House Bill 1839c1

CODING: Words stricken are deletions; words underlined are additions.







    Florida House of Representatives - 1999             CS/HB 1839

        By the Committee on Health Care Licensing & Regulation and
    Representatives Ritter and Goodlette





  1                      A bill to be entitled

  2         An act relating to governmental reorganization;

  3         amending s. 20.42, F.S.; reassigning the Agency

  4         for Health Care Administration to the

  5         Department of Health Care; requiring the

  6         Executive Director of Health Care

  7         Administration to be confirmed by the Senate;

  8         making changes in the organizational structure

  9         of the agency; amending s. 20.43, F.S.;

10         redesignating the Department of Health as the

11         Department of Health Care; repealing

12         authorization for the Department of Health to

13         contract with the Agency for Health Care

14         Administration for certain services;

15         transferring to the Department of Health Care

16         the powers, duties, functions, and assets that

17         relate to the consumer complaint services,

18         investigations, and prosecutorial services that

19         are performed by the Agency for Health Care

20         Administration under contract with the

21         Department of Health; providing for the

22         appointment of and duties for an Organizational

23         Efficiency Advisory Committee; providing for a

24         reviser's bill; providing for the validity of

25         pending judicial and administrative

26         proceedings; providing an effective date.

27

28  Be It Enacted by the Legislature of the State of Florida:

29

30         Section 1.  Section 20.42, Florida Statutes, 1998

31  Supplement, is amended to read:

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         20.42  Agency for Health Care Administration.--There is

  2  created the Agency for Health Care Administration within the

  3  Department of Health Care Business and Professional

  4  Regulation. The agency shall be a separate budget entity, and

  5  the executive director of the agency shall be the agency head

  6  for all purposes. The agency shall not be subject to control,

  7  supervision, or direction by the Department of Health Care

  8  Business and Professional Regulation in any manner, including,

  9  but not limited to, personnel, purchasing, transactions

10  involving real or personal property, and budgetary matters.

11         (1)  EXECUTIVE DIRECTOR OF HEALTH CARE

12  ADMINISTRATION.--The head of the agency is the Executive

13  Director of Health Care Administration, who shall be appointed

14  by the Governor, subject to confirmation by the Senate. The

15  executive director shall serve at the pleasure of and report

16  to the Governor. The requirement for Senate confirmation

17  applies to any person appointed on or after October 1, 1999.

18         (2)  ORGANIZATION OF THE AGENCY.--The agency shall be

19  organized as follows:

20         (a)  The Division of Managed Care and Health Quality

21  Assurance, which shall be responsible for health facility

22  licensure and inspection, managed competition, managed care,

23  and the certificate-of-need program.

24         (b)  The Division of Health Policy and Cost Control,

25  which shall be responsible for health policy, the State Center

26  for Health Statistics, the development of The Florida Health

27  Plan, certificate of need, state and local health planning

28  under s. 408.033, and research and analysis.

29         (b)(c)  The Division of Medicaid, which State Health

30  Purchasing shall be responsible for the Medicaid program. The

31  division shall also administer the Florida Kidcare program

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1  contracts with the Florida Health Access Corporation program

  2  and the Florida Health Care Purchasing Cooperative and the

  3  contract with the Florida Healthy Kids Corporation.

  4         (c)(d)  The Division of Administration and Information

  5  Administrative Services, which shall be responsible for

  6  finance and accounting revenue management, budget, personnel,

  7  and general services, management information services, and the

  8  State Center for Health Statistics.

  9         (3)  DEPUTY DIRECTOR FOR MANAGED CARE AND HEALTH

10  QUALITY ASSURANCE.--The director shall appoint a Deputy

11  Director for Managed Care and Health Quality Assurance who

12  shall serve at the pleasure of, and be directly responsible

13  to, the executive director. The Deputy Director for Managed

14  Care and Health Quality Assurance shall be responsible for the

15  Division of Managed Care and Health Quality Assurance.

16         (4)  DEPUTY DIRECTOR FOR HEALTH POLICY AND COST

17  CONTROL.--The director shall appoint a Deputy Director for

18  Health Policy and Cost Control who shall serve at the pleasure

19  of, and be directly responsible to, the director. The Deputy

20  Director for Health Policy and Cost Control shall be

21  responsible for the Division of Health Policy and Cost

22  Control.

23         (4)(5)  DEPUTY DIRECTOR FOR MEDICAID STATE HEALTH

24  PURCHASING.--The executive director shall appoint a Deputy

25  Director for Medicaid State Health Purchasing who shall serve

26  at the pleasure of, and be directly responsible to, the

27  executive director. The Deputy Director for Medicaid State

28  Health Purchasing shall be responsible for the Division of

29  Medicaid State Health Purchasing.

30         (5)(6)  DEPUTY DIRECTOR FOR ADMINISTRATION AND

31  INFORMATION OF ADMINISTRATIVE SERVICES.--The executive

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1  director shall appoint a Deputy Director for Administration

