House Bill 2037e1

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                                          HB 2037, First Engrossed



  1                      A bill to be entitled

  2         An act relating to health care; creating the

  3         Public Cord Blood Tissue Bank as a statewide

  4         consortium; providing purposes, membership, and

  5         duties of the consortium; providing duties of

  6         the Agency for Health Care Administration;

  7         providing requirements of specified

  8         state-funded health care programs; providing an

  9         exception from provisions of the act; requiring

10         specified written disclosure by certain health

11         care facilities and providers; specifying that

12         donation under the act is voluntary;

13         authorizing the consortium to charge fees;

14         amending s. 20.42, F.S.; designating the agency

15         as a department; reorganizing the agency and

16         removing it from under the Department of

17         Business and Professional Regulation; providing

18         for appointment of the Secretary of Health Care

19         Administration by the Governor, subject to

20         confirmation by the Senate; providing for

21         responsibilities and administration of the

22         department; amending s. 440.134, F.S.;

23         providing exclusive jurisdiction of the Agency

24         for Health Care Administration over workers'

25         compensation managed care arrangements and

26         exclusive authority to investigate medical

27         services provided under such arrangements;

28         limiting the agency's duties relating to

29         quality of medical care; amending ss. 120.80,

30         215.5601, 381.6023, 381.90, 395.0163,

31         395.10972, 400.0067, 400.235, 400.4415,


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                                          HB 2037, First Engrossed



  1         400.967, 408.036, 408.05, 408.902, 409.8132,

  2         430.710, 478.44, 627.4236, 641.454, 641.60,

  3         641.70, 732.9216, to conform provisions to

  4         changes made by the act; repealing s. 408.001,

  5         F.S., relating to the Florida Health Care

  6         Purchasing Cooperative; providing for repeal on

  7         a date certain or upon the occurrence of a

  8         contingency; transferring all powers, duties,

  9         and functions and funds of the Agency for

10         Health Care Administration of the Department of

11         Business and Professional Regulation to the new

12         department; providing for certain transfer of

13         positions and funds from the Department of

14         Labor and Employment Security; providing an

15         effective date.

16

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

18

19         Section 1.  PUBLIC CORD BLOOD TISSUE BANK.--

20         (1)  There is established a statewide consortium to be

21  known as the Public Cord Blood Tissue Bank. The Public Cord

22  Blood Tissue Bank is established as a nonprofit legal entity

23  to collect, screen for infectious and genetic diseases,

24  perform tissue typing, cryopreserve, and store umbilical cord

25  blood as a resource to the public.  The University of Florida,

26  the University of South Florida, the University of Miami, and

27  the Mayo Clinic, Jacksonville shall jointly form the

28  collaborative consortium, each working with community

29  resources such as regional blood banks, hospitals, and other

30  health care providers to develop local and regional coalitions

31  for the purposes set forth in this act.  The consortium


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                                          HB 2037, First Engrossed



  1  participants shall align their outreach programs and

  2  activities to all geographic areas of the state, covering the

  3  entire state.  The consortium is encouraged to conduct

  4  outreach and research for Hispanics, African Americans, Native

  5  Americans, and other ethnic and racial minorities.

  6         (2)  The Agency for Health Care Administration shall

  7  develop and make available to all health care providers

  8  information relating to and standardized release forms for

  9  donation of umbilical cord blood. The agency and the

10  Department of Health shall encourage health care providers,

11  including, but not limited to, hospitals, birthing facilities,

12  county health departments, physicians, midwives, and nurses,

13  to disseminate information about the Public Cord Blood Tissue

14  Bank.

15         (3)  The Agency for Health Care Administration shall

16  develop training materials for agencies and state employees

17  working with pregnant women to educate and inform pregnant

18  women about the public cord blood tissue bank program.

19         (4)  All state-funded health care programs providing

20  education or services to pregnant women shall provide

21  information on the Public Cord Blood Tissue Bank program.

22  Information regarding this program shall be provided by, but

23  not be limited to, the Healthy Start program, county health

24  departments, Medicaid, and MediPass.

25         (5)  Nothing in this act creates a requirement of any

26  health care or services program that is directly affiliated

27  with a bona fide religious denomination that includes as an

28  integral part of its beliefs and practices the tenet that

29  blood transfer is contrary to the moral principles the

30  denomination considers to be an essential part of its beliefs.

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                                          HB 2037, First Engrossed



  1         (6)  Any health care facility or health care provider

  2  receiving financial remuneration for the collection of

  3  umbilical cord blood shall provide written disclosure of this

  4  information to any woman postpartum or parent of a newborn

  5  from whom the umbilical cord blood is collected prior to the

  6  harvesting of the umbilical cord blood.

  7         (7)  All women admitted to a hospital or birthing

  8  facility for obstetrical services may be offered the

  9  opportunity to donate umbilical cord blood to the Public Cord

10  Blood Tissue Bank.  No woman shall be required to make such a

11  donation.

12         (8)  The consortium may charge reasonable rates and

13  fees to recipients of cord blood tissue bank products.

14         (9)  In order to fund the provisions of this section

15  the consortium participants and the Agency for Health Care

16  Administration shall seek private or federal funds or utilize

17  existing budgetary resources to the extent possible to

18  initiate program actions for fiscal year 2000-2001.

