Florida Senate - 2017                        COMMITTEE AMENDMENT
       Bill No. SB 62
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/07/2017           .                                

       The Committee on Governmental Oversight and Accountability
       (Bean) recommended the following:
    1         Senate Substitute for Amendment (883976) (with title
    2  amendment)
    4         Delete lines 50 - 196
    5  and insert:
    6         (a) The council shall be composed of no more than 15 voting
    7  members with technical expertise in cardiac medicine, appointed
    8  by the State Surgeon General for staggered terms of 4 years. The
    9  State Surgeon General may appoint an alternate member for each
   10  voting member. An alternate member may participate in council
   11  discussions and subcommittees but is eligible to vote only in
   12  those instances when the voting member for whom he or she is the
   13  alternate cannot cast a vote. An employee of the department or a
   14  contracted consultant paid by the department may not serve as an
   15  appointed or ex officio member of the council. Council
   16  membership must include the following voting members:
   17         1. Pediatric cardiologists or pediatric cardiovascular
   18  surgeons nominated by the chief executive officers of the
   19  following hospitals:
   20         a. Johns Hopkins All Children’s Hospital in St. Petersburg.
   21         b. Arnold Palmer Hospital for Children in Orlando.
   22         c. Joe DiMaggio Children’s Hospital in Hollywood.
   23         d. Nicklaus Children’s Hospital in Miami.
   24         e. St. Joseph’s Children’s Hospital in Tampa.
   25         f. University of Florida Health Shands Hospital in
   26  Gainesville.
   27         g. University of Miami Holtz Children’s Hospital in Miami.
   28         h. Wolfson Children’s Hospital in Jacksonville.
   29         i. Florida Hospital for Children in Orlando.
   30         j. Nemours Children’s Hospital in Orlando.
   31         2. Pediatric cardiologists or pediatric cardiovascular
   32  surgeons nominated by the chief executive officer of a hospital
   33  that holds a current certificate of need for a pediatric cardiac
   34  program and that meets state and national standards as
   35  recommended by the council following an onsite visit by a panel
   36  from the council.
   37         3. Two physicians who are pediatric cardiologists or
   38  subspecialists with expertise in congenital heart disease; who
   39  are not associated with a facility otherwise represented by a
   40  voting member of the council; and who are appointed in
   41  consultation with the Deputy Secretary for Children’s Medical
   42  Services and the Director of Children’s Medical Services.
   43         4. A community physician who has ongoing involvement with
   44  and special interest in the treatment of children with heart
   45  disease and who is not associated with a facility represented in
   46  the membership of the council pursuant to subparagraph 1. or
   47  subparagraph 2. or a community-based medical internist who has
   48  experience in treating adults with congenital heart disease.
   49  Appointment of a community physician shall be made in
   50  consultation with the Deputy Secretary for Children’s Medical
   51  Services and the Director of Children’s Medical Services.
   52         5.Appointments made under subparagraphs 1. and 2. are
   53  contingent on the nominating hospital’s maintenance of pediatric
   54  certificates of need and the hospital’s compliance with the
   55  state and national standards identified by the council in
   56  exercising its duties under subparagraph (f)5. A member whose
   57  hospital fails to maintain such certificates or comply with such
   58  standards during his or her term, as determined by the State
   59  Surgeon General, may serve only in an advisory capacity as a
   60  nonvoting member until such time as the maintenance of such
   61  certificates and compliance with such standards are restored.
   62         (b) The State Surgeon General may appoint nonvoting,
   63  advisory members to the council in consultation with the Deputy
   64  Secretary for Children’s Medical Services and the Director of
   65  Children’s Medical Services. Such members may participate in
   66  council discussions and subcommittees created by the council.
   67         (c) The chair and vice chair of the council shall be
   68  elected by the council members to 2-year terms and may not serve
   69  more than 2 consecutive terms.
   70         (d) The council shall meet upon the call of the chair or
   71  two or more voting members or upon the call of the State Surgeon
   72  General, but must meet at least quarterly. Council meetings must
   73  be conducted by teleconference or through other electronic means
   74  when feasible.
