Florida Senate - 2018 COMMITTEE AMENDMENT
Bill No. PCS (452688) for SB 622
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LEGISLATIVE ACTION
Senate . House
Comm: RCS .
02/01/2018 .
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The Committee on Appropriations (Bean) recommended the
following:
1 Senate Amendment (with directory and title amendments)
2
3 Between lines 921 and 922
4 insert:
5 (9) The agency shall establish a technical advisory panel,
6 pursuant to s. 20.052, to develop procedures and standards for
7 measuring outcomes of pediatric cardiac catheterization programs
8 and pediatric cardiovascular open-heart surgery programs.
9 (a) Members of the panel must have technical expertise in
10 pediatric cardiac medicine and shall serve without compensation
11 and shall not be reimbursed for per diem and travel expenses.
12 composed
13 (b) Voting members of the panel shall include: 3 at-large
14 members, including 1 cardiologist who is board certified in
15 caring for adults with congenital heart disease and 2 board
16 certified pediatric cardiologists, neither of whom may be
17 employed by any of the hospitals specified in subparagraphs 1.
18 10. or their affiliates, each of whom is appointed by the
19 Secretary of Health Care Administration, and 10 members, and an
20 alternate for each member, each of whom is a pediatric
21 cardiologist or a pediatric cardiovascular surgeon, each
22 appointed by the chief executive officer of one of the following
23 hospitals:
24 1. Johns Hopkins All Children’s Hospital in St. Petersburg.
25 2. Arnold Palmer Hospital for Children in Orlando.
26 3. Joe DiMaggio Children’s Hospital in Hollywood.
27 4. Nicklaus Children’s Hospital in Miami.
28 5. St. Joseph’s Children’s Hospital in Tampa.
29 6. University of Florida Health Shands Hospital in
30 Gainesville.
31 7. University of Miami Holtz Children’s Hospital in Miami.
32 8. Wolfson Children’s Hospital in Jacksonville.
33 9. Florida Hospital for Children in Orlando.
34 10. Nemours Children’s Hospital in Orlando.
35
36 Appointments made under subparagraphs 1.-10. are contingent upon
37 the hospital’s maintenance of pediatric certificates of need and
38 the hospital’s compliance with this section and rules adopted
39 thereunder, as determined by the Secretary of Health Care
40 Administration. A member appointed under subparagraphs 1.-10.
41 whose hospital fails to maintain such certificates or comply
42 with standards may serve only as a nonvoting member until the
43 hospital restores such certificates or complies with such
44 standards.
45 (c) The Secretary of Health Care Administration may appoint
46 nonvoting members to the panel. Nonvoting members may include:
47 1. The Secretary of Health Care Administration.
48 2. The Surgeon General.
49 3. The Deputy Secretary of Children’s Medical Services.
50 4. Any current or past Division Director of Children’s
51 Medical Services.
52 5. A parent of a child with congenital heart disease.
53 6. An adult with congenital heart disease.
54 7. A representative from each of the following
55 organizations: the Florida Chapter of the American Academy of
56 Pediatrics, the Florida Chapter of the American College of
57 Cardiology, the Greater Southeast Affiliate of the American
58 Heart Association, the Adult Congenital Heart Association, the
59 March of Dimes, the Florida Association of Children’s Hospitals,
60 and the Florida Society of Thoracic and Cardiovascular Surgeons.
61 (d) The panel shall meet biannually, or more frequently
62 upon the call of the Secretary of Health Care Administration.
63 Such meetings may be conducted telephonically, or by other
64 electronic means.
65 (e) The duties of the panel include recommending to the
66 agency standards for quality of care, personnel, physical plant,
67 equipment, emergency transportation, and data reporting for
68 hospitals that provide pediatric cardiac services.
69 (f) Beginning in January 1, 2020, and annually thereafter,
70 the panel shall submit a report to the Governor, the President
71 of the Senate, the Speaker of the House of Representatives, the
72 Secretary of Health Care Administration, and the State Surgeon
73 General. The report must summarize the panel’s activities during
74 the preceding fiscal year and include data and performance
75 measures on surgical morbidity and mortality for all pediatric
76 cardiac programs.
