals, the department, or the Agency for Health Care
  133  Administration to determine if established state and national
  134  standards for cardiac services are met.
  135         6. Providing input on all aspects of the state’s Children’s
  136  Medical Services cardiac programs, including rulemaking.
  137         7. Addressing all components of the care of adults and
  138  children with congenital heart disease and children with
  139  acquired heart disease, as indicated and appropriate.
  140         8. Abiding by the recognized state and national
  141  professional standards of care for children with heart disease.
  142         9. Making recommendations to the State Surgeon General for
  143  legislation and appropriations for children’s cardiac services.
  144         10. Providing advisory opinions to the Agency for Health
  145  Care Administration before the agency approves a certificate of
  146  need for children’s cardiac services.
  147         (g) A council member shall serve without compensation, but
  148  is entitled to reimbursement for per diem and travel expenses in
  149  accordance with s. 112.061.
  150         (h) At the recommendation of the Pediatric Cardiac Advisory
  151  Council and with the approval of the Director of Children’s
  152  Medical Services, the State Surgeon General shall designate
  153  facilities meeting the council’s approved state and national
  154  professional standards of care for children with heart disease
  155  as “Pediatric and Congenital Cardiovascular Centers of
  156  Excellence.” The designation is withdrawn automatically if a
  157  particular center no longer meets such standards.
  158         1. The council shall develop and recommend to the State
  159  Surgeon General measurable performance standards and goals for
  160  determining whether a facility meets the requirements for
  161  designation as a “Pediatric and Congenital Cardiovascular Center
  162  of Excellence.”
  163         2. The council shall develop and recommend to the State
  164  Surgeon General evaluation tools for measuring the goals and
  165  performance standards of the facilities seeking and receiving
  166  the “Pediatric and Congenital Cardiovascular Center of
  167  Excellence” designation.
  168         (3) ANNUAL REPORT.—The council shall submit an annual
  169  report to the Governor, the President of the Senate, the Speaker
  170  of the House of Representatives, and the State Surgeon General
  171  by January 1 of each year, beginning in 2017. The report must
  172  summarize the council’s activities for the preceding fiscal year
  173  and include data and performance measures for all pediatric
  174  cardiac facilities that participate in the Children’s Medical
  175  Services Network relating to surgical morbidity and mortality.
  176  The report must also recommend any policy or procedural changes
  177  that would increase the council’s effectiveness in monitoring
  178  the pediatric cardiovascular programs in the state.
  179         (4) RULEMAKING.—The department, in coordination with the
  180  Agency for Health Care Administration, shall develop rules
  181  related to pediatric cardiac facilities that participate in the
  182  Children’s Medical Services Network. The rules may establish
  183  standards relating to the training and credentialing of medical
  184  and surgical personnel, facility and physician minimum case
  185  volumes, and data reporting requirements for monitoring and
  186  enhancing quality assurance. The department may adopt rules
  187  relating to the establishment, operations, and authority of the
  188  Pediatric Cardiac Advisory Council and the establishment, goals,
  189  performance standards, and evaluation tools for designating
  190  facilities as Pediatric and Congenital Cardiovascular Centers of
  191  Excellence. The rules relating to pediatric cardiac services and
  192  facilities in effect on October 1, 2015, are authorized pursuant
  193  to this subsection and shall remain in effect until amended
  194  pursuant to this subsection.
  195         Section 2. This act shall take effect upon becoming a law.