Florida Senate - 2016 CS for CS for SB 378 By the Committees on Governmental Oversight and Accountability; and Health Policy; and Senator Bean 585-01305-16 2016378c2 1 A bill to be entitled 2 An act relating to pediatric cardiac care in the 3 Children’s Medical Services Network; creating s. 4 391.224, F.S.; providing legislative findings and 5 intent; creating the Pediatric Cardiac Advisory 6 Council; determining the chair of the advisory 7 council; establishing the membership of the advisory 8 council; identifying the duties of the advisory 9 council; setting the minimum qualifications for the 10 designation of a facility as a Pediatric and 11 Congenital Cardiovascular Center of Excellence; 12 requiring a report to the Governor, the Legislature, 13 and the State Surgeon General; requiring the 14 Department of Health to develop rules relating to 15 pediatric cardiac services and facilities in the 16 Children’s Medical Services Network; authorizing the 17 department to adopt rules relating to the council and 18 the designation of facilities as Pediatric and 19 Congenital Cardiovascular Centers of Excellence; 20 authorizing and preserving until amended specified 21 rules relating to pediatric cardiac services and 22 facilities; 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 Advisory Council.— 29 (1) LEGISLATIVE FINDINGS AND INTENT.— 30 (a) The Legislature finds significant benefits in the 31 continued coordination of activities by several state agencies 32 regarding access to pediatric cardiac care in this state. It is 33 the intent of the Legislature that the Department of Health, the 34 department’s cardiac consultants, and the Agency for Health Care 35 Administration maintain their long-standing interagency teams 36 and agreements for the development and adoption of guidelines, 37 standards, and rules for those portions of the state cardiac 38 care system within the statutory authority of each agency. This 39 coordinated approach will continue to ensure the necessary 40 continuum of care for the pediatric cardiac patient. The 41 department has the leadership responsibility for this activity. 42 (b) It is further the intent of the Legislature to 43 establish the Pediatric Cardiac Advisory Council, a statewide, 44 inclusive council within the department. 45 (2) PEDIATRIC CARDIAC ADVISORY COUNCIL.— 46 (a) The State Surgeon General shall appoint the Pediatric 47 Cardiac Advisory Council for the purpose of advising the 48 department on the delivery of cardiac services to children. 49 (b) The chair of the council shall be elected from among 50 the council members every 2 years and may not serve more than 51 two consecutive terms. 52 (c) The council shall meet upon the call of the chair or 53 two or more voting members or upon the call of the State Surgeon 54 General, but must meet at least quarterly. Council meetings must 55 be conducted by teleconference or through other electronic means 56 when feasible. 57 (d) The council shall be composed of no more than 13 voting 58 members with technical expertise in cardiac medicine. Members 59 shall be appointed by the State Surgeon General for staggered 60 terms of 4 years. An employee of the department or a contracted 61 consultant paid by the department may not serve as an appointed 62 member or ex officio member of the council. Council members 63 shall include the following voting members: 64 1. Pediatric cardiologists or pediatric cardiovascular 65 surgeons who have been nominated by their respective chief 66 executive officers and approved by the State Surgeon General 67 from the following facilities for as long as such facilities 68 maintain their pediatric certificates of need: 69 a. All Children’s Hospital in St. Petersburg; 70 b. Arnold Palmer Hospital for Children in Orlando; 71 c. Joe DiMaggio Children’s Hospital in Hollywood; 72 d. Nicklaus Children’s Hospital in Miami; 73 e. St. Joseph’s Children’s Hospital in Tampa; 74 f. University of Florida Health Shands Hospital in 75 Gainesville; 76 g. University of Miami Holtz Children’s Hospital in Miami; 77 and 78 h. Wolfson Children’s Hospital in Jacksonville. 79 80 A hospital with a certificate of need for a pediatric cardiac 81 program that meets state and national standards as determined by 82 the council following an onsite visit by a panel from the 83 council shall have one of its pediatric cardiologists or 84 pediatric cardiovascular surgeons who has been nominated by its 85 chief executive officer and approved by the State Surgeon 86 General appointed to the council as a new voting member. The 87 voting privilege of a voting member of the council appointed 88 pursuant to this subparagraph shall be suspended if the facility 89 he or she represents no longer meets state and national 90 standards as adopted by the council. Such individual may remain 91 a member of the council in an advisory capacity but shall 92 relinquish voting privileges until his or her facility meets 93 such standards. 94 2. Two physicians at large, not associated with a facility 95 that has a representative appointed as a voting member of the 96 council, who are pediatric cardiologists or subspecialists with 97 special expertise or experience in dealing with children or 98 adults with congenital heart disease. These physicians shall be 99 selected by the State Surgeon General in consultation with the 100 Deputy Secretary for Children’s Medical Services and the 101 Director of Children’s Medical Services. 