Senate Bill 0880c1

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    Florida Senate - 1999                            CS for SB 880

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Myers




    317-1781A-99

  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         judicial and administrative proceedings;

26         providing an effective date.

27

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

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30         Section 1.  Section 20.42, Florida Statutes, 1998

31  Supplement, is amended to read:

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    Florida Senate - 1999                            CS for SB 880
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  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. The executive director shall serve at the

15  pleasure of and report to the Governor, subject to

16  confirmation by the Senate. The requirement for Senate

17  confirmation applies to any person appointed on or after

18  October 1, 1999.

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

20  organized as follows:

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

22  Assurance, which shall be responsible for health facility

23  licensure and inspection, managed competition, managed care,

24  and certificate-of-need program.

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

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

27  for Health Statistics, the development of The Florida Health

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

29  under s. 408.033, and research and analysis.

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

31  Purchasing shall be responsible for the Medicaid program. The

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    Florida Senate - 1999                            CS for SB 880
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  1  division shall also administer the Florida Kidcare program

  2  contracts with the Florida Health Access Corporation program

  3  and the Florida Health Care Purchasing Cooperative and the

  4  contract with the Florida Healthy Kids Corporation.

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

  6  Administrative Services, which shall be responsible for

  7  finance and accounting revenue management, budget, personnel,

  8  and general services, management information services, and the

  9  State Center for Health Statistics.

10         (3)  DEPUTY DIRECTOR FOR MANAGED CARE AND HEALTH

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

12  Director for Managed Care and Health Quality Assurance who

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

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

15  Care and Health Quality Assurance shall be responsible for the

16  Division of Managed Care and Health Quality Assurance.

17         (4)  DEPUTY DIRECTOR FOR HEALTH POLICY AND COST

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

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

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

21  Director for Health Policy and Cost Control shall be

22  responsible for the Division of Health Policy and Cost

23  Control.

24         (4)(5)  DEPUTY DIRECTOR FOR MEDICAID STATE HEALTH

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

26  Director for Medicaid State Health Purchasing who shall serve

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

28  executive director. The Deputy Director for Medicaid State

29  Health Purchasing shall be responsible for the Division of

30  Medicaid State Health Purchasing.

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  1         (5)(6)  DEPUTY DIRECTOR FOR ADMINISTRATION AND

  2  INFORMATION OF ADMINISTRATIVE SERVICES.--The executive

  3  director shall appoint a Deputy Director for Administration

  4  and Information of Administrative Services who shall serve at

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

  6  director. The Deputy Director for Administration and

  7  Information Services shall be responsible for the Division of

  8  Administration and Information Administrative Services.

  9         Section 2.  Section 20.43, Florida Statutes, 1998

10  Supplement, is amended to read:

11         20.43  Department of Health Care.--There is created a

12  Department of Health Care.

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

14  promote and protect the health of all residents and visitors

15  in the state through organized state and community efforts,

16  including cooperative agreements with counties.  The

17  department shall:

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

19  occurrence and progression of communicable and noncommunicable

20  diseases and disabilities.

21         (b)  Maintain a constant surveillance of disease

22  occurrence and accumulate health statistics necessary to

23  establish disease trends and to design health programs.

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

25  and formulate preventive strategies.

26         (d)  Promote the maintenance and improvement of the

27  environment as it affects public health.

28         (e)  Promote the maintenance and improvement of health

29  in the residents of the state.

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

  2  and private sectors, in establishing statewide and community

  3  public health delivery systems.

  4         (g)  Provide health care and early intervention

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

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

  7  conditions or have chronic illnesses.

  8         (h)  Provide services to abused and neglected children

  9  through child protection teams and sexual abuse treatment

10  programs.

11         (i)  Develop working associations with all agencies and

12  organizations involved and interested in health and health

13  care delivery.

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

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

16  health delivery systems.

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

18  data accumulated by state agencies related to health care;

19  analyze that data and issue periodic reports and policy

20  statements, as appropriate; require that all aggregated data

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

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

23  provide technical assistance as required; and work

24  cooperatively with the state's higher education programs to

25  promote further study and analysis of health care systems and

26  health care outcomes.

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

28  health plan that assesses current health programs, systems,

29  and costs; makes projections of future problems and

30  opportunities; and recommends changes needed in the health

31  care system to improve the public health.

