Florida Senate - 2013 SENATOR AMENDMENT
Bill No. CS/CS/HB 1159, 1st Eng.
Senate . House
Floor: 1/AD/3R . Floor: CA
05/03/2013 11:09 AM . 05/03/2013 05:53 PM
Senator Hays moved the following:
1 Senate Amendment (with title amendment)
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Paragraph (a) of subsection (7) and subsection
6 (14) of section 395.4001, Florida Statutes, are amended to read:
7 395.4001 Definitions.—As used in this part, the term:
8 (7) “Level II trauma center” means a trauma center that:
9 (a) Is verified by the department to be in substantial
10 compliance with Level II trauma center standards and has been
11 approved by the department to operate as a Level II trauma
12 center or is designated pursuant to s. 395.4025(14).
13 (14) “Trauma center” means a hospital that has been
14 verified by the department to be in substantial compliance with
15 the requirements in s. 395.4025 and has been approved by the
16 department to operate as a Level I trauma center, Level II
17 trauma center, or pediatric trauma center, or is designated by
18 the department as a Level II trauma center pursuant to s.
20 Section 2. Paragraph (k) of subsection (1) of section
21 395.401, Florida Statutes, is amended to read:
22 395.401 Trauma services system plans; approval of trauma
23 centers and pediatric trauma centers; procedures; renewal.—
25 (k) It is unlawful for any hospital or other facility to
26 hold itself out as a trauma center unless it has been so
27 verified or designated pursuant to s. 395.4025(14).
28 Section 3. Subsection (14) of section 395.4025, Florida
29 Statutes, is amended to read:
30 395.4025 Trauma centers; selection; quality assurance;
32 (14) Notwithstanding the procedures established pursuant to
33 subsections (1) through (13) in this section, hospitals located
34 in areas with limited access to trauma center services shall be
35 designated by the department as Level II trauma centers based on
36 documentation of a valid certificate of trauma center
37 verification from the American College of Surgeons. Areas with
38 limited access to trauma center services are defined by the
39 following criteria:
40 (a) The hospital is located in a trauma service area with a
41 population greater than 600,000 persons but a population density
42 of less than 225 persons per square mile; and
43 (b) The hospital is located in a county with no verified
44 trauma center; and
45 (c) The hospital is located at least 15 miles or 20 minutes
46 travel time by ground transport from the nearest verified trauma
any other provisions of this section and rules adopted
48 pursuant to this section, until the department has conducted the
49 review provided under s. 395.402 , only hospitals located in
50 trauma services areas where there is no existing trauma center
51 may apply.
52 Section 4. Paragraphs (l) and (m) of subsection (4) of
53 section 400.9905, Florida Statutes, are amended to read:
54 400.9905 Definitions.—
55 (4) “Clinic” means an entity where health care services are
56 provided to individuals and which tenders charges for
57 reimbursement for such services, including a mobile clinic and a
58 portable equipment provider. As used in this part, the term does
59 not include and the licensure requirements of this part do not
60 apply to:
61 (l) Orthotic, or prosthetic, pediatric cardiology, or
62 perinatology clinical facilities or anesthesia clinical
63 facilities that are not otherwise exempt under paragraph (a) or
64 paragraph (k) and that are a publicly traded corporation or that
65 are wholly owned, directly or indirectly, by a publicly traded
66 corporation. As used in this paragraph, a publicly traded
67 corporation is a corporation that issues securities traded on an
68 exchange registered with the United States Securities and
69 Exchange Commission as a national securities exchange.
70 (m) Entities that are owned by a corporation that has $250
71 million or more in total annual sales of health care services
72 provided by licensed health care practitioners where one or more
73 of the persons responsible for the operations of the entity are
74 owners is a health care practitioner who is licensed in this
75 state and who is responsible for supervising the business
76 activities of the entity and is legally responsible for the
77 entity’s compliance with state law for purposes of this part.
79 Notwithstanding this subsection, an entity shall be deemed a
80 clinic and must be licensed under this part in order to receive
81 reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
82 627.730-627.7405, unless exempted under s. 627.736(5)(h).
83 Section 5. Subsection (2) of section 408.036, Florida
84 Statutes, is amended to read:
85 408.036 Projects subject to review; exemptions.—
86 (2) PROJECTS SUBJECT TO EXPEDITED REVIEW.—Unless exempt
87 pursuant to subsection (3), projects subject to an expedited
88 review shall include, but not be limited to:
89 (a) A transfer of a certificate of need, except that when
90 an existing hospital is acquired by a purchaser, all
91 certificates of need issued to the hospital which are not yet
92 operational shall be acquired by the purchaser, without need for
93 a transfer.
