Florida Senate - 2017                                      SB 62
       By Senator Bean
       4-00013A-17                                             201762__
    1                        A bill to be entitled                      
    2         An act relating to pediatric cardiac care in the
    3         Children’s Medical Services program; creating s.
    4         391.224, F.S.; providing legislative findings and
    5         intent; creating the Pediatric Cardiac Care Advisory
    6         Council within the Department of Health; specifying
    7         the council membership; providing for election of the
    8         council chair and vice chair; providing for per diem
    9         and travel expenses; specifying the duties of the
   10         council; requiring the State Surgeon General to
   11         designate certain facilities as Pediatric and
   12         Congenital Cardiovascular Centers of Excellence;
   13         establishing prerequisites for the designation of a
   14         facility as a center of excellence; requiring that the
   15         council provide an annual report to the Governor, the
   16         Legislature, and the State Surgeon General; requiring
   17         the department to develop rules relating to pediatric
   18         cardiac care and facilities in the program;
   19         authorizing the department to adopt rules relating to
   20         the council and the designation of facilities as
   21         Pediatric and Congenital Cardiovascular Centers of
   22         Excellence; reauthorizing specified rules relating to
   23         pediatric cardiac services and facilities; providing
   24         an effective date.
   26  Be It Enacted by the Legislature of the State of Florida:
   28         Section 1. Section 391.224, Florida Statutes, is created to
   29  read:
   30         391.224 Pediatric Cardiac Care Advisory Council.—
   31         (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds
   32  significant benefits in the continued coordination of the
   33  activities of state agencies regarding the delivery of pediatric
   34  cardiac care in this state. It is the intent of the Legislature
   35  that the Department of Health and its cardiac consultants and
   36  the Agency for Health Care Administration maintain their long
   37  standing interagency teams and agreements to support the
   38  coordinated development and adoption of guidelines, standards,
   39  and rules under the agencies’ existing statutory authority for
   40  the state pediatric cardiac care system to ensure the necessary
   41  continuum of care for pediatric cardiac patients. The
   42  Legislature also intends that the department take the lead in
   43  this process.
   45  COUNCIL.—The Pediatric Cardiac Care Advisory Council, an
   46  advisory council as defined in s. 20.03, is created within the
   47  department to advise it on the delivery of all types of cardiac
   48  care to children and adults with congenital heart disease. The
   49  council is subject to s. 20.052.
   50         (a) The council shall be composed of no more than 13 voting
   51  members with technical expertise in cardiac medicine, appointed
   52  by the State Surgeon General for staggered terms of 4 years. The
   53  State Surgeon General may appoint an alternate member for each
   54  voting member. An alternate member may participate in council
   55  discussions and subcommittees but is eligible to vote only in
   56  those instances when the voting member for whom he or she is the
   57  alternate cannot cast a vote. An employee of the department or a
   58  contracted consultant paid by the department may not serve as an
   59  appointed or ex officio member of the council. Council
   60  membership must include the following voting members:
   61         1. Pediatric cardiologists or pediatric cardiovascular
   62  surgeons nominated by the chief executive officers of the
   63  following hospitals:
   64         a. Johns Hopkins All Children’s Hospital in St. Petersburg.
   65         b. Arnold Palmer Hospital for Children in Orlando.
   66         c. Joe DiMaggio Children’s Hospital in Hollywood.
   67         d. Nicklaus Children’s Hospital in Miami.
   68         e. St. Joseph’s Children’s Hospital in Tampa.
   69         f. University of Florida Health Shands Hospital in
   70  Gainesville.
   71         g. University of Miami Holtz Children’s Hospital in Miami.
   72         h. Wolfson Children’s Hospital in Jacksonville.
   73         2. Pediatric cardiologists or pediatric cardiovascular
   74  surgeons nominated by the chief executive officer of a hospital
   75  that holds a current certificate of need for a pediatric cardiac
   76  program and that meets state and national standards as
   77  recommended by the council following an onsite visit by a panel
   78  from the council.
   79         3. Two physicians who are pediatric cardiologists or
   80  subspecialists with expertise in congenital heart disease; who
   81  are not associated with a facility otherwise represented by a
   82  voting member of the council; and who are appointed in
   83  consultation with the Deputy Secretary for Children’s Medical
   84  Services and the Director of Children’s Medical Services.
   85         4. A community physician who has ongoing involvement with
   86  and special interest in the treatment of children with heart
   87  disease and who is not associated with a facility represented in
   88  the membership of the council pursuant to subparagraph 1. or
   89  subparagraph 2. or a community-based medical internist who has
   90  experience in treating adults with congenital heart disease.
   91  Appointment of a community physician shall be made in
   92  consultation with the Deputy Secretary for Children’s Medical
   93  Services and the Director of Children’s Medical Services.
   95  Appointments made under subparagraphs 1. and 2. are contingent
   96  on the nominating hospital’s maintenance of pediatric
   97  certificates of need and the hospital’s compliance with the
   98  state and national standards identified by the council in
   99  exercising its duties under subparagraph (f)5. A member whose
  100  hospital fails to maintain such certificates or comply with such
  101  standards during his or her term, as determined by the State
  102  Surgeon General, may serve only in an advisory capacity as a
  103  nonvoting member until such time as the maintenance of such
  104  certificates and compliance with such standards are restored.