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  1         (m)  Regulate health practitioners, to the extent

  2  authorized by the Legislature, as necessary for the

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

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

  5  Secretary of Health Care and State Health Officer.  The

  6  secretary must be a physician licensed under chapter 458 or

  7  chapter 459 who has advanced training or extensive experience

  8  in public health administration.  The secretary is appointed

  9  by the Governor subject to confirmation by the Senate.  The

10  secretary serves at the pleasure of the Governor.

11         (3)  The following divisions of the Department of

12  Health Care are established. Each division is under the direct

13  supervision of a division director appointed by the

14  secretary.:

15         (a)  Division of Administration.

16         (b)  Division of Environmental Health.

17         (c)  Division of Disease Control.

18         (d)  Division of Family Health Services.

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

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

21  Workforce Development.

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

23  responsible for the following boards and professions

24  established within the division:

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

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

27  402.48.

28         3.  The Board of Acupuncture, created under chapter

29  457.

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

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    Florida Senate - 1999                            CS for SB 880
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  1         5.  The Board of Osteopathic Medicine, created under

  2  chapter 459.

  3         6.  The Board of Chiropractic Medicine, created under

  4  chapter 460.

  5         7.  The Board of Podiatric Medicine, created under

  6  chapter 461.

  7         8.  Naturopathy, as provided under chapter 462.

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

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

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

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

12         13.  Midwifery, as provided under chapter 467.

13         14.  The Board of Speech-Language Pathology and

14  Audiology, created under part I of chapter 468.

15         15.  The Board of Nursing Home Administrators, created

16  under part II of chapter 468.

17         16.  The Board of Occupational Therapy, created under

18  part III of chapter 468.

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

20  chapter 468.

21         18.  Dietetics and nutrition practice, as provided

22  under part X of chapter 468.

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

24  chapter 468.

25         20.  The Board of Orthotists and Prosthetists, created

26  under part XIV of chapter 468.

27         21.  Electrolysis, as provided under chapter 478.

28         22.  The Board of Massage Therapy, created under

29  chapter 480.

30         23.  The Board of Clinical Laboratory Personnel,

31  created under part III of chapter 483.

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

  2  chapter 483.

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

  4  chapter 484.

  5         26.  The Board of Hearing Aid Specialists, created

  6  under part II of chapter 484.

  7         27.  The Board of Physical Therapy Practice, created

  8  under chapter 486.

  9         28.  The Board of Psychology, created under chapter

10  490.

11         29.  School psychologists, as provided under chapter

12  490.

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

14  Family Therapy, and Mental Health Counseling, created under

15  chapter 491.

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17  The department may contract with the Agency for Health Care

18  Administration who shall provide consumer complaint,

19  investigative, and prosecutorial services required by the

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

21  appropriate.

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

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

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

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

26  4-year terms, and such terms shall expire on October 31.

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

28  that:

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

30  same calendar year for boards consisting of seven or eight

31  members.

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    Florida Senate - 1999                            CS for SB 880
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  1         2.  No more than 3 members' terms expire during the

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

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

  4  same calendar year for boards consisting of 13 or more

  5  members.

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

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

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

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

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

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

13  terms of the member's own appointment thereafter.

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

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

16  members or practitioners of the profession regulated by such

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

18  fewer than five members shall have at least one consumer

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

20  practitioner of the profession regulated by such board or of

21  any closely related profession.

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

23  department is authorized to establish uniform application

24  forms and certificates of licensure for use by the boards

25  within the department.  Nothing in this paragraph authorizes

26  the department to vary any substantive requirements, duties,

27  or eligibilities for licensure or certification as provided by

28  law.

29         (5)  The department shall plan and administer its

30  public health programs through its county health departments

31  and may, for administrative purposes and efficient service

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    Florida Senate - 1999                            CS for SB 880
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  1  delivery, establish up to 15 service areas to carry out such

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

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

  4  the districts of the health and human services boards

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

  6  take into consideration the boundaries of the jobs and

  7  education regional boards.

  8         (6)  The secretary and division directors are

  9  authorized to appoint ad hoc advisory committees as necessary.