  2  and Information of Administrative Services who shall serve at

  3  the pleasure of, and be directly responsible to, the executive

  4  director. The Deputy Director for Administration and

  5  Information Services shall be responsible for the Division of

  6  Administration and Information Administrative Services.

  7         Section 2.  Section 20.43, Florida Statutes, 1998

  8  Supplement, is amended to read:

  9         20.43  Department of Health Care.--There is created a

10  Department of Health Care.

11         (1)  The purpose of the Department of Health Care is to

12  promote and protect the health of all residents and visitors

13  in the state through organized state and community efforts,

14  including cooperative agreements with counties.  The

15  department shall:

16         (a)  Prevent, to the fullest extent possible, the

17  occurrence and progression of communicable and noncommunicable

18  diseases and disabilities.

19         (b)  Maintain a constant surveillance of disease

20  occurrence and accumulate health statistics necessary to

21  establish disease trends and to design health programs.

22         (c)  Conduct special studies of the causes of diseases

23  and formulate preventive strategies.

24         (d)  Promote the maintenance and improvement of the

25  environment as it affects public health.

26         (e)  Promote the maintenance and improvement of health

27  in the residents of the state.

28         (f)  Provide leadership, in cooperation with the public

29  and private sectors, in establishing statewide and community

30  public health delivery systems.

31

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         (g)  Provide health care and early intervention

  2  services to infants, toddlers, children, adolescents, and

  3  high-risk perinatal patients who are at risk for disabling

  4  conditions or have chronic illnesses.

  5         (h)  Provide services to abused and neglected children

  6  through child protection teams and sexual abuse treatment

  7  programs.

  8         (i)  Develop working associations with all agencies and

  9  organizations involved and interested in health and health

10  care delivery.

11         (j)  Analyze trends in the evolution of health systems,

12  and identify and promote the use of innovative, cost-effective

13  health delivery systems.

14         (k)  Serve as the statewide repository of all aggregate

15  data accumulated by state agencies related to health care;

16  analyze that data and issue periodic reports and policy

17  statements, as appropriate; require that all aggregated data

18  be kept in a manner that promotes easy utilization by the

19  public, state agencies, and all other interested parties;

20  provide technical assistance as required; and work

21  cooperatively with the state's higher education programs to

22  promote further study and analysis of health care systems and

23  health care outcomes.

24         (l)  Biennially publish, and annually update, a state

25  health plan that assesses current health programs, systems,

26  and costs; makes projections of future problems and

27  opportunities; and recommends changes needed in the health

28  care system to improve the public health.

29         (m)  Regulate health practitioners, to the extent

30  authorized by the Legislature, as necessary for the

31  preservation of the health, safety, and welfare of the public.

                                  5

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         (2)  The head of the Department of Health Care is the

  2  Secretary of Health Care and State Health Officer.  The

  3  secretary must be a physician licensed under chapter 458 or

  4  chapter 459 who has advanced training or extensive experience

  5  in public health administration.  The secretary is appointed

  6  by the Governor, subject to confirmation by the Senate.  The

  7  secretary serves at the pleasure of the Governor.

  8         (3)  The following divisions of the Department of

  9  Health Care are established, and each division is under the

10  direct supervision of a division director appointed by the

11  secretary:

12         (a)  Division of Administration.

13         (b)  Division of Environmental Health.

14         (c)  Division of Disease Control.

15         (d)  Division of Family Health Services.

16         (e)  Division of Children's Medical Services.

17         (f)  Division of Local Health Planning, Education, and

18  Workforce Development.

19         (g)  Division of Medical Quality Assurance, which is

20  responsible for the following boards and professions

21  established within the division:

22         1.  Nursing assistants, as provided under s. 400.211.

23         2.  Health care services pools, as provided under s.

24  402.48.

25         3.  The Board of Acupuncture, created under chapter

26  457.

27         4.  The Board of Medicine, created under chapter 458.

28         5.  The Board of Osteopathic Medicine, created under

29  chapter 459.

30         6.  The Board of Chiropractic Medicine, created under

31  chapter 460.

                                  6

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         7.  The Board of Podiatric Medicine, created under

  2  chapter 461.

  3         8.  Naturopathy, as provided under chapter 462.

  4         9.  The Board of Optometry, created under chapter 463.

