CODING: Words stricken are deletions; words underlined are additions.
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
CHAMBER ACTION
Senate House
.
.
1 .
.
2 .
.
3 .
.
4
5
6
7
8
9
10
11 Senator Diaz-Balart moved the following amendment:
12
13 Senate Amendment (with title amendment)
14 On page 85, between lines 13 and 14,
15
16 insert:
17 Section 56. Florida Commission on Excellence in Health
18 Care.--
19 (1) LEGISLATIVE FINDINGS AND INTENT.--The Legislature
20 finds that the health care delivery industry is one of the
21 largest and most complex industries in Florida. The
22 Legislature finds that additional focus on strengthening
23 health care delivery systems by eliminating avoidable mistakes
24 in the diagnosis and treatment of Floridians holds tremendous
25 promise to increase the quality of health care services
26 available to Floridians. To achieve this enhanced focus, it is
27 the intent of the Legislature to create the Florida Commission
28 on Excellence in Health Care to facilitate the development of
29 a comprehensive statewide strategy for improving health care
30 delivery systems through meaningful reporting standards, data
31 collection and review, and quality measurement.
1
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 (2) DEFINITIONS.--As used in this act, the term:
2 (a) "Agency" means the Agency for Health Care
3 Administration.
4 (b) "Commission" means the Florida Commission on
5 Excellence in Health Care.
6 (c) "Department" means the Department of Health.
7 (d) "Error," with respect to health care, means an
8 unintended act, by omission or commission.
9 (e) "Health care practitioner" means any person
10 licensed under chapter 457; chapter 458; chapter 459; chapter
11 460; chapter 461; chapter 462; chapter 463; chapter 464;
12 chapter 465; chapter 466; chapter 467; part I, part II, part
13 III, part V, part X, part XIII, or part XIV of chapter 468;
14 chapter 478; chapter 480; part III or part IV of chapter 483;
15 chapter 484; chapter 486; chapter 490; or chapter 491, Florida
16 Statutes.
17 (f) "Health care provider" means any health care
18 facility or other health care organization licensed or
19 certified to provide approved medical and allied health
20 services in this state, or any entity licensed by the
21 Department of Insurance as a prepaid health care plan or
22 health maintenance organization or as an insurer to provide
23 coverage for health care services through a network of
24 providers.
25 (3) COMMISSION; DUTIES AND RESPONSIBILITIES.--There is
26 created the Florida Commission on Excellence in Health Care.
27 The commission shall:
28 (a) Identify existing data sources that evaluate
29 quality of care in Florida and collect, analyze, and evaluate
30 this data.
31 (b) Establish guidelines for data sharing and
2
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 coordination.
2 (c) Identify core sets of quality measures for
3 standardized reporting by appropriate components of the health
4 care continuum.
5 (d) Recommend a framework for quality measurement and
6 outcome reporting.
7 (e) Develop quality measures that enhance and improve
8 the ability to evaluate and improve care.
9 (f) Make recommendations regarding research and
10 development needed to advance quality measurement and
11 reporting.
12 (g) Evaluate regulatory issues relating to the
13 pharmacy profession and recommend changes necessary to
14 optimize patient safety.
15 (h) Facilitate open discussion of a process to ensure
16 that comparative information on health care quality is valid,
17 reliable, comprehensive, understandable, and widely available
18 in the public domain.
19 (i) Sponsor public hearings to share information and
20 expertise, identify "best practices," and recommend methods to
21 promote their acceptance.
22 (j) Evaluate current regulatory programs to determine
23 what changes, if any, need to be made to facilitate patient
24 safety.
25 (k) Review public and private health care purchasing
26 systems to determine if there are sufficient mandates and
27 incentives to facilitate continuous improvement in patient
28 safety.
29 (l) Analyze how effective existing regulatory systems
30 are in ensuring continuous competence and knowledge of
31 effective safety practices.
3
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 (m) Develop a framework for organizations that
2 license, accredit, or credential health care practitioners and
3 health care providers to more quickly and effectively identify
4 unsafe providers and practitioners and to take action
5 necessary to remove the unsafe provider or practitioner from
6 practice or operation until such time as the practitioner or
7 provider has proven safe to practice or operate.