94 (b) Replacement of a nursing home within the same district,
95 if the proposed project site is located within a geographic area
96 that contains at least 65 percent of the facility’s current
97 residents and is within a 30-mile radius of the replaced nursing
99 (c) Relocation of a portion of a nursing home’s licensed
100 beds to a facility within the same district, if the relocation
101 is within a 30-mile radius of the existing facility and the
102 total number of nursing home beds in the district does not
104 (d) The new construction of a community nursing home in a
105 retirement community as further provided in this paragraph.
106 1. Expedited review under this paragraph is available if
107 all of the following criteria are met:
108 a. The residential use area of the retirement community is
109 deed-restricted as housing for older persons as defined in s.
111 b. The retirement community is located in a county in which
112 25 percent or more of its population is age 65 and older.
113 c. The retirement community is located in a county that has
114 a rate of no more than 16.1 beds per 1,000 persons age 65 years
115 or older. The rate shall be determined by using the current
116 number of licensed and approved community nursing home beds in
117 the county per the agency’s most recent published inventory.
118 d. The retirement community has a population of at least
119 8,000 residents within the county, based on a population data
120 source accepted by the agency.
121 e. The number of proposed community nursing home beds in an
122 application does not exceed the projected bed need after
123 applying the rate of 16.1 beds per 1,000 persons aged 65 years
124 and older projected for the county 3 years into the future using
125 the estimates adopted by the agency, after subtracting the
126 inventory of licensed and approved community nursing home beds
127 in the county per the agency’s most recent published inventory.
128 2. No more than 120 community nursing home beds shall be
129 approved for a qualified retirement community under each request
130 for application for expedited review. Subsequent requests for
131 expedited review under this process shall not be made until 2
132 years after construction of the facility has commenced or 1 year
133 after the beds approved through the initial request are
134 licensed, whichever occurs first.
135 3. The total number of community nursing home beds which
136 may be approved for any single deed-restricted community
137 pursuant to this paragraph shall not exceed 240, regardless of
138 whether the retirement community is located in more than one
139 qualifying county.
140 4. Each nursing home facility approved under this paragraph
141 shall be dually certified for participation in the Medicare and
142 Medicaid programs.
143 5. Each nursing home facility approved under this paragraph
144 shall be at least one mile from an existing approved and
145 licensed community nursing home, measured over publicly owned
147 6. Section 408.0435 does not apply to this paragraph.
148 7. A retirement community requesting expedited review under
149 this paragraph shall submit a written request to the agency for
150 an expedited review. The request shall include the number of
151 beds to be added and provide evidence of compliance with the
152 criteria specified in subparagraph 1.
153 8. After verifying that the retirement community meets the
154 criteria for expedited review specified in subparagraph 1., the
155 agency shall publicly notice in the Florida Administrative
156 Register that a request for an expedited review has been
157 submitted by a qualifying retirement community and that the
158 qualifying retirement community intends to make land available
159 for the construction and operation of a community nursing home.
160 The agency’s notice shall identify where potential applicants
161 can obtain information describing the sales price of, or terms
162 of the land lease for, the property on which the project will be
163 located and the requirements established by the retirement
164 community. The agency notice shall also specify the deadline for
165 submission of any certificate-of-need application, which shall
166 not be earlier than the 91st day and not be later than the 125th
167 day after the date the notice appears in the Florida
168 Administrative Register.
169 9. The qualified retirement community shall make land
170 available to applicants it deems to have met its requirements
171 for the construction and operation of a community nursing home
172 but will sell or lease the land only to the applicant that is
173 issued a certificate of need by the agency under the provisions
174 of this paragraph.
175 a. A certificate of need application submitted pursuant to
176 this paragraph shall identify the intended site for the project
177 within the retirement community and the anticipated costs for
178 the project based on that site. The application shall also
179 include written evidence that the retirement community has
180 determined that the provider submitting the application and the
181 project proposed by that provider satisfies its requirements for
182 the project.
183 b. The retirement community’s determination that more than
184 one provider satisfies its requirements for the project does not
185 preclude the retirement community from notifying the agency of
186 the provider it prefers.
187 10. Each application submitted shall be reviewed by the
188 agency. If multiple applications are submitted for the project
189 as published pursuant to subparagraph 8. above, then the
190 competing applications shall be reviewed by the agency.
192 The agency shall develop rules to implement the provisions for
193 expedited review, including time schedule, application content
194 which may be reduced from the full requirements of s.