19         Section 2.  Section 20.42, Florida Statutes, is amended

20  to read:

21         20.42  Agency for Health Care Administration.--

22         (1)  There is created a department that,

23  notwithstanding the provisions of subsection 20.04(1), shall

24  be called the Agency for Health Care Administration within the

25  Department of Business and Professional Regulation. The agency

26  shall be a separate budget entity, and the director of the

27  agency shall be the agency head for all purposes. The agency

28  shall not be subject to control, supervision, or direction by

29  the Department of Business and Professional Regulation in any

30  manner, including, but not limited to, personnel, purchasing,

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                                          HB 2037, First Engrossed



  1  transactions involving real or personal property, and

  2  budgetary matters.

  3         (2)(1)  DIRECTOR OF HEALTH CARE ADMINISTRATION.--The

  4  head of the department agency is the Secretary Director of

  5  Health Care Administration, who shall be appointed by the

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

  7  director shall serve at the pleasure of and report to the

  8  Governor.

  9         (3)(2)  ORGANIZATION OF THE AGENCY.--The department

10  agency shall be the chief health policy and planning entity

11  for the state. The department is responsible for health

12  facility licensure, inspection, and regulatory enforcement;

13  investigation of consumer complaints related to health care

14  facilities and managed care plans; the implementation of the

15  certificate of need program; the operation of the State Center

16  for Health Statistics; the administration of the Medicaid

17  program; the administration of the contracts with the Florida

18  Healthy Kids Corporation; the certification of health

19  maintenance organizations and prepaid health clinics as set

20  forth in ch. 641, part III; and any other duties prescribed by

21  statute or agreement. organized as follows:

22         (a)  The Division of Health Quality Assurance, which

23  shall be responsible for health facility licensure and

24  inspection.

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         (c)  The Division of State Health Purchasing shall be

31  responsible for the Medicaid program. The division shall also


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                                          HB 2037, First Engrossed



  1  administer the contracts with the Florida Health Access

  2  Corporation program and the Florida Health Care Purchasing

  3  Cooperative and the Florida Healthy Kids Corporation.

  4         (d)  The Division of Administrative Services, which

  5  shall be responsible for revenue management, budget,

  6  personnel, and general services.

  7         (3)  DEPUTY DIRECTOR FOR HEALTH QUALITY ASSURANCE.--The

  8  director shall appoint a Deputy Director for Health Quality

  9  Assurance who shall serve at the pleasure of, and be directly

10  responsible to, the director. The Deputy Director for Health

11  Quality Assurance shall be responsible for the Division of

12  Health Quality Assurance.

13         (4)  DEPUTY DIRECTOR FOR HEALTH POLICY AND COST

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

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

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

17  Director for Health Policy and Cost Control shall be

18  responsible for the Division of Health Policy and Cost

19  Control.

20         (5)  DEPUTY DIRECTOR FOR STATE HEALTH PURCHASING.--The

21  director shall appoint a Deputy Director for State Health

22  Purchasing who shall serve at the pleasure of, and be directly

23  responsible to, the director. The Deputy Director for State

24  Health Purchasing shall be responsible for the Division of

25  State Health Purchasing.

26         (6)  DEPUTY DIRECTOR OF ADMINISTRATIVE SERVICES.--The

27  director shall appoint a Deputy Director of Administrative

28  Services who shall serve at the pleasure of, and be directly

29  responsible to, the director. The deputy director shall be

30  responsible for the Division of Administrative Services.

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                                          HB 2037, First Engrossed



  1         Section 3.  Paragraph (a) of subsection (2) of section

  2  440.134, Florida Statutes, is amended to read:

  3         440.134  Workers' compensation managed care

  4  arrangement.--

  5         (2)(a)  The agency shall, beginning April 1, 1994,

  6  authorize an insurer to offer or utilize a workers'

  7  compensation managed care arrangement after the insurer files

  8  a completed application along with the payment of a $1,000

  9  application fee, and upon the agency's being satisfied that

10  the applicant has the ability to provide quality of care

11  consistent with the prevailing professional standards of care

12  and the insurer and its workers' compensation managed care

13  arrangement otherwise meets the requirements of this section.

14  Effective April 1, 1994, No insurer may offer or utilize a

15  managed care arrangement without such authorization. The

16  authorization, unless sooner suspended or revoked, shall

17  automatically expire 2 years after the date of issuance unless

18  renewed by the insurer. The authorization shall be renewed

19  upon application for renewal and payment of a renewal fee of

20  $1,000, provided that the insurer is in compliance with the

21  requirements of this section and any rules adopted hereunder.

22  An application for renewal of the authorization shall be made

23  90 days prior to expiration of the authorization, on forms

24  provided by the agency. The renewal application shall not

25  require the resubmission of any documents previously filed

26  with the agency if such documents have remained valid and

27  unchanged since their original filing. The agency shall have

28  exclusive jurisdiction over workers' compensation managed care

29  arrangements and shall have exclusive authority to investigate

30  the quality of medical services provided by a workers'

31  compensation managed care arrangement. When reviewing the


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                                          HB 2037, First Engrossed



  1  quality of medical services offered by or provided through a

  2  workers' compensation managed care arrangement, the agency

  3  shall only review issues related to the managed care

  4  arrrangement as a whole, pertaining to the ability of the

  5  managed care arrangement to provide quality of care as

  6  required herein. The agency shall not interpret managed care

  7  arrangements as they pertain to an individual employee.

