Florida Senate - 2017 CS for SB 62 By the Committee on Governmental Oversight and Accountability; and Senator Bean 585-01718-17 201762c1 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; providing an effective date. 23 24 Be It Enacted by the Legislature of the State of Florida: 25 26 Section 1. Section 391.224, Florida Statutes, is created to 27 read: 28 391.224 Pediatric Cardiac Care Advisory Council.— 29 (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds 30 significant benefits in the continued coordination of the 31 activities of state agencies regarding the delivery of pediatric 32 cardiac care in this state. It is the intent of the Legislature 33 that the Department of Health and its cardiac consultants and 34 the Agency for Health Care Administration maintain their long 35 standing interagency teams and agreements to support the 36 coordinated development and adoption of guidelines, standards, 37 and rules under the agencies’ existing statutory authority for 38 the state pediatric cardiac care system to ensure the necessary 39 continuum of care for pediatric cardiac patients. The 40 Legislature also intends that the department take the lead in 41 this process. 42 (2) ESTABLISHMENT OF PEDIATRIC CARDIAC CARE ADVISORY 43 COUNCIL.—The Pediatric Cardiac Care Advisory Council, an 44 advisory council as defined in s. 20.03, is created within the 45 department to advise it on the delivery of all types of cardiac 46 care to children and adults with congenital heart disease. The 47 council is subject to s. 20.052. 48 (a) The council shall be composed of no more than 15 voting 49 members with technical expertise in cardiac medicine, appointed 50 by the State Surgeon General for staggered terms of 4 years. The 51 State Surgeon General may appoint an alternate member for each 52 voting member. An alternate member may participate in council 53 discussions and subcommittees but is eligible to vote only in 54 those instances when the voting member for whom he or she is the 55 alternate cannot cast a vote. An employee of the department or a 56 contracted consultant paid by the department may not serve as an 57 appointed or ex officio member of the council. Council 58 membership must include the following voting members: 59 1. Pediatric cardiologists or pediatric cardiovascular 60 surgeons nominated by the chief executive officers of the 61 following hospitals: 62 a. Johns Hopkins All Children’s Hospital in St. Petersburg. 63 b. Arnold Palmer Hospital for Children in Orlando. 64 c. Joe DiMaggio Children’s Hospital in Hollywood. 65 d. Nicklaus Children’s Hospital in Miami. 66 e. St. Joseph’s Children’s Hospital in Tampa. 67 f. University of Florida Health Shands Hospital in 68 Gainesville. 69 g. University of Miami Holtz Children’s Hospital in Miami. 70 h. Wolfson Children’s Hospital in Jacksonville. 71 i. Florida Hospital for Children in Orlando. 72 j. Nemours Children’s Hospital in Orlando. 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. 94 5. Appointments made under subparagraphs 1. and 2. are 95 contingent on the nominating hospital’s maintenance of pediatric 96 certificates of need and the hospital’s compliance with the 97 state and national standards identified by the council in 98 exercising its duties under subparagraph (f)5. A member whose 99 hospital fails to maintain such certificates or comply with such 100 standards during his or her term, as determined by the State 101 Surgeon General, may serve only in an advisory capacity as a 102 nonvoting member until such time as the maintenance of such 103 certificates and compliance with such standards are restored. 104 (b) The State Surgeon General may appoint nonvoting, 105 advisory members to the council in consultation with the Deputy 106 Secretary for Children’s Medical Services and the Director of 107 Children’s Medical Services. Such members may participate in 108 council discussions and subcommittees created by the council. 109 (c) The chair and vice chair of the council shall be 110 elected by the council members to 2-year terms and may not serve 111 more than 2 consecutive terms. 112 (d) The council shall meet upon the call of the chair or 113 two or more voting members or upon the call of the State Surgeon 114 General, but must meet at least quarterly. Council meetings must 115 be conducted by teleconference or through other electronic means 116 when feasible. 117 (e) Council members shall serve without compensation, but 118 are entitled to reimbursement for per diem and travel expenses 119 in accordance with s. 112.061. 