House Bill 2037e2

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                                         HB 2037, Second 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 and

  7         the Department of Health; providing an

  8         exception from provisions of the act; requiring

  9         specified written disclosure by certain health

10         care facilities and providers; specifying that

11         donation under the act is voluntary;

12         authorizing the consortium to charge fees;

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

14         as a department; reorganizing the agency and

15         removing it from under the Department of

16         Business and Professional Regulation; providing

17         for appointment of the Secretary of Health Care

18         Administration by the Governor, subject to

19         confirmation by the Senate; providing for

20         responsibilities and administration of the

21         department; amending s. 440.134, F.S.; deleting

22         obsolete language; amending ss. 120.80,

23         215.5601, 381.6023, 381.90, 395.0163,

24         395.10972, 400.0067, 400.235, 400.4415,

25         400.967, 408.036, 408.05, 408.902, 409.8132,

26         430.710, 478.44, 627.4236, 641.454, 641.60,

27         641.70, 732.9216, to conform provisions to

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

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

30         Purchasing Cooperative; providing for repeal on

31         a date certain or upon the occurrence of a


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                                         HB 2037, Second Engrossed



  1         contingency; transferring all powers, duties,

  2         and functions and funds of the Agency for

  3         Health Care Administration of the Department of

  4         Business and Professional Regulation to the new

  5         department; providing an effective date.

  6

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

  8

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

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

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

12  Blood Tissue Bank is established as a nonprofit legal entity

13  to collect, screen for infectious and genetic diseases,

14  perform tissue typing, cryopreserve, and store umbilical cord

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

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

17  the Mayo Clinic, Jacksonville shall jointly form the

18  collaborative consortium, each working with community

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

20  health care providers to develop local and regional coalitions

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

22  participants shall align their outreach programs and

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

24  entire state.  The consortium is encouraged to conduct

25  outreach and research for Hispanics, African Americans, Native

26  Americans, and other ethnic and racial minorities.

27         (2)  The Agency for Health Care Administration and the

28  Department of Health shall encourage health care providers,

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

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

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                                         HB 2037, Second Engrossed



  1  to disseminate information about the Public Cord Blood Tissue

  2  Bank.

  3         (3)  Nothing in this section creates a requirement of

  4  any health care or services program that is directly

  5  affiliated with a bona fide religious denomination that

  6  includes as an integral part of its beliefs and practices the

  7  tenet that blood transfer is contrary to the moral principles

  8  the denomination considers to be an essential part of its

  9  beliefs.

10         (4)  Any health care facility or health care provider

11  receiving financial remuneration for the collection of

12  umbilical cord blood shall provide written disclosure of this

13  information to any woman postpartum or parent of a newborn

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

15  harvesting of the umbilical cord blood.

16         (5)  A woman admitted to a hospital or birthing

17  facility for obstetrical services may be offered the

18  opportunity to donate umbilical cord blood to the Public Cord

19  Blood Tissue Bank.  A woman may not be required to make such a

20  donation.

21         (6)  The consortium may charge reasonable rates and

22  fees to recipients of cord blood tissue bank products.

23         (7)  In order to fund the provisions of this section

24  the consortium participants, the Agency for Health Care

25  Administration, and the Department of Health shall seek

26  private or federal funds to initiate program actions for

27  fiscal year 2000-2001.

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

29  to read:

30         20.42  Agency for Health Care Administration.--

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                                         HB 2037, Second Engrossed



  1         (1)  There is created a department that,

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

  3  be called the Agency for Health Care Administration within the

  4  Department of Business and Professional Regulation. The agency

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

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

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

  8  the Department of Business and Professional Regulation in any

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

10  transactions involving real or personal property, and

11  budgetary matters.

12         (2)(1)  DIRECTOR OF HEALTH CARE ADMINISTRATION.--The

13  head of the department agency is the Secretary Director of

14  Health Care Administration, who shall be appointed by the

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

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

17  Governor.

18         (3)(2)  ORGANIZATION OF THE AGENCY.--The department

19  agency shall be the chief health policy and planning entity

20  for the state. The department is responsible for health

21  facility licensure, inspection, and regulatory enforcement;

22  investigation of consumer complaints related to health care

23  facilities and managed care plans; the implementation of the

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

25  for Health Statistics; the administration of the Medicaid

26  program; the administration of the contracts with the Florida

27  Healthy Kids Corporation; the certification of health

28  maintenance organizations and prepaid health clinics as set

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

30  statute or agreement. organized as follows:

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                                         HB 2037, Second Engrossed



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

  2  shall be responsible for health facility licensure and

  3  inspection.

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

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

  6  for Health Statistics, the development of The Florida Health

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

  8  under s. 408.033, and research and analysis.

  9         (c)  The Division of State Health Purchasing shall be

10  responsible for the Medicaid program. The division shall also

11  administer the contracts with the Florida Health Access

12  Corporation program and the Florida Health Care Purchasing

13  Cooperative and the Florida Healthy Kids Corporation.

14         (d)  The Division of Administrative Services, which

15  shall be responsible for revenue management, budget,

16  personnel, and general services.