  8         Section 4.  Subsection (15) of section 120.80, Florida

  9  Statutes, is amended to read:

10         120.80  Exceptions and special requirements;

11  agencies.--

12         (15)  DEPARTMENT OF HEALTH.--Notwithstanding s.

13  120.57(1)(a), formal hearings may not be conducted by the

14  Secretary of Health, the Secretary of director of the Agency

15  for Health Care Administration, or a board or member of a

16  board within the Department of Health or the Agency for Health

17  Care Administration for matters relating to the regulation of

18  professions, as defined by part II of chapter 455.

19  Notwithstanding s. 120.57(1)(a), hearings conducted within the

20  Department of Health in execution of the Special Supplemental

21  Nutrition Program for Women, Infants, and Children; Child Care

22  Food Program; Children's Medical Services Program; and the

23  exemption from disqualification reviews for certified nurse

24  assistants program need not be conducted by an administrative

25  law judge assigned by the division. The Department of Health

26  may contract with the Department of Children and Family

27  Services for a hearing officer in these matters.

28         Section 5.  Paragraph (d) of subsection (4) of section

29  215.5601, Florida Statutes, is amended to read:

30         215.5601  Lawton Chiles Endowment Fund.--

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                                          HB 2037, First Engrossed



  1         (4)  LAWTON CHILES ENDOWMENT FUND; CREATION; PURPOSES

  2  AND USES.--

  3         (d)  The Secretary of Health, the Secretary of Children

  4  and Family Services, the Secretary of Elderly Affairs, and the

  5  Secretary Director of Health Care Administration shall conduct

  6  meetings to discuss program priorities for endowment funding

  7  prior to submitting their budget requests to the Executive

  8  Office of the Governor and the Legislature. The purpose of the

  9  meetings shall be to gain consensus for priority requests and

10  recommended endowment funding levels for those priority

11  requests. An agency head may not designate a proxy for these

12  meetings.

13         Section 6.  Subsections (2), (3) and (7) of section

14  381.0602, Florida Statutes, are amended to read:

15         381.0602  Organ Transplant Advisory Council;

16  membership; responsibilities.--

17         (2)  The Secretary Director of Health Care

18  Administration shall appoint all members of the council to

19  serve a term of 2 years.

20         (3)  The Secretary Director of Health Care

21  Administration shall fill each vacancy on the council for the

22  balance of the unexpired term. Priority consideration must be

23  given to the appointment of an individual whose primary

24  interest, experience, or expertise lies with clients of the

25  Department of Health and the agency. If an appointment is not

26  made within 120 days after a vacancy occurs on the council,

27  the vacancy must be filled by the majority vote of the

28  council.

29         (7)  The council shall meet at least annually or upon

30  the call of the chairperson or the Secretary Director of

31  Health Care Administration.


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                                          HB 2037, First Engrossed



  1         Section 7.  Subsection (1) of section 381.6023, Florida

  2  Statutes, is amended to read:

  3         381.6023  Organ and Tissue Procurement and

  4  Transplantation Advisory Board; creation; duties.--

  5         (1)  There is hereby created the Organ and Tissue

  6  Procurement and Transplantation Advisory Board, which shall

  7  consist of 14 members who are appointed by and report directly

  8  to the Secretary Director of Health Care Administration. The

  9  membership must be regionally distributed and must include:

10         (a)  Two representatives who have expertise in vascular

11  organ transplant surgery;

12         (b)  Two representatives who have expertise in vascular

13  organ procurement, preservation, and distribution;

14         (c)  Two representatives who have expertise in

15  musculoskeletal tissue transplant surgery;

16         (d)  Two representatives who have expertise in

17  musculoskeletal tissue procurement, processing, and

18  distribution;

19         (e)  A representative who has expertise in eye and

20  cornea transplant surgery;

21         (f)  A representative who has expertise in eye and

22  cornea procurement, processing, and distribution;

23         (g)  A representative who has expertise in bone marrow

24  procurement, processing, and transplantation;

25         (h)  A representative from the Florida Pediatric

26  Society;

27         (i)  A representative from the Florida Society of

28  Pathologists; and

29         (j)  A representative from the Florida Medical

30  Examiners Commission.

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                                          HB 2037, First Engrossed



  1         Section 8.  Subsection (3) of section 381.90, Florida

  2  Statutes, is amended to read:

  3         381.90  Health Information Systems Council; legislative

  4  intent; creation, appointment, duties.--

  5         (3)  The council shall be composed of the following

  6  members or their senior executive-level designees:

  7         (a)  The secretary of the Department of Health;

  8         (b)  The secretary of the Department of Business and

  9  Professional Regulation;

10         (c)  The secretary of the Department of Children and

11  Family Services;

12         (d)  The secretary of director of the Agency for Health

13  Care Administration;

14         (e)  The secretary of the Department of Corrections;

15         (f)  The Attorney General;

16         (g)  The executive director of the Correctional Medical

17  Authority;

18         (h)  Two members representing county health

19  departments, one from a small county and one from a large

20  county, appointed by the Governor;

21         (i)  A representative from the Florida Association of

22  Counties;

23         (j)  The State Treasurer and Insurance Commissioner;

24         (k)  A representative from the Florida Healthy Kids

25  Corporation;

26         (l)  A representative from a school of public health

27  chosen by the Board of Regents;

28         (m)  The Commissioner of Education;

29         (n)  The secretary of the Department of Elderly

30  Affairs; and

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                                          HB 2037, First Engrossed



  1         (o)  The secretary of the Department of Juvenile

  2  Justice.

  3

  4  Representatives of the Federal Government may serve without

  5  voting rights.