  5         10.  The Board of Nursing, created under chapter 464.

  6         11.  The Board of Pharmacy, created under chapter 465.

  7         12.  The Board of Dentistry, created under chapter 466.

  8         13.  Midwifery, as provided under chapter 467.

  9         14.  The Board of Speech-Language Pathology and

10  Audiology, created under part I of chapter 468.

11         15.  The Board of Nursing Home Administrators, created

12  under part II of chapter 468.

13         16.  The Board of Occupational Therapy, created under

14  part III of chapter 468.

15         17.  Respiratory therapy, as provided under part V of

16  chapter 468.

17         18.  Dietetics and nutrition practice, as provided

18  under part X of chapter 468.

19         19.  Athletic trainers, as provided under part XIII of

20  chapter 468.

21         20.  The Board of Orthotists and Prosthetists, created

22  under part XIV of chapter 468.

23         21.  Electrolysis, as provided under chapter 478.

24         22.  The Board of Massage Therapy, created under

25  chapter 480.

26         23.  The Board of Clinical Laboratory Personnel,

27  created under part III of chapter 483.

28         24.  Medical physicists, as provided under part IV of

29  chapter 483.

30         25.  The Board of Opticianry, created under part I of

31  chapter 484.

                                  7

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         26.  The Board of Hearing Aid Specialists, created

  2  under part II of chapter 484.

  3         27.  The Board of Physical Therapy Practice, created

  4  under chapter 486.

  5         28.  The Board of Psychology, created under chapter

  6  490.

  7         29.  School psychologists, as provided under chapter

  8  490.

  9         30.  The Board of Clinical Social Work, Marriage and

10  Family Therapy, and Mental Health Counseling, created under

11  chapter 491.

12

13  The department may contract with the Agency for Health Care

14  Administration who shall provide consumer complaint,

15  investigative, and prosecutorial services required by the

16  Division of Medical Quality Assurance, councils, or boards, as

17  appropriate.

18         (4)(a)  The members of each board within the department

19  shall be appointed by the Governor, subject to confirmation by

20  the Senate. Consumer members on the board shall be appointed

21  pursuant to paragraph (b). Members shall be appointed for

22  4-year terms, and such terms shall expire on October 31.

23  However, a term of less than 4 years may be used to ensure

24  that:

25         1.  No more than two members' terms expire during the

26  same calendar year for boards consisting of seven or eight

27  members.

28         2.  No more than 3 members' terms expire during the

29  same calendar year for boards consisting of 9 to 12 members.

30

31

                                  8

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         3.  No more than 5 members' terms expire during the

  2  same calendar year for boards consisting of 13 or more

  3  members.

  4

  5  A member whose term has expired shall continue to serve on the

  6  board until such time as a replacement is appointed.  A

  7  vacancy on the board shall be filled for the unexpired portion

  8  of the term in the same manner as the original appointment.

  9  No member may serve for more than the remaining portion of a

10  previous member's unexpired term, plus two consecutive 4-year

11  terms of the member's own appointment thereafter.

12         (b)  Each board with five or more members shall have at

13  least two consumer members who are not, and have never been,

14  members or practitioners of the profession regulated by such

15  board or of any closely related profession. Each board with

16  fewer than five members shall have at least one consumer

17  member who is not, and has never been, a member or

18  practitioner of the profession regulated by such board or of

19  any closely related profession.

20         (c)  Notwithstanding any other provision of law, the

21  department is authorized to establish uniform application

22  forms and certificates of licensure for use by the boards

23  within the department.  Nothing in this paragraph authorizes

24  the department to vary any substantive requirements, duties,

25  or eligibilities for licensure or certification as provided by

26  law.

27         (5)  The department shall plan and administer its

28  public health programs through its county health departments

29  and may, for administrative purposes and efficient service

30  delivery, establish up to 15 service areas to carry out such

31  duties as may be prescribed by the secretary. The boundaries

                                  9

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1  of the service areas shall be the same as, or combinations of,

  2  the districts of the health and human services boards

  3  established in s. 20.19 and, to the extent practicable, shall

  4  take into consideration the boundaries of the jobs and

  5  education regional boards.

  6         (6)  The secretary and division directors are

  7  authorized to appoint ad hoc advisory committees as necessary.

  8  The issue or problem that the ad hoc committee shall address,

  9  and the timeframe within which the committee is to complete

10  its work, shall be specified at the time the committee is

11  appointed. Ad hoc advisory committees shall include

12  representatives of groups or entities affected by the issue or

13  problem that the committee is asked to examine. Members of ad

14  hoc advisory committees shall receive no compensation, but

15  may, within existing departmental resources, receive

16  reimbursement for travel expenses as provided in s. 112.061.