77 (b) Based on the recommendations of the panel, the agency
78 shall develop and adopt rules for pediatric cardiac
79 catheterization programs and pediatric open-heart surgery
80 programs which include at least the following:
81 1. A risk adjustment procedure that accounts for the
82 variations in severity and case mix found in hospitals in this
83 state;
84 2. Outcome standards specifying expected levels of
85 performance in pediatric cardiac programs. Such standards may
86 include, but are not limited to, in-hospital mortality,
87 infection rates, nonfatal myocardial infarctions, length of
88 postoperative bleeds, and returns to surgery; and
89 3. Specific steps to be taken by the agency and licensed
90 facilities that do not meet the outcome standards within a
91 specified time, including time required for detailed case
92 reviews and development and implementation of corrective action
93 plans.
94 (c) This subsection is repealed on July 1, 2022.
95 (10) Based on the recommendations of the advisory panel in
96 subsection (9), the agency shall adopt rules for pediatric
97 cardiac programs that, at a minimum, include:
98 (a) Standards for pediatric cardiac catheterization
99 services and pediatric cardiovascular surgery including quality
100 of care, personnel, physical plant, equipment, emergency
101 transportation, data reporting, and appropriate operating hours
102 and timeframes for mobilization for emergency procedures.
103 (b) Outcome standards consistent with nationally
104 established levels of performance in pediatric cardiac programs.
105 (c) Specific steps to be taken by the agency and licensed
106 facilities when the facilities do not meet the outcome standards
107 within a specified time, including time required for detailed
108 case reviews and development and implementation of corrective
109 action plans.
110 (11) A pediatric cardiac program shall:
111 (a) Be located in a hospital licensed under this chapter
112 and include the following co-located components: a pediatric
113 cardiology clinic, a pediatric cardiac catheterization
114 laboratory, and a pediatric cardiovascular surgery program.
115 (b) Have a risk adjustment surgical procedure protocol
116 following the guidelines established by the Society of Thoracic
117 Surgeons.
118 (c) Have quality assurance and quality improvement
119 processes in place to enhance clinical operation and patient
120 satisfaction with services.
121 (d) Participate in the clinical outcome reporting systems
122 operated by the Society of Thoracic Surgeons and the American
123 College of Cardiology.
124 (12)(10) The agency may adopt rules to administer the
125 requirements of part II of chapter 408.
126 Section 32. Paragraph (k) is added to subsection (3) of
127 section 408.05, Florida Statutes, to read:
128 408.05 Florida Center for Health Information and
129 Transparency.—
130 (3) HEALTH INFORMATION TRANSPARENCY.—In order to
131 disseminate and facilitate the availability of comparable and
132 uniform health information, the agency shall perform the
133 following functions:
134 (k) Contract with the Society of Thoracic Surgeons and the
135 American College of Cardiology to obtain data reported pursuant
136 to s. 395.1055 for publication on the agency’s website in a
137 manner that will allow consumers to be informed of aggregate
138 data and to compare pediatric cardiac programs.
139
140 ====== D I R E C T O R Y C L A U S E A M E N D M E N T ======
141 And the directory clause is amended as follows:
142 Delete lines 888 - 890
143 and insert:
144 Section 31. Present subsection (10) of section 395.1055,
145 Florida Statutes, is redesignated as subsection (12),
146 subsections (2), (3), and (9) of that section are amended,
147 paragraph (i) is added to subsection (1) of that section, and a
148 new subsection (10) and subsection (11) are added to that
149 section, to read:
150
151 ================= T I T L E A M E N D M E N T ================
152 And the title is amended as follows:
153 Delete line 43
154 and insert:
155 nursing units; requiring the agency to adopt rules
156 establishing standards for pediatric cardiac
157 catheterization and pediatric cardiovascular surgery
158 programs located in licensed hospitals; providing
159 requirements for such programs; establishing minimum
160 standards for rules for such pediatric cardiac
161 programs; requiring hospitals with pediatric cardiac
162 programs to participate in the clinical outcome
163 reporting systems; revising duties and membership of
164 the pediatric cardiac technical advisory panel;
165 amending s. 408.05, F.S.; requiring the agency to
166 contract with the Society of Thoracic Surgeons and the
167 American College of Cardiology for collection of
168 certain data for publication on the agency’s website
169 for certain purposes; repealing ss. 395.10971 and
170 395.10972,