   75         (e) Council members shall serve without compensation, but
   76  are entitled to reimbursement for per diem and travel expenses
   77  in accordance with s. 112.061.
   78         (f) The duties of the council include, but are not limited
   79  to:
   80         1. Recommending standards for personnel, clinics, and
   81  facilities that provide cardiac services to clients of the
   82  department and the program and for the diagnosis of cardiac
   83  conditions.
   84         2. Analyzing reports on the periodic review of cardiac care
   85  personnel, clinics, facilities, and diagnoses to determine if
   86  established state and national standards for cardiac services
   87  are being met.
   88         3. Making recommendations to the Director of Children’s
   89  Medical Services regarding determinations of whether reviewed
   90  cardiac care personnel, clinics, facilities, and diagnoses meet
   91  established state and national standards for cardiac services.
   92         4. Making recommendations to the Director of Children’s
   93  Medical Services regarding the intervals for reinspection of
   94  cardiac care personnel, clinics, facilities, and diagnoses
   95  meeting established state and national standards for cardiac
   96  services.
   97         5. Reviewing and inspecting a hospital upon the request of
   98  the hospital, the department, or the Agency for Health Care
   99  Administration to analyze its compliance with established state
  100  and national standards for cardiac services.
  101         6. Advising the department and the Agency for Health Care
  102  Administration on all aspects of the provision of cardiac care
  103  under the program, including rulemaking, and on all components
  104  of providing care to adults and children with congenital heart
  105  disease and children with acquired heart disease.
  106         7. Reviewing and analyzing compliance by cardiac care
  107  personnel, clinics, and facilities with the recognized state and
  108  national professional standards of care for children with heart
  109  disease.
  110         8. Making recommendations to the State Surgeon General for
  111  legislation regarding and appropriations for pediatric cardiac
  112  services.
  113         9. Providing advisory opinions to the Agency for Health
  114  Care Administration before the agency approves a certificate of
  115  need for pediatric cardiac services.
  117  CENTERS OF EXCELLENCE.—Upon the recommendation of the council
  118  and the Director of Children’s Medical Services, the State
  119  Surgeon General shall designate facilities that the council
  120  recommends have met state and national professional standards of
  121  care for children with heart disease as Pediatric and Congenital
  122  Cardiovascular Centers of Excellence. The council shall
  123  recommend measurable performance standards and evaluation tools
  124  to be used in determining whether a facility qualifies for such
  125  designation. The designation of a facility as a center of
  126  excellence is automatically withdrawn if the facility no longer
  127  meets, as determined by the State Surgeon General, the
  128  performance standards that qualified it for such designation.
  129         (4) ANNUAL REPORT.—Beginning in January 1, 2019, and by
  130  each January 1 thereafter, the council shall submit an annual
  131  report to the Governor, the President of the Senate, the Speaker
  132  of the House of Representatives, and the State Surgeon General.
  133  The report must summarize the council’s activities during the
  134  preceding fiscal year and include data and performance measures
  135  on surgical morbidity and mortality for all the pediatric
  136  cardiac facilities that participated in the program. The report
  137  must also recommend any policy or procedural changes that would
  138  increase the council’s effectiveness in monitoring the
  139  performance of such facilities.
  140         (5) RULEMAKING.—
  141         (a) The department, in coordination with the Agency for
  142  Health Care Administration, shall develop rules related to
  143  pediatric cardiac care and facilities that participate in the
  144  program. The rules shall establish standards relating to the
  145  training and credentialing of medical and surgical personnel,
  146  minimum case volumes for facilities and physicians, and data
  147  reporting requirements for monitoring and enhancing quality
  148  assurance. The rules shall meet or exceed the standard of care
  149  provided in Children’s Medical Services Pediatric Cardiac
  150  Facilities Standards established in October 2012.
  151         (b) The department may also adopt rules relating to the
  152  establishment, operation, and authority of the council and the
  153  process, performance standards, and evaluation tools for
  154  designating facilities as Pediatric and Congenital
  155  Cardiovascular Centers of Excellence.
  157  ================= T I T L E  A M E N D M E N T ================
  158  And the title is amended as follows:
  159         Delete lines 22 - 23
  160  and insert:
  161         Excellence; providing