102 3. One community physician who has ongoing involvement with 103 and special interest in children with heart disease and who is 104 not associated with a facility represented in subparagraph 1. or 105 one community-based medical internist having experience with 106 adults with congenital heart disease. The community physician 107 shall be selected by the State Surgeon General in consultation 108 with the Deputy Secretary of Children’s Medical Services and the 109 Director of the Division of Children’s Medical Services. 110 (e) The State Surgeon General may appoint nonvoting 111 advisory members to the council in consultation with the Deputy 112 Secretary for Children’s Medical Services and the Director of 113 Children’s Medical Services. Such members may participate in 114 council discussions and subcommittees created by the council, 115 but may not vote. 116 (f) The duties of the council include, but are not limited 117 to: 118 1. Recommending standards for personnel, diagnoses, 119 clinics, and facilities rendering cardiac services to the 120 department and the Division of Children’s Medical Services. 121 2. Analyzing reports on the periodic review of cardiac 122 personnel, diagnoses, clinics, and facilities to determine if 123 established state and national standards for cardiac services 124 are met. 125 3. Making recommendations to the Director of Children’s 126 Medical Services as to the approval or disapproval of reviewed 127 cardiac care personnel, diagnoses, clinics, and facilities. 128 4. Making recommendations as to the intervals for 129 reinspection of approved personnel, diagnoses, clinics, and 130 facilities for cardiac care. 131 5. Reviewing and inspecting hospitals upon the request of 132 the hospitals, the department, or the Agency for Health Care 133 Administration to determine if established state and national 134 standards for cardiac services are met. 135 6. Providing input on all aspects of the state’s Children’s 136 Medical Services cardiac programs, including rulemaking. 137 7. Addressing all components of the care of adults and 138 children with congenital heart disease and children with 139 acquired heart disease, as indicated and appropriate. 140 8. Abiding by the recognized state and national 141 professional standards of care for children with heart disease. 142 9. Making recommendations to the State Surgeon General for 143 legislation and appropriations for children’s cardiac services. 144 10. Providing advisory opinions to the Agency for Health 145 Care Administration before the agency approves a certificate of 146 need for children’s cardiac services. 147 (g) A council member shall serve without compensation, but 148 is entitled to reimbursement for per diem and travel expenses in 149 accordance with s. 112.061. 150 (h) At the recommendation of the Pediatric Cardiac Advisory 151 Council and with the approval of the Director of Children’s 152 Medical Services, the State Surgeon General shall designate 153 facilities meeting the council’s approved state and national 154 professional standards of care for children with heart disease 155 as “Pediatric and Congenital Cardiovascular Centers of 156 Excellence.” The designation is withdrawn automatically if a 157 particular center no longer meets such standards. 158 1. The council shall develop and recommend to the State 159 Surgeon General measurable performance standards and goals for 160 determining whether a facility meets the requirements for 161 designation as a “Pediatric and Congenital Cardiovascular Center 162 of Excellence.” 163 2. The council shall develop and recommend to the State 164 Surgeon General evaluation tools for measuring the goals and 165 performance standards of the facilities seeking and receiving 166 the “Pediatric and Congenital Cardiovascular Center of 167 Excellence” designation. 168 (3) ANNUAL REPORT.—The council shall submit an annual 169 report to the Governor, the President of the Senate, the Speaker 170 of the House of Representatives, and the State Surgeon General 171 by January 1 of each year, beginning in 2017. The report must 172 summarize the council’s activities for the preceding fiscal year 173 and include data and performance measures for all pediatric 174 cardiac facilities that participate in the Children’s Medical 175 Services Network relating to surgical morbidity and mortality. 176 The report must also recommend any policy or procedural changes 177 that would increase the council’s effectiveness in monitoring 178 the pediatric cardiovascular programs in the state. 179 (4) RULEMAKING.—The department, in coordination with the 180 Agency for Health Care Administration, shall develop rules 181 related to pediatric cardiac facilities that participate in the 182 Children’s Medical Services Network. The rules may establish 183 standards relating to the training and credentialing of medical 184 and surgical personnel, facility and physician minimum case 185 volumes, and data reporting requirements for monitoring and 186 enhancing quality assurance. The department may adopt rules 187 relating to the establishment, operations, and authority of the 188 Pediatric Cardiac Advisory Council and the establishment, goals, 189 performance standards, and evaluation tools for designating 190 facilities as Pediatric and Congenital Cardiovascular Centers of 191 Excellence. The rules relating to pediatric cardiac services and 192 facilities in effect on October 1, 2015, are authorized pursuant 193 to this subsection and shall remain in effect until amended 194 pursuant to this subsection. 195 Section 2. This act shall take effect upon becoming a law.