Florida Senate - 2017 COMMITTEE AMENDMENT
Bill No. CS for SB 1550
Ì9280462Î928046
LEGISLATIVE ACTION
Senate . House
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The Committee on Appropriations (Grimsley) recommended the
following:
1 Senate Amendment (with title amendment)
2
3 Before line 34
4 insert:
5 Section 1. Present subsection (9) of section 395.1055,
6 Florida Statutes, is redesignated as subsection (10), and a new
7 subsection (9) is added to that section, to read:
8 395.1055 Rules and enforcement.—
9 (9) The agency shall establish a technical advisory panel
10 to develop procedures and standards for measuring outcomes of
11 pediatric cardiac catheterization programs and pediatric open
12 heart surgery programs.
13 (a) The panel must be composed of three at-large members,
14 including one cardiologist who is board certified in caring for
15 adults with congenital heart disease and two board-certified
16 pediatric cardiologists, neither of whom may be employed by any
17 of the hospitals specified in subparagraphs 1.-10. or their
18 affiliates, each of whom is appointed by the Secretary of Health
19 Care Administration, and 10 members, each of whom is a pediatric
20 cardiologist or a pediatric cardiovascular surgeon, each
21 appointed by the chief executive officer of one of the following
22 hospitals:
23 1. Johns Hopkins All Children’s Hospital in St. Petersburg.
24 2. Arnold Palmer Hospital for Children in Orlando.
25 3. Joe DiMaggio Children’s Hospital in Hollywood.
26 4. Nicklaus Children’s Hospital in Miami.
27 5. St. Joseph’s Children’s Hospital in Tampa.
28 6. University of Florida Health Shands Hospital in
29 Gainesville.
30 7. University of Miami Holtz Children’s Hospital in Miami.
31 8. Wolfson Children’s Hospital in Jacksonville.
32 9. Florida Hospital for Children in Orlando.
33 10. Nemours Children’s Hospital in Orlando.
34 (b) Based on the recommendations of the panel, the agency
35 shall develop and adopt rules for pediatric cardiac
36 catheterization programs and pediatric open-heart surgery
37 programs which include at least the following:
38 1. A risk adjustment procedure that accounts for the
39 variations in severity and case mix found in hospitals in this
40 state;
41 2. Outcome standards specifying expected levels of
42 performance in pediatric cardiac programs. Such standards may
43 include, but are not limited to, in-hospital mortality,
44 infection rates, nonfatal myocardial infarctions, length of
45 postoperative bleeds, and returns to surgery; and
46 3. Specific steps to be taken by the agency and licensed
47 facilities that do not meet the outcome standards within a
48 specified time, including time required for detailed case
49 reviews and development and implementation of corrective action
50 plans.
51 Section 2. Paragraph (b) of subsection (3) of section
52 408.0361, Florida Statutes, is amended to read:
53 408.0361 Cardiovascular services and burn unit licensure.—
54 (3) In establishing rules for adult cardiovascular
55 services, the agency shall include provisions that allow for:
56 (b) For a hospital seeking a Level I program, demonstration
57 that, for the most recent 12-month period as reported to the
58 agency, it has provided a minimum of 300 adult inpatient and
59 outpatient diagnostic cardiac catheterizations or, for the most
60 recent 12-month period, has discharged or transferred at least
61 300 inpatients with the principal diagnosis of ischemic heart
62 disease and that it has a formalized, written transfer agreement
63 with a hospital that has a Level II program, including written
64 transport protocols to ensure safe and efficient transfer of a
65 patient within 60 minutes. However, a hospital located more than
66 100 road miles from the closest Level II adult cardiovascular
67 services program does not need to meet the 60-minute transfer
68 time protocol if the hospital demonstrates that it has a
69 formalized, written transfer agreement with a hospital that has
70 a Level II program. The agreement must include written transport
71 protocols to ensure the safe and efficient transfer of a
72 patient, taking into consideration the patient’s clinical and
73 physical characteristics, road and weather conditions, and
74 viability of ground and air ambulance service to transfer the
75 patient. At a minimum, the rules for adult cardiovascular
76 services must require nursing and technical staff to have
77 demonstrated experience in handling acutely ill patients
78 requiring percutaneous cardiac intervention in dedicated cardiac
79 interventional laboratories or surgical centers. If a staff
80 member’s previous experience was in a dedicated cardiac
81 interventional laboratory at a hospital that did not have an
82 approved adult open-heart-surgery program, the staff member’s
83 previous experience does not qualify unless, at the time the
84 staff member acquired his or her experience, the dedicated
85 cardiac interventional laboratory:
86 1. Had an annual volume of 500 or more percutaneous cardiac
87 intervention procedures;
88 2. Achieved a demonstrated success rate of 95 percent or
89 greater for percutaneous cardiac intervention procedures;
90 3. Experienced a complication rate of less than 5 percent
91 for percutaneous cardiac intervention procedures; and
92 4. Performed diverse cardiac procedures, including, but not
93 limited to, balloon angioplasty and stenting, rotational
94 atherectomy, cutting balloon atheroma remodeling, and procedures
95 relating to left ventricular support capability.
96 Section 3. For the 2017-2018 fiscal year, the sum of
97 $95,620 is appropriated from the Health Care Trust Fund to the
98 Agency for Health Care Administration for the purpose of
99 implementing s. 395.1055(9), Florida Statutes.
100
101 ================= T I T L E A M E N D M E N T ================
102 And the title is amended as follows:
103 Delete line 2
104 and insert:
105 An act relating to health care services; amending s.
106 395.1055, F.S.; requiring the Agency for Health Care
107 Administration to establish a technical advisory panel
108 to develop procedures and standards for measuring
109 outcomes of pediatric cardiac catheterization programs
110 and pediatric open-heart surgery programs; providing
111 for the membership of the technical advisory panel;
112 requiring the agency to develop and adopt rules for
113 pediatric cardiac catheterization programs and
114 pediatric open-heart surgery programs based on
115 recommendations of the technical advisory panel;
116 amending s. 408.0361, F.S.; establishing additional
117 criteria that must be included by the agency in rules
118 relating to adult cardiovascular services at hospitals
119 seeking licensure for a Level I program; providing an
120 appropriation;