  6         Section 9.  Paragraph (a) of subsection (1) of section

  7  395.0163, Florida Statutes, is amended to read:

  8         395.0163  Construction inspections; plan submission and

  9  approval; fees.--

10         (1)(a)  The agency shall make, or cause to be made,

11  such construction inspections and investigations as it deems

12  necessary. The agency may prescribe by rule that any licensee

13  or applicant desiring to make specified types of alterations

14  or additions to its facilities or to construct new facilities

15  shall, before commencing such alteration, addition, or new

16  construction, submit plans and specifications therefor to the

17  agency for preliminary inspection and approval or

18  recommendation with respect to compliance with agency rules

19  and standards.  The agency shall approve or disapprove the

20  plans and specifications within 60 days after receipt of the

21  fee for review of plans as required in subsection (2).  The

22  agency may be granted one 15-day extension for the review

23  period if the secretary director of the agency approves the

24  extension. If the agency fails to act within the specified

25  time, it shall be deemed to have approved the plans and

26  specifications.  When the agency disapproves plans and

27  specifications, it shall set forth in writing the reasons for

28  its disapproval. Conferences and consultations may be provided

29  as necessary.

30         Section 10.  Section 395.10972, Florida Statutes, is

31  amended to read:


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                                          HB 2037, First Engrossed



  1         395.10972  Health Care Risk Manager Advisory

  2  Council.--The Secretary Director of Health Care Administration

  3  may appoint a five-member advisory council to advise the

  4  agency on matters pertaining to health care risk managers. The

  5  members of the council shall serve at the pleasure of the

  6  secretary director. The council shall designate a chair. The

  7  council shall meet at the call of the secretary director or at

  8  those times as may be required by rule of the agency.  The

  9  members of the advisory council shall receive no compensation

10  for their services, but shall be reimbursed for travel

11  expenses as provided in s. 112.061. The council shall consist

12  of individuals representing the following areas:

13         (1)  Two shall be active health care risk managers.

14         (2)  One shall be an active hospital administrator.

15         (3)  One shall be an employee of an insurer or

16  self-insurer of medical malpractice coverage.

17         (4)  One shall be a representative of the

18  health-care-consuming public.

19         Section 11.  Paragraph (h) of subsection (2) of section

20  400.0067, Florida Statutes, is amended to read:

21         400.0067  Establishment of State Long-Term Care

22  Ombudsman Council; duties; membership.--

23         (2)  The State Long-Term Care Ombudsman Council shall:

24         (h)  Prepare an annual report describing the activities

25  carried out by the ombudsman and the State Long-Term Care

26  Ombudsman Council in the year for which the report is

27  prepared.  The State Long-Term Care Ombudsman Council shall

28  submit the report to the Commissioner of the United States

29  Administration on Aging, the Governor, the President of the

30  Senate, the Speaker of the House of Representatives, the

31  minority leaders of the House and Senate, the chairpersons of


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                                          HB 2037, First Engrossed



  1  appropriate House and Senate committees, the Secretaries of

  2  Elderly Affairs and Children and Family Services, and the

  3  Secretary Director of Health Care Administration. The report

  4  shall be submitted at least 30 days before the convening of

  5  the regular session of the Legislature and shall, at a

  6  minimum:

  7         1.  Contain and analyze data collected concerning

  8  complaints about and conditions in long-term care facilities.

  9         2.  Evaluate the problems experienced by residents of

10  long-term care facilities.

11         3.  Contain recommendations for improving the quality

12  of life of the residents and for protecting the health,

13  safety, welfare, and rights of the residents.

14         4.  Analyze the success of the ombudsman program during

15  the preceding year and identify the barriers that prevent the

16  optimal operation of the program.  The report of the program's

17  successes shall also address the relationship between the

18  state long-term care ombudsman program, the Department of

19  Elderly Affairs, the Agency for Health Care Administration,

20  and the Department of Children and Family Services, and an

21  assessment of how successfully the state long-term care

22  ombudsman program has carried out its responsibilities under

23  the Older Americans Act.

24         5.  Provide policy and regulatory and legislative

25  recommendations to solve identified problems; resolve

26  residents' complaints; improve the quality of care and life of

27  the residents; protect the health, safety, welfare, and rights

28  of the residents; and remove the barriers to the optimal

29  operation of the state long-term care ombudsman program.

30         6.  Contain recommendations from the district ombudsman

31  councils regarding program functions and activities.


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                                          HB 2037, First Engrossed



  1         7.  Include a report on the activities of the legal

  2  advocate and other legal advocates acting on behalf of the

  3  district and state councils.