120 (f) The duties of the council include, but are not limited 121 to: 122 1. Recommending standards for personnel, clinics, and 123 facilities that provide cardiac services to clients of the 124 department and the program and for the diagnosis of cardiac 125 conditions. 126 2. Analyzing reports on the periodic review of cardiac care 127 personnel, clinics, facilities, and diagnoses to determine if 128 established state and national standards for cardiac services 129 are being met. 130 3. Making recommendations to the Director of Children’s 131 Medical Services regarding determinations of whether reviewed 132 cardiac care personnel, clinics, facilities, and diagnoses meet 133 established state and national standards for cardiac services. 134 4. Making recommendations to the Director of Children’s 135 Medical Services regarding the intervals for reinspection of 136 cardiac care personnel, clinics, facilities, and diagnoses 137 meeting established state and national standards for cardiac 138 services. 139 5. Reviewing and inspecting a hospital upon the request of 140 the hospital, the department, or the Agency for Health Care 141 Administration to analyze its compliance with established state 142 and national standards for cardiac services. 143 6. Advising the department and the Agency for Health Care 144 Administration on all aspects of the provision of cardiac care 145 under the program, including rulemaking, and on all components 146 of providing care to adults and children with congenital heart 147 disease and children with acquired heart disease. 148 7. Reviewing and analyzing compliance by cardiac care 149 personnel, clinics, and facilities with the recognized state and 150 national professional standards of care for children with heart 151 disease. 152 8. Making recommendations to the State Surgeon General for 153 legislation regarding and appropriations for pediatric cardiac 154 services. 155 9. Providing advisory opinions to the Agency for Health 156 Care Administration before the agency approves a certificate of 157 need for pediatric cardiac services. 158 (3) DESIGNATION OF PEDIATRIC AND CONGENITAL CARDIOVASCULAR 159 CENTERS OF EXCELLENCE.—Upon the recommendation of the council 160 and the Director of Children’s Medical Services, the State 161 Surgeon General shall designate facilities that the council 162 recommends have met state and national professional standards of 163 care for children with heart disease as Pediatric and Congenital 164 Cardiovascular Centers of Excellence. The council shall 165 recommend measurable performance standards and evaluation tools 166 to be used in determining whether a facility qualifies for such 167 designation. The designation of a facility as a center of 168 excellence is automatically withdrawn if the facility no longer 169 meets, as determined by the State Surgeon General, the 170 performance standards that qualified it for such designation. 171 (4) ANNUAL REPORT.—Beginning in January 1, 2019, and by 172 each January 1 thereafter, the council shall submit an annual 173 report to the Governor, the President of the Senate, the Speaker 174 of the House of Representatives, and the State Surgeon General. 175 The report must summarize the council’s activities during the 176 preceding fiscal year and include data and performance measures 177 on surgical morbidity and mortality for all the pediatric 178 cardiac facilities that participated in the program. The report 179 must also recommend any policy or procedural changes that would 180 increase the council’s effectiveness in monitoring the 181 performance of such facilities. 182 (5) RULEMAKING.— 183 (a) The department, in coordination with the Agency for 184 Health Care Administration, shall develop rules related to 185 pediatric cardiac care and facilities that participate in the 186 program. The rules shall establish standards relating to the 187 training and credentialing of medical and surgical personnel, 188 minimum case volumes for facilities and physicians, and data 189 reporting requirements for monitoring and enhancing quality 190 assurance. The rules shall meet or exceed the standard of care 191 provided in Children’s Medical Services Pediatric Cardiac 192 Facilities Standards established in October 2012. 193 (b) The department may also adopt rules relating to the 194 establishment, operation, and authority of the council and the 195 process, performance standards, and evaluation tools for 196 designating facilities as Pediatric and Congenital 197 Cardiovascular Centers of Excellence. 198 Section 2. This act shall take effect upon becoming a law.