8 (n) Recommend procedures for development of a
9 curriculum on patient safety and methods of incorporating such
10 curriculum into training, licensure, and certification
11 requirements.
12 (o) Develop a framework for regulatory bodies to
13 disseminate information on patient safety to health care
14 practitioners, health care providers, and consumers through
15 conferences, journal articles and editorials, newsletters,
16 publications, and Internet websites.
17 (p) Recommend procedures to incorporate recognized
18 patient safety considerations into practice guidelines and
19 into standards related to the introduction and diffusion of
20 new technologies, therapies, and drugs.
21 (q) Recommend a framework for development of
22 community-based collaborative initiatives for error reporting
23 and analysis and implementation of patient safety
24 improvements.
25 (r) Evaluate the role of advertising in promoting or
26 adversely affecting patient safety.
27 (4) MEMBERSHIP, ORGANIZATION, MEETINGS, PROCEDURES,
28 STAFF.--
29 (a) The commission shall consist of:
30 1. The Secretary of Health and the Director of Health
31 Care Administration;
4
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 2. One representative each from the following agencies
2 or organizations: the Board of Medicine, the Board of
3 Osteopathic Medicine, the Board of Pharmacy, the Board of
4 Dentistry, the Board of Nursing, the Florida Dental
5 Association, the Florida Medical Association, the Florida
6 Osteopathic Medical Association, the Florida Chiropractic
7 Association, the Florida Podiatric Medical Association, the
8 Florida Nurses Association, the Florida Organization of
9 Nursing Executives, the Florida Pharmacy Association, the
10 Florida Society of Health System Pharmacists, Inc., the
11 Florida Hospital Association, the Association of Community
12 Hospitals and Health Systems of Florida, Inc., the Florida
13 League of Health Systems, the Florida Health Care Risk
14 Management Advisory Council, the Florida Health Care
15 Association, the Florida Statutory Teaching Hospital Council,
16 Inc., the Florida Statutory Rural Hospital Council, and the
17 Florida Association of Homes for the Aging;
18 3. Two health lawyers, appointed by the Secretary of
19 Health, one of whom must be a member of the Health Law Section
20 of The Florida Bar who defends physicians and one of whom must
21 be a member of the Academy of Florida Trial Lawyers;
22 4. Two representatives of the health insurance
23 industry, appointed by the Director of Health Care
24 Administration, one of whom shall represent indemnity plans
25 and one of whom shall represent managed care;
26 5. Five consumer advocates, consisting of one from the
27 Association for Responsible Medicine, two appointed by the
28 Governor, one appointed by the President of the Senate, and
29 one appointed by the Speaker of the House of Representatives;
30 6. Two legislators, one appointed by the President of
31 the Senate and one appointed by the Speaker of the House of
5
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 Representatives; and
2 7. One representative of a Florida medical school
3 appointed by the Secretary of Health.
4
5 Commission membership shall reflect the geographic and
6 demographic diversity of the state.
7 (b) The Secretary of Health and the Director of Health
8 Care Administration shall jointly chair the commission.
9 Subcommittees shall be formed by the joint chairs, as needed,
10 to make recommendations to the full commission on the subjects
11 assigned. However, all votes on work products of the
12 commission shall be at the full commission level, and all
13 recommendations to the Governor, the President of the Senate,
14 and the Speaker of the House of Representatives must pass by a
15 two-thirds vote of the full commission. Sponsoring agencies
16 and organizations may designate an alternative member who may
17 attend and vote on behalf of the sponsoring agency or
18 organization in the event the appointed member is unable to
19 attend a meeting of the commission or any subcommittee. The
20 commission shall be staffed by employees of the Department of
21 Health and the Agency for Health Care Administration.
22 Sponsoring agencies or organizations must fund the travel and
23 related expenses of their appointed members on the commission.
24 Travel and related expenses for the consumer members of the
25 commission shall be reimbursed by the state pursuant to
26 section 112.061, Florida Statutes. The commission shall hold
27 its first meeting no later than July 15, 2000.