  4         Section 12.  Paragraph (a) of subsection (3) of section

  5  400.235, Florida Statutes, is amended to read:

  6         400.235  Nursing home quality and licensure status;

  7  Gold Seal Program.--

  8         (3)(a)  The Gold Seal Program shall be developed and

  9  implemented by the Governor's Panel on Excellence in Long-Term

10  Care which shall operate under the authority of the Executive

11  Office of the Governor. The panel shall be composed of three

12  persons appointed by the Governor, to include a consumer

13  advocate for senior citizens and two persons with expertise in

14  the fields of quality management, service delivery excellence,

15  or public sector accountability; three persons appointed by

16  the Secretary of Elderly Affairs, to include an active member

17  of a nursing facility family and resident care council and a

18  member of the University Consortium on Aging; the State

19  Long-Term Care Ombudsman; one person appointed by the Florida

20  Life Care Residents Association; one person appointed by the

21  Secretary of Health; two persons appointed by the Secretary

22  Director of Health Care Administration, to include the Deputy

23  Director for State Health Purchasing; one person appointed by

24  the Florida Association of Homes for the Aging; and one person

25  appointed by the Florida Health Care Association. All members

26  of the panel shall be appointed by October 1, 1999, and the

27  panel shall hold its organizational meeting no later than

28  December 10, 1999. Vacancies on the panel shall be filled in

29  the same manner as the original appointments. No member shall

30  serve for more than 4 consecutive years from the date of

31  appointment.


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                                          HB 2037, First Engrossed



  1         Section 13.  Subsection (1) of section 400.4415,

  2  Florida Statutes, is amended to read:

  3         400.4415  Assisted living facilities advisory

  4  committee.--

  5         (1)  There is created the assisted living facilities

  6  advisory committee, which shall assist the agency in

  7  developing and implementing a pilot rating system for

  8  facilities. The committee shall consist of nine members who

  9  are to be appointed by, and report directly to, the secretary

10  director of the agency.  The membership is to include:

11         (a)  One researcher from a university center on aging.

12         (b)  One representative from the Florida Health Care

13  Association.

14         (c)  One representative from the Florida Assisted

15  Living Association.

16         (d)  One representative from the Florida Association of

17  Homes for the Aging.

18         (e)  One representative from the Agency for Health Care

19  Administration.

20         (f)  One representative from the adult services program

21  of the Department of Children and Family Services.

22         (g)  One representative from the alcohol, drug abuse,

23  and mental health program of the Department of Children and

24  Family Services.

25         (h)  One representative from the Department of Elderly

26  Affairs.

27         (i)  One consumer representative from a district

28  long-term care ombudsman council.

29         Section 14.  Subsection (5) of section 400.967, Florida

30  Statutes, is amended to read:

31         400.967  Rules and classification of deficiencies.--


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                                          HB 2037, First Engrossed



  1         (5)  The agency shall approve or disapprove the plans

  2  and specifications within 60 days after receipt of the final

  3  plans and specifications. The agency may be granted one 15-day

  4  extension for the review period, if the secretary director of

  5  the agency so approves. If the agency fails to act within the

  6  specified time, it is deemed to have approved the plans and

  7  specifications. When the agency disapproves plans and

  8  specifications, it must set forth in writing the reasons for

  9  disapproval. Conferences and consultations may be provided as

10  necessary.

11         Section 15.  Subsection (3) of section 408.036, Florida

12  Statutes, is amended to read:

13         408.036  Projects subject to review.--

14         (3)  EXEMPTIONS.--Upon request, supported by such

15  documentation as the agency requires, the agency shall grant

16  an exemption from the provisions of subsection (1):

17         (a)  For the initiation or expansion of obstetric

18  services.

19         (b)  For any expenditure to replace or renovate any

20  part of a licensed health care facility, provided that the

21  number of licensed beds will not increase and, in the case of

22  a replacement facility, the project site is the same as the

23  facility being replaced.

24         (c)  For providing respite care services. An individual

25  may be admitted to a respite care program in a hospital

26  without regard to inpatient requirements relating to admitting

27  order and attendance of a member of a medical staff.

28         (d)  For hospice services or home health services

29  provided by a rural hospital, as defined in s. 395.602, or for

30  swing beds in such rural hospital in a number that does not

31  exceed one-half of its licensed beds.


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                                          HB 2037, First Engrossed



  1         (e)  For the conversion of licensed acute care hospital

  2  beds to Medicare and Medicaid certified skilled nursing beds

  3  in a rural hospital as defined in s. 395.602, so long as the

  4  conversion of the beds does not involve the construction of

  5  new facilities. The total number of skilled nursing beds,

  6  including swing beds, may not exceed one-half of the total

  7  number of licensed beds in the rural hospital as of July 1,

  8  1993. Certified skilled nursing beds designated under this

  9  paragraph, excluding swing beds, shall be included in the

10  community nursing home bed inventory.  A rural hospital which

11  subsequently decertifies any acute care beds exempted under

12  this paragraph shall notify the agency of the decertification,

13  and the agency shall adjust the community nursing home bed

14  inventory accordingly.

15         (f)  For the addition of nursing home beds at a skilled

16  nursing facility that is part of a retirement community that

17  provides a variety of residential settings and supportive

18  services and that has been incorporated and operated in this

19  state for at least 65 years on or before July 1, 1994. All

20  nursing home beds must not be available to the public but must

21  be for the exclusive use of the community residents.

22         (g)  For an increase in the bed capacity of a nursing

23  facility licensed for at least 50 beds as of January 1, 1994,

24  under part II of chapter 400 which is not part of a continuing

25  care facility if, after the increase, the total licensed bed

26  capacity of that facility is not more than 60 beds and if the

27  facility has been continuously licensed since 1950 and has

28  received a superior rating on each of its two most recent

29  licensure surveys.