17         (7)  To protect and improve the public health, the

18  department may use state or federal funds to:

19         (a)  Provide incentives, including food coupons or

20  payment for travel expenses, for encouraging disease

21  prevention and patient compliance with medical treatment, such

22  as tuberculosis therapy.

23         (b)  Plan and conduct health education campaigns for

24  the purpose of protecting or improving public health. The

25  department may purchase promotional items and advertising,

26  such as space on billboards or in publications or radio or

27  television time, for health information and promotional

28  messages that recognize that the following behaviors, among

29  others, are detrimental to public health: unprotected sexual

30  intercourse, other than with one's spouse; cigarette smoking;

31  alcohol consumption or other substance abuse during pregnancy;

                                  10

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1  alcohol abuse or other substance abuse; lack of exercise and

  2  poor diet and nutrition habits; and failure to recognize and

  3  address a genetic tendency to suffer from sickle-cell anemia,

  4  diabetes, high blood pressure, cardiovascular disease, or

  5  cancer. For purposes of activities under this paragraph, the

  6  department of Health may establish requirements for local

  7  matching funds or in-kind contributions to create and

  8  distribute advertisements, in either print or electronic

  9  format, which are concerned with each of the targeted

10  behaviors, establish an independent evaluation and feedback

11  system for the public health communication campaign, and

12  monitor and evaluate the efforts to determine which of the

13  techniques and methodologies are most effective.

14         (c)  Plan and conduct promotional campaigns to recruit

15  health professionals to be employed by the department or to

16  recruit participants in departmental programs for health

17  practitioners, such as scholarship, loan repayment, or

18  volunteer programs. To this effect the department may purchase

19  promotional items and advertising.

20         Section 3.  (1)  Effective July 1, 1999, all powers,

21  duties, functions, records, personnel, property, and

22  unexpended balances of appropriations, allocations, and other

23  funds of the Agency for Health Care Administration which

24  relate to consumer complaint services, investigations, and

25  prosecutorial services and which are currently provided by the

26  Agency for Health Care Administration under a contract with

27  the Department of Health are transferred by a type two

28  transfer, as defined in s. 20.06(2), Florida Statutes, to the

29  Department of Health Care. Any rules adopted by or for the

30  Agency for Health Care Administration for the purpose of

31  administering or operating such programs are included in this

                                  11

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1  transfer and shall remain in effect until specifically changed

  2  in the manner provided by law.

  3         (2)(a)  All records, personnel, and funds of the

  4  consumer complaint and investigative services units are

  5  transferred and assigned to the Division of Medical Quality

  6  Assurance of the Department of Health Care.

  7         (b)  All records, personnel, and funds of the

  8  prosecutorial unit are transferred and assigned to the Office

  9  of the General Counsel of the Department of Health Care.

10         Section 4.  The Secretary of Health Care and the

11  Executive Director of Health Care Administration shall each

12  appoint four staff members to an Organizational Efficiency

13  Advisory Committee. Appointments must be made no later than

14  August 1, 1999. The Secretary of Health Care shall designate a

15  member of the committee to serve as committee chair. The

16  committee shall be assigned, for administrative purposes only,

17  to the Department of Health Care. The committee shall review

18  current activities and make recommendations regarding

19  consolidation of potentially duplicative functions,

20  particularly those relating to administrative services, legal

21  services, information and management information systems, and

22  data and planning services, and any needed modifications in

23  organizational structure. The committee shall report its

24  findings, including recommendations for changes in state

25  policy, rules, and statutes that will improve the

26  administrative efficiency of the Department of Health Care and

27  the Agency for Health Care Administration, to the Secretary of

28  Health Care, the Executive Director of Health Care

29  Administration, the Governor, the President of the Senate, and

30  the Speaker of the House of Representatives by January 15,

31  2000.

                                  12

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1839

    601-156-99






  1         Section 5.  The Division of Statutory Revision of the

  2  Office of Legislative Services is requested to prepare a

  3  reviser's bill for introduction at a subsequent session of the

  4  Legislature to change the term "Department of Health" to

  5  "Department of Health Care" in the Florida Statutes and to

  6  make such further changes as are necessary to conform the

  7  Florida Statutes to the organizational changes effected by

  8  this act.

  9         Section 6.  This act does not affect the validity of

10  any judicial or administrative proceeding pending as of the

11  effective date of this act, and any entity to which are

12  transferred the powers, duties, and functions of any agency

13  relating to the pending proceedings shall be substituted as a

14  party in interest.

15         Section 7.  This act shall take effect July 1, 1999.

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

                                  13