  105         (b) The State Surgeon General may appoint nonvoting,
  106  advisory members to the council in consultation with the Deputy
  107  Secretary for Children’s Medical Services and the Director of
  108  Children’s Medical Services. Such members may participate in
  109  council discussions and subcommittees created by the council.
  110         (c) The chair and vice chair of the council shall be
  111  elected by the council members to 2-year terms and may not serve
  112  more than two consecutive terms.
  113         (d) The council shall meet upon the call of the chair or
  114  two or more voting members or upon the call of the State Surgeon
  115  General, but must meet at least quarterly. Council meetings must
  116  be conducted by teleconference or through other electronic means
  117  when feasible.
  118         (e) Council members shall serve without compensation, but
  119  are entitled to reimbursement for per diem and travel expenses
  120  in accordance with s. 112.061.
  121         (f) The duties of the council include, but are not limited
  122  to:
  123         1. Recommending standards for personnel, clinics, and
  124  facilities that provide cardiac services to clients of the
  125  department and the program and for the diagnosis of cardiac
  126  conditions.
  127         2. Analyzing reports on the periodic review of cardiac care
  128  personnel, clinics, facilities, and diagnoses to determine if
  129  established state and national standards for cardiac services
  130  are being met.
  131         3. Making recommendations to the Director of Children’s
  132  Medical Services regarding determinations of whether reviewed
  133  cardiac care personnel, clinics, facilities, and diagnoses meet
  134  established state and national standards for cardiac services.
  135         4. Making recommendations to the Director of Children’s
  136  Medical Services regarding the intervals for reinspection of
  137  cardiac care personnel, clinics, facilities, and diagnoses
  138  meeting established state and national standards for cardiac
  139  services.
  140         5. Reviewing and inspecting a hospital upon the request of
  141  the hospital, the department, or the Agency for Health Care
  142  Administration to analyze its compliance with established state
  143  and national standards for cardiac services.
  144         6. Advising the department and the Agency for Health Care
  145  Administration on all aspects of the provision of cardiac care
  146  under the program, including rulemaking, and on all components
  147  of providing care to adults and children with congenital heart
  148  disease and children with acquired heart disease.
  149         7. Reviewing and analyzing compliance by cardiac care
  150  personnel, clinics, and facilities with the recognized state and
  151  national professional standards of care for children with heart
  152  disease.
  153         8. Making recommendations to the State Surgeon General for
  154  legislation regarding and appropriations for pediatric cardiac
  155  services.
  156         9. Providing advisory opinions to the Agency for Health
  157  Care Administration before the agency approves a certificate of
  158  need for pediatric cardiac services.
  160  CENTERS OF EXCELLENCE.—Upon the recommendation of the council
  161  and the Director of Children’s Medical Services, the State
  162  Surgeon General shall designate facilities that the council
  163  recommends have met state and national professional standards of
  164  care for children with heart disease as Pediatric and Congenital
  165  Cardiovascular Centers of Excellence. The council shall
  166  recommend measurable performance standards and evaluation tools
  167  to be used in determining whether a facility qualifies for such
  168  designation. The designation of a facility as a center of
  169  excellence is automatically withdrawn if the facility no longer
  170  meets, as determined by the State Surgeon General, the
  171  performance standards that qualified it for such designation.
  172         (4) ANNUAL REPORT.—Beginning in January 1, 2019, and by
  173  each January 1 thereafter, the council shall submit an annual
  174  report to the Governor, the President of the Senate, the Speaker
  175  of the House of Representatives, and the State Surgeon General.
  176  The report must summarize the council’s activities during the
  177  preceding fiscal year and include data and performance measures
  178  on surgical morbidity and mortality for all the pediatric
  179  cardiac facilities that participated in the program. The report
  180  must also recommend any policy or procedural changes that would
  181  increase the council’s effectiveness in monitoring the
  182  performance of such facilities.
  183         (5) RULEMAKING.—The department, in coordination with the
  184  Agency for Health Care Administration, shall develop rules
  185  related to pediatric cardiac care and facilities that
  186  participate in the program. The rules may establish standards
  187  relating to the training and credentialing of medical and
  188  surgical personnel, minimum case volumes for facilities and
  189  physicians, and data reporting requirements for monitoring and
  190  enhancing quality assurance. The department may also adopt rules
  191  relating to the establishment, operation, and authority of the
  192  council and the process, performance standards, and evaluation
  193  tools for designating facilities as Pediatric and Congenital
  194  Cardiovascular Centers of Excellence. The rules relating to
  195  pediatric cardiac services and facilities in effect on October
  196  1, 2015, are hereby reauthorized pursuant to this subsection.
  197         Section 2. This act shall take effect upon becoming a law.