30         (h)  For the establishment of a Medicare-certified home

31  health agency by a facility certified under chapter 651; a


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                                          HB 2037, First Engrossed



  1  retirement community, as defined in s. 400.404(2)(g); or a

  2  residential facility that serves only retired military

  3  personnel, their dependents, and the surviving dependents of

  4  deceased military personnel. Medicare-reimbursed home health

  5  services provided through such agency shall be offered

  6  exclusively to residents of the facility or retirement

  7  community or to residents of facilities or retirement

  8  communities owned, operated, or managed by the same corporate

  9  entity. Each visit made to deliver Medicare-reimbursable home

10  health services to a home health patient who, at the time of

11  service, is not a resident of the facility or retirement

12  community shall be a deceptive and unfair trade practice and

13  constitutes a violation of ss. 501.201-501.213.

14         (i)  For the establishment of a Medicare-certified home

15  health agency. This paragraph shall take effect 90 days after

16  the adjournment sine die of the next regular session of the

17  Legislature occurring after the legislative session in which

18  the Legislature receives a report from the Secretary Director

19  of Health Care Administration certifying that the federal

20  Health Care Financing Administration has implemented a

21  per-episode prospective pay system for Medicare-certified home

22  health agencies.

23         (j)  For an inmate health care facility built by or for

24  the exclusive use of the Department of Corrections as provided

25  in chapter 945. This exemption expires when such facility is

26  converted to other uses.

27         (k)  For an expenditure by or on behalf of a health

28  care facility to provide a health service exclusively on an

29  outpatient basis.

30         (l)  For the termination of a health care service.

31


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                                          HB 2037, First Engrossed



  1         (m)  For the delicensure of beds. An application

  2  submitted under this paragraph must identify the number, the

  3  classification, and the name of the facility in which the beds

  4  to be delicensed are located.

  5         (n)  For the provision of adult inpatient diagnostic

  6  cardiac catheterization services in a hospital.

  7         1.  In addition to any other documentation otherwise

  8  required by the agency, a request for an exemption submitted

  9  under this paragraph must comply with the following criteria:

10         a.  The applicant must certify it will not provide

11  therapeutic cardiac catheterization pursuant to the grant of

12  the exemption.

13         b.  The applicant must certify it will meet and

14  continuously maintain the minimum licensure requirements

15  adopted by the agency governing such programs pursuant to

16  subparagraph 2.

17         c.  The applicant must certify it will provide a

18  minimum of 2 percent of its services to charity and Medicaid

19  patients.

20         2.  The agency shall adopt licensure requirements by

21  rule which govern the operation of adult inpatient diagnostic

22  cardiac catheterization programs established pursuant to the

23  exemption provided in this paragraph. The rules shall ensure

24  that such programs:

25         a.  Perform only adult inpatient diagnostic cardiac

26  catheterization services authorized by the exemption and will

27  not provide therapeutic cardiac catheterization or any other

28  services not authorized by the exemption.

29         b.  Maintain sufficient appropriate equipment and

30  health personnel to ensure quality and safety.

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                                          HB 2037, First Engrossed



  1         c.  Maintain appropriate times of operation and

  2  protocols to ensure availability and appropriate referrals in

  3  the event of emergencies.

  4         d.  Maintain appropriate program volumes to ensure

  5  quality and safety.

  6         e.  Provide a minimum of 2 percent of its services to

  7  charity and Medicaid patients each year.

  8         3.a.  The exemption provided by this paragraph shall

  9  not apply unless the agency determines that the program is in

10  compliance with the requirements of subparagraph 1. and that

11  the program will, after beginning operation, continuously

12  comply with the rules adopted pursuant to subparagraph 2.  The

13  agency shall monitor such programs to ensure compliance with

14  the requirements of subparagraph 2.

15         b.(I)  The exemption for a program shall expire

16  immediately when the program fails to comply with the rules

17  adopted pursuant to sub-subparagraphs 2.a., b., and c.

18         (II)  Beginning 18 months after a program first begins

19  treating patients, the exemption for a program shall expire

20  when the program fails to comply with the rules adopted

21  pursuant to sub-subparagraphs 2.d. and e.

22         (III)  If the exemption for a program expires pursuant

23  to sub-sub-subparagraph (I) or sub-sub-subparagraph (II), the

24  agency shall not grant an exemption pursuant to this paragraph

25  for an adult inpatient diagnostic cardiac catheterization

26  program located at the same hospital until 2 years following

27  the date of the determination by the agency that the program

28  failed to comply with the rules adopted pursuant to

29  subparagraph 2.

30         4.  The agency shall not grant any exemption under this

31  paragraph until the adoption of the rules required under this


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                                          HB 2037, First Engrossed



  1  paragraph, or until March 1, 1998, whichever comes first.

  2  However, if final rules have not been adopted by March 1,

  3  1998, the proposed rules governing the exemptions shall be

  4  used by the agency to grant exemptions under the provisions of

  5  this paragraph until final rules become effective.

  6         (o)  For any expenditure to provide mobile surgical

  7  facilities and related health care services under contract

  8  with the Department of Corrections or a private correctional

  9  facility operating pursuant to chapter 957.

10         (p)  For state veterans' nursing homes operated by or

11  on behalf of the Florida Department of Veterans' Affairs in

12  accordance with part II of chapter 296 for which at least 50

13  percent of the construction cost is federally funded and for

14  which the Federal Government pays a per diem rate not to

15  exceed one-half of the cost of the veterans' care in such

16  state nursing homes. These beds shall not be included in the

17  nursing home bed inventory.