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

11  and the timeframe within which the committee is to complete

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

13  appointed. Ad hoc advisory committees shall include

14  representatives of groups or entities affected by the issue or

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

16  hoc advisory committees shall receive no compensation, but

17  may, within existing departmental resources, receive

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

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

20  department may use state or federal funds to:

21         (a)  Provide incentives, including food coupons or

22  payment for travel expenses, for encouraging disease

23  prevention and patient compliance with medical treatment, such

24  as tuberculosis therapy.

25         (b)  Plan and conduct health education campaigns for

26  the purpose of protecting or improving public health. The

27  department may purchase promotional items and advertising,

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

29  television time, for health information and promotional

30  messages that recognize that the following behaviors, among

31  others, are detrimental to public health: unprotected sexual

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

  2  alcohol consumption or other substance abuse during pregnancy;

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

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

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

  6  diabetes, high blood pressure, cardiovascular disease, or

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

  8  Department of Health may establish requirements for local

  9  matching funds or in-kind contributions to create and

10  distribute advertisements, in either print or electronic

11  format, which are concerned with each of the targeted

12  behaviors, establish an independent evaluation and feedback

13  system for the public health communication campaign, and

14  monitor and evaluate the efforts to determine which of the

15  techniques and methodologies are most effective.

16         (c)  Plan and conduct promotional campaigns to recruit

17  health professionals to be employed by the department or to

18  recruit participants in departmental programs for health

19  practitioners, such as scholarship, loan repayment, or

20  volunteer programs. To this effect the department may purchase

21  promotional items and advertising.

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

23  duties, functions, records, personnel, property, and

24  unexpended balances of appropriations, allocations, and other

25  funds of the Agency for Health Care Administration which

26  relate to consumer complaint services, investigations, and

27  prosecutorial services and which are currently provided by the

28  Agency for Health Care Administration under a contract with

29  the Department of Health, are transferred by a type two

30  transfer, as defined in section 20.06(2), Florida Statutes, to

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

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  1  Agency for Health Care Administration for the purpose of

  2  administering or operating such programs are included in this

  3  transfer and shall remain in effect until specifically changed

  4  in the manner provided by law.

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

  6  consumer complaint and investigative services units are

  7  transferred and assigned to the Division of Medical Quality

  8  Assurance of the Department of Health Care.

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

10  prosecutorial unit are transferred and assigned to the Office

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

12         Section 4.  The Secretary of Health Care and the

13  Executive Director of Health Care Administration shall each

14  appoint four staff members to an Organizational Efficiency

15  Advisory Committee. Appointments must be made no later than

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

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

18  committee shall be assigned, for administrative purposes only,

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

20  current activities and make recommendations regarding

21  consolidation of potentially duplicative functions,

22  particularly those relating to administrative services, legal

23  services, information and management information systems, and

24  data and planning services, and any needed modifications in

25  organizational structure. The committee shall report its

26  findings, including recommendations for changes in state

27  policy, rules, and statutes that will improve the

28  administrative efficiency of the Department of Health Care and

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

30  Health Care, the Executive Director of Health Care

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

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

  2  2000.

  3         Section 5.  The Division of Statutory Revision of the

  4  Office of Legislative Services is requested to prepare a

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

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

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

  8  make such further changes as are necessary to conform the

  9  Florida Statutes to the organizational changes effected by

10  this act.

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

12  any judicial or administrative proceeding pending as of the

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

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

15  relating to the pending proceedings shall be substituted as a

16  party in interest.

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

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  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                              SB 880

  3

  4  The Agency for Health Care Administration is reassigned from
    the Department of Business and Professional Regulation to the
  5  Department of Health Care rather than being transferred to the
    Department of Health Care and being incorporated as a division
  6  within the department.

  7  The internal organizational structure of the Agency for Health
    Care Administration is modified and the Executive Director of
  8  Health Care Administration is made subject to Senate
    confirmation.
  9
    Effective July 1, 1999, consumer complaint services,
10  investigations, and prosecutorial services relating to health
    care practitioners which are currently provided by the Agency
11  for Health Care Administration under a contract with the
    Department of Health are transferred by a type two transfer
12  from the agency to the department.

13  A provision is added to the bill that clarifies that the
    validity of judicial or administrative proceedings pending as
14  of the effective date of the act are not affected by the
    transfer and that the Department of Health will be substituted
15  as a party in interest in the pending proceedings.

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