195 408.037(1), and application processing.
196 Section 6. Paragraph (b) of subsection (2), subsection
197 (10), and paragraph (c) of subsection (11) of section 893.055,
198 Florida Statutes, is amended to read:
199 893.055 Prescription drug monitoring program.—
201 (b) The department , when the direct support organization
202 receives at least $20,000 in nonstate moneys or the state
203 receives at least $20,000 in federal grants for the prescription
204 drug monitoring program, shall adopt rules as necessary
205 concerning the reporting, accessing the database, evaluation,
206 management, development, implementation, operation, security,
207 and storage of information within the system, including rules
208 for when patient advisory reports are provided to pharmacies and
209 prescribers. The patient advisory report shall be provided in
210 accordance with s. 893.13(7)(a)8. The department shall work with
211 the professional health care licensure boards, such as the Board
212 of Medicine, the Board of Osteopathic Medicine, and the Board of
213 Pharmacy; other appropriate organizations, such as the Florida
214 Pharmacy Association, the Florida Medical Association, the
215 Florida Retail Federation, and the Florida Osteopathic Medical
216 Association, including those relating to pain management; and
217 the Attorney General, the Department of Law Enforcement, and the
218 Agency for Health Care Administration to develop rules
219 appropriate for the prescription drug monitoring program.
220 (10) All costs incurred by the department in administering
221 the prescription drug monitoring program shall be funded through
222 state funds, federal grants, or private funding applied for or
223 received by the state. The department may not commit funds for
224 the monitoring program without ensuring funding is available.
225 The prescription drug monitoring program and the implementation
226 thereof are contingent upon receipt of the nonstate funding. The
227 department and state government shall cooperate with the direct
228 support organization established pursuant to subsection (11) in
229 seeking state funds, federal grant funds, other nonstate grant
230 funds, gifts, donations, or other private moneys for the
231 department if so long as the costs of doing so are not
232 considered material. Nonmaterial costs for this purpose include,
233 but are not limited to, the costs of mailing and personnel
234 assigned to research or apply for a grant. Notwithstanding the
235 exemptions to competitive-solicitation requirements under s.
236 287.057(3)(f), the department shall comply with the competitive
237 solicitation requirements under s. 287.057 for the procurement
238 of any goods or services required by this section. Funds
239 provided, directly or indirectly, by prescription drug
240 manufacturers may not be used to implement the program.
241 (11) The department may establish a direct-support
242 organization that has a board consisting of at least five
243 members to provide assistance, funding, and promotional support
244 for the activities authorized for the prescription drug
245 monitoring program.
246 (c) The State Surgeon General shall appoint a board of
247 directors for the direct-support organization. Members of the
248 board shall serve at the pleasure of the State Surgeon General.
249 The State Surgeon General shall provide guidance to members of
250 the board to ensure that moneys received by the direct-support
251 organization are not received from inappropriate sources.
252 Inappropriate sources include, but are not limited to, donors,
253 grantors, persons, or organizations, or pharmaceutical
254 companies, that may monetarily or substantively benefit from the
255 purchase of goods or services by the department in furtherance
256 of the prescription drug monitoring program.
257 Section 7. This act shall take effect upon becoming a law.
259 ================= T I T L E A M E N D M E N T ================
260 And the title is amended as follows:
261 Delete everything before the enacting clause
262 and insert:
263 A bill to be entitled
264 An act relating to health care facilities;
265 amending s. 395.4001, F.S.; revising the definition of
266 the terms “level II trauma center” and “trauma
267 center”; amending s. 395.401, F.S.; making conforming
268 changes; amending s. 395.4025, F.S.; establishing
269 criteria for designating Level II trauma centers in
270 areas with limited access to trauma center services;
271 amending s. 400.9905, F.S.; revising a definition;
272 amending s. 408.036, F.S.; providing for expedited
273 review of certificate-of-need for licensed skilled
274 nursing facilities in qualifying retirement
275 communities; providing criteria for expedited review
276 for licensed skilled nursing homes in qualifying
277 retirement communities; limiting the number of beds
278 per retirement community that can be added through
279 expedited review; amending s. 893.055, F.S.; deleting
280 obsolete provisions; deleting a provision that
281 prohibits funds from prescription drug manufacturers
282 to be used to implement the prescription drug
283 monitoring program; authorizing the prescription drug
284 monitoring program to be funded by state funds;
285 revising the sources of money which are inappropriate
286 for the direct-support organization of the
287 prescription drug monitoring program to receive;
288 providing an effective date.