18

19  A request for exemption under this subsection may be made at

20  any time and is not subject to the batching requirements of

21  this section.

22         Section 16.  Paragraph (a) of subsection (8) of section

23  408.05, Florida Statutes, is amended to read:

24         408.05  State Center for Health Statistics.--

25         (8)  STATE COMPREHENSIVE HEALTH INFORMATION SYSTEM

26  ADVISORY COUNCIL.--

27         (a)  There is established in the agency the State

28  Comprehensive Health Information System Advisory Council to

29  assist the center in reviewing the comprehensive health

30  information system and to recommend improvements for such

31  system. The council shall consist of the following members:


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                                          HB 2037, First Engrossed



  1         1.  An employee of the Executive Office of the

  2  Governor, to be appointed by the Governor.

  3         2.  An employee of the Department of Insurance, to be

  4  appointed by the Insurance Commissioner.

  5         3.  An employee of the Department of Education, to be

  6  appointed by the Commissioner of Education.

  7         4.  Ten persons, to be appointed by the Secretary

  8  Director of Health Care Administration, representing other

  9  state and local agencies, state universities, the Florida

10  Association of Business/Health Coalitions, local health

11  councils, professional health-care-related associations,

12  consumers, and purchasers.

13         Section 17.  Subsection (1) of section 408.902, Florida

14  Statutes, is amended to read:

15         408.902  MedAccess program; creation; program title.--

16         (1)  Effective July 1, 1994, there is hereby created

17  the MedAccess program to be administered by the Agency for

18  Health Care Administration.  The MedAccess program shall not

19  be subject to the requirements of the Department of Insurance

20  or chapter 627. The secretary director of the agency shall

21  appoint an administrator of the MedAccess program which shall

22  be located in the Division of State Health Purchasing.

23         Section 18.  Subsection (2) of section 409.8132,

24  Florida Statutes, is amended to read:

25         409.8132  Medikids program component.--

26         (2)  ADMINISTRATION.--The secretary director of the

27  agency shall appoint an administrator of the Medikids program

28  component, which shall be located in the Division of State

29  Health Purchasing.  The Agency for Health Care Administration

30  is designated as the state agency authorized to make payments

31  for medical assistance and related services for the Medikids


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                                          HB 2037, First Engrossed



  1  program component of the Florida Kidcare program. Payments

  2  shall be made, subject to any limitations or directions in the

  3  General Appropriations Act, only for covered services provided

  4  to eligible children by qualified health care providers under

  5  the Florida Kidcare program.

  6         Section 19.  Subsection (1) of section 430.710, Florida

  7  Statutes, is amended to read:

  8         430.710  Long-term care interagency advisory council.--

  9         (1)  The long-term care interagency advisory council is

10  created within the Department of Elderly Affairs to advise the

11  secretary of the department on matters related to the

12  long-term care community diversion pilot projects.  The

13  department and the agency shall provide staff support to the

14  council, as determined by the secretary of the department and

15  the secretary director of the agency.

16         (a)  The Secretary of the Department of Children and

17  Family Services shall appoint four members, one each to

18  represent the following:

19         1.  Consumers, or family or guardians of consumers, of

20  optional state supplementation, adult protective services,

21  developmental services, or mental health services from the

22  department.

23         2.  Providers of community-based services.

24         3.  Consumer advocacy organizations.

25         4.  Consumers, or representatives of consumers, who

26  have nonage related physical disabilities.

27         (b)  The Secretary of the Department of Elderly Affairs

28  shall appoint five members, one each to represent the

29  following:

30         1.  The nursing home industry.

31         2.  The assisted living industry.


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                                          HB 2037, First Engrossed



  1         3.  Consumers of long-term care services.

  2         4.  Providers of community-based services.

  3         5.  Area Agencies on Aging.

  4         (c)  The Commissioner of Insurance shall appoint one

  5  member to represent the insurance industry.

  6         (d)  The Secretary of Director of the Agency for Health

  7  Care Administration shall appoint three members, one each to

  8  represent the following:

  9         1.  The hospital industry.

10         2.  The home health industry.

11         3.  Health maintenance organizations.

12         Section 20.  Paragraph (c) of subsection (4) of section

13  478.44, Florida Statutes, is amended to read:

14         478.44  Electrolysis Council; creation; function;

15  powers and duties.--

16         (4)

17         (c)  Unless otherwise provided by law, a council member

18  shall be compensated $50 for each day the member attends an

19  official meeting of the council or participates in official

20  council business.  A council member is also entitled to

21  reimbursement for expenses pursuant to s. 112.061. Travel out

22  of state requires the prior approval of the Secretary Director

23  of Health Care Administration.