28 (5) EVIDENTIARY PROHIBITIONS.--
29 (a) The findings, recommendations, evaluations,
30 opinions, investigations, proceedings, records, reports,
31 minutes, testimony, correspondence, work product, and actions
6
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 of the commission shall be available to the public, but may
2 not be introduced into evidence at any civil, criminal,
3 special, or administrative proceeding against a health care
4 practitioner or health care provider arising out of the
5 matters which are the subject of the findings of the
6 commission. Moreover, no member of the commission shall be
7 examined in any civil, criminal, special, or administrative
8 proceeding against a health care practitioner or health care
9 provider as to any evidence or other matters produced or
10 presented during the proceedings of this commission or as to
11 any findings, recommendations, evaluations, opinions,
12 investigations, proceedings, records, reports, minutes,
13 testimony, correspondence, work product, or other actions of
14 the commission or any members thereof. However, nothing in
15 this section shall be construed to mean that information,
16 documents, or records otherwise available and obtained from
17 original sources are immune from discovery or use in any
18 civil, criminal, special, or administrative proceeding merely
19 because they were presented during proceedings of the
20 commission. Nor shall any person who testifies before the
21 commission or who is a member of the commission be prevented
22 from testifying as to matters within his or her knowledge in a
23 subsequent civil, criminal, special, or administrative
24 proceeding merely because such person testified in front of
25 the commission.
26 (b) The findings, recommendations, evaluations,
27 opinions, investigations, proceedings, records, reports,
28 minutes, testimony, correspondence, work product, and actions
29 of the commission shall be used as a guide and resource and
30 shall not be construed as establishing or advocating the
31 standard of care for health care practitioners or health care
7
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 providers unless subsequently enacted into law or adopted in
2 rule. Nor shall any findings, recommendations, evaluations,
3 opinions, investigations, proceedings, records, reports,
4 minutes, testimony, correspondence, work product, or actions
5 of the commission be admissible as evidence in any way,
6 directly or indirectly, by introduction of documents or as a
7 basis of an expert opinion as to the standard of care
8 applicable to health care practitioners or health care
9 providers in any civil, criminal, special, or administrative
10 proceeding unless subsequently enacted into law or adopted in
11 rule.
12 (c) No person who testifies before the commission or
13 who is a member of the commission may specifically identify
14 any patient, health care practitioner, or health care provider
15 by name. Moreover, the findings, recommendations, evaluations,
16 opinions, investigations, proceedings, records, reports,
17 minutes, testimony, correspondence, work product, and actions
18 of the commission may not specifically identify any patient,
19 health care practitioner, or health care provider by name.
20 (6) REPORT; TERMINATION.--The commission shall provide
21 a report of its findings and recommendations to the Governor,
22 the President of the Senate, and the Speaker of the House of
23 Representatives no later than February 1, 2001. After
24 submission of the report, the commission shall continue to
25 exist for the purpose of assisting the Department of Health,
26 the Agency for Health Care Administration, and the regulatory
27 boards in their drafting of proposed legislation and rules to
28 implement its recommendations and for the purpose of providing
29 information to the health care industry on its
30 recommendations. The commission shall be terminated June 1,
31 2001.
8
12:40 PM 04/27/00 s2154c3c-37j01
SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2154, CS for SB 1900 & SB 282
Amendment No.
1 Section 57. The sum of $91,000 in nonrecurring general
2 revenue is hereby appropriated from the General Revenue Fund
3 to the Department of Health to cover costs of the Florida
4 Commission on Excellence in Health Care relating to the travel
5 and related expenses of staff and consumer members and the
6 reproduction and dissemination of documents.
7
8 (Redesignate subsequent sections.)
9
10
11 ================ T I T L E A M E N D M E N T ===============
12 And the title is amended as follows:
13 On page 7, line 10, after the semicolon,
14
15 insert:
16 creating the Florida Commission on Excellence
17 in Health Care; providing legislative findings
18 and intent; providing definitions; providing
19 duties and responsibilities; providing for
20 membership, organization, meetings, procedures,
21 and staff; providing for reimbursement of
22 travel and related expenses of certain members;
23 providing certain evidentiary prohibitions;
24 requiring a report to the Governor, the
25 President of the Senate, and the Speaker of the
26 House of Representatives; providing for
27 termination of the commission; providing an
28 appropriation;
29
30
31
9
12:40 PM 04/27/00 s2154c3c-37j01