24         Section 21.  Subsection (3) of section 627.4236,

25  Florida Statutes, is amended to read:

26         627.4236  Coverage for bone marrow transplant

27  procedures.--

28         (3)(a)  The Agency for Health Care Administration shall

29  adopt rules specifying the bone marrow transplant procedures

30  that are accepted within the appropriate oncological specialty

31  and are not experimental for purposes of this section. The


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                                          HB 2037, First Engrossed



  1  rules must be based upon recommendations of an advisory panel

  2  appointed by the secretary director of the agency, composed

  3  of:

  4         1.  One adult oncologist, selected from a list of three

  5  names recommended by the Florida Medical Association;

  6         2.  One pediatric oncologist, selected from a list of

  7  three names recommended by the Florida Pediatric Society;

  8         3.  One representative of the J. Hillis Miller Health

  9  Center at the University of Florida;

10         4.  One representative of the H. Lee Moffitt Cancer

11  Center and Research Institute, Inc.;

12         5.  One consumer representative, selected from a list

13  of three names recommended by the Insurance Commissioner;

14         6.  One representative of the Health Insurance

15  Association of America;

16         7.  Two representatives of health insurers, one of whom

17  represents the insurer with the largest Florida health

18  insurance premium volume and one of whom represents the

19  insurer with the second largest Florida health insurance

20  premium volume; and

21         8.  One representative of the insurer with the largest

22  Florida small group health insurance premium volume.

23         (b)  The director shall also appoint a member of the

24  advisory panel to serve as chairperson.

25         (c)  The agency shall provide, within existing

26  resources, staff support to enable the panel to carry out its

27  responsibilities under this section.

28         (d)  In making recommendations and adopting rules under

29  this section, the advisory panel and the director shall:

30         1.  Take into account findings, studies, or research of

31  the federal Agency for Health Care Policy, National Cancer


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                                          HB 2037, First Engrossed



  1  Institute, National Academy of Sciences, Health Care Financing

  2  Administration, and Congressional Office of Technology

  3  Assessment, and any other relevant information.

  4         2.  Consider whether the federal Food and Drug

  5  Administration or National Cancer Institute are conducting or

  6  sponsoring assessment procedures to determine the safety and

  7  efficacy of the procedure or substantially similar procedures,

  8  or of any part of such procedures.

  9         3.  Consider practices of providers with respect to

10  requesting or requiring patients to sign a written

11  acknowledgment that a bone marrow transplant procedure is

12  experimental.

13         (e)  The advisory panel shall conduct, at least

14  biennially, a review of scientific evidence to ensure that its

15  recommendations are based on current research findings and

16  that insurance policies offer coverage for the latest

17  medically acceptable bone marrow transplant procedures.

18         Section 22.  Section 641.454, Florida Statutes, is

19  amended to read:

20         641.454  Civil action to enforce prepaid health clinic

21  contract; attorney's fees; court costs.--In any civil action

22  brought to enforce the terms and conditions of a prepaid

23  health clinic contract, the prevailing party is entitled to

24  recover reasonable attorney's fees and court costs.  This

25  section shall not be construed to authorize a civil action

26  against the department, its employees, or the Insurance

27  Commissioner and Treasurer or against the Agency for Health

28  Care Administration, the employees of the Agency for Health

29  Care Administration, or the Secretary Director of Health Care

30  Administration.

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                                          HB 2037, First Engrossed



  1         Section 23.  Paragraph (f) of subsection (6) of section

  2  641.60, Florida Statutes, is amended to read:

  3         641.60  Statewide Managed Care Ombudsman Committee.--

  4         (6)  The statewide committee or a member of the

  5  committee:

  6         (f)  Shall conduct meetings at least two times a year

  7  at the call of the chairperson and at other times at the call

  8  of the secretary of the agency director or by written request

  9  of three members.

10         Section 24.  Subsection (3) of section 641.70, Florida

11  Statutes, is amended to read:

12         641.70  Agency duties relating to the Statewide Managed

13  Care Ombudsman Committee and the district managed care

14  ombudsman committees.--

15         (3)  The secretary director of the agency shall ensure

16  the full cooperation and assistance of agency employees with

17  members of the statewide committee and district committees.

18         Section 25.  Subsections (3) and (5) of section

19  732.9216, Florida Statutes, are amended to read:

20         732.9216  Organ and tissue donor education panel.--

21         (3)  All members of the panel shall be appointed by the

22  Secretary Director of Health Care Administration to serve a

23  term of 2 years, except that, initially, six members shall be

24  appointed for 1-year terms and six members shall be appointed

25  for 2-year terms.

26         (5)  The panel shall meet at least semiannually or upon

27  the call of the chairperson or the Secretary Director of

28  Health Care Administration.

29         Section 26.  Section 408.001, Florida Statutes, is

30  repealed effective December 31, 2000, or upon dissolution of

31


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                                          HB 2037, First Engrossed



  1  the Florida Health Care Purchasing Cooperative, whichever

  2  occurs first.

  3         Section 27.  All powers, duties, and functions and

  4  rules, records, personnel, property, and unexpended balances

  5  of appropriations, allocations, or other funds of the Agency

  6  for Health Care Administration within the Department of

  7  Business and Professional Regulation are transferred by a type

  8  one transfer, as defined in s. 20.06(1), Florida Statutes, to

  9  the Agency for Health Care Administration, as created by this

10  act.

11         Section 28.  Twenty full-time-equivalent positions and

12  $686,835 in salaries and benefits, and $135,138 in expenses,

13  are transferred by a type two transfer, as defined in section

14  20.06(2), Florida Statutes, from the Department of Labor and

15  Employment Security to the Agency for Health Care

16  Administration to carry out the agency's responsibilities

17  under sections 440.13(1)(m), 440.13(15), 440.132, and 440.134,

18  Florida Statutes, relating to workers' compensation managed

19  care arrangements.

20         Section 29.  This act shall take effect October 1,

21  2000.

22

23

24

25

26

27

28

29

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