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

18  director shall appoint a Deputy Director for Health Quality

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

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

21  Quality Assurance shall be responsible for the Division of

22  Health Quality Assurance.

23         (4)  DEPUTY DIRECTOR FOR HEALTH POLICY AND COST

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

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

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

27  Director for Health Policy and Cost Control shall be

28  responsible for the Division of Health Policy and Cost

29  Control.

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

31  director shall appoint a Deputy Director for State Health


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                                         HB 2037, Second Engrossed



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

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

  3  Health Purchasing shall be responsible for the Division of

  4  State Health Purchasing.

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

  6  director shall appoint a Deputy Director of Administrative

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

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

  9  responsible for the Division of Administrative Services.

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

11  440.134, Florida Statutes, is amended to read:

12         440.134  Workers' compensation managed care

13  arrangement.--

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

15  authorize an insurer to offer or utilize a workers'

16  compensation managed care arrangement after the insurer files

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

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

19  the applicant has the ability to provide quality of care

20  consistent with the prevailing professional standards of care

21  and the insurer and its workers' compensation managed care

22  arrangement otherwise meets the requirements of this section.

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

24  managed care arrangement without such authorization. The

25  authorization, unless sooner suspended or revoked, shall

26  automatically expire 2 years after the date of issuance unless

27  renewed by the insurer. The authorization shall be renewed

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

29  $1,000, provided that the insurer is in compliance with the

30  requirements of this section and any rules adopted hereunder.

31  An application for renewal of the authorization shall be made


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                                         HB 2037, Second Engrossed



  1  90 days prior to expiration of the authorization, on forms

  2  provided by the agency. The renewal application shall not

  3  require the resubmission of any documents previously filed

  4  with the agency if such documents have remained valid and

  5  unchanged since their original filing.

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

  7  Statutes, is amended to read:

  8         120.80  Exceptions and special requirements;

  9  agencies.--

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

11  120.57(1)(a), formal hearings may not be conducted by the

12  Secretary of Health, the Secretary of director of the Agency

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

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

15  Care Administration for matters relating to the regulation of

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

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

18  Department of Health in execution of the Special Supplemental

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

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

21  exemption from disqualification reviews for certified nurse

22  assistants program need not be conducted by an administrative

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

24  may contract with the Department of Children and Family

25  Services for a hearing officer in these matters.

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

27  215.5601, Florida Statutes, is amended to read:

28         215.5601  Lawton Chiles Endowment Fund.--

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

30  AND USES.--

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                                         HB 2037, Second Engrossed



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

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

  3  Secretary Director of Health Care Administration shall conduct

  4  meetings to discuss program priorities for endowment funding

  5  prior to submitting their budget requests to the Executive

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

  7  meetings shall be to gain consensus for priority requests and

  8  recommended endowment funding levels for those priority

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

10  meetings.

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

12  381.0602, Florida Statutes, are amended to read:

13         381.0602  Organ Transplant Advisory Council;

14  membership; responsibilities.--

15         (2)  The Secretary Director of Health Care

16  Administration shall appoint all members of the council to

17  serve a term of 2 years.

18         (3)  The Secretary Director of Health Care

19  Administration shall fill each vacancy on the council for the

20  balance of the unexpired term. Priority consideration must be

21  given to the appointment of an individual whose primary

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

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

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

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

26  council.

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

28  the call of the chairperson or the Secretary Director of

29  Health Care Administration.

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

31  Statutes, is amended to read:


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                                         HB 2037, Second Engrossed



  1         381.6023  Organ and Tissue Procurement and

  2  Transplantation Advisory Board; creation; duties.--

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

  4  Procurement and Transplantation Advisory Board, which shall

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

  6  to the Secretary Director of Health Care Administration. The

  7  membership must be regionally distributed and must include:

  8         (a)  Two representatives who have expertise in vascular

  9  organ transplant surgery;

10         (b)  Two representatives who have expertise in vascular

11  organ procurement, preservation, and distribution;

12         (c)  Two representatives who have expertise in

13  musculoskeletal tissue transplant surgery;

14         (d)  Two representatives who have expertise in

15  musculoskeletal tissue procurement, processing, and

16  distribution;

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

18  cornea transplant surgery;

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

20  cornea procurement, processing, and distribution;

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

22  procurement, processing, and transplantation;

23         (h)  A representative from the Florida Pediatric

24  Society;

25         (i)  A representative from the Florida Society of

26  Pathologists; and

27         (j)  A representative from the Florida Medical

28  Examiners Commission.

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

30  Statutes, is amended to read:

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                                         HB 2037, Second Engrossed



  1         381.90  Health Information Systems Council; legislative

  2  intent; creation, appointment, duties.--

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

  4  members or their senior executive-level designees:

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

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

  7  Professional Regulation;

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

  9  Family Services;

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

11  Care Administration;

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

13         (f)  The Attorney General;

14         (g)  The executive director of the Correctional Medical

15  Authority;

16         (h)  Two members representing county health

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

18  county, appointed by the Governor;

19         (i)  A representative from the Florida Association of

20  Counties;

21         (j)  The State Treasurer and Insurance Commissioner;

22         (k)  A representative from the Florida Healthy Kids

23  Corporation;

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

25  chosen by the Board of Regents;

26         (m)  The Commissioner of Education;

27         (n)  The secretary of the Department of Elderly

28  Affairs; and

29         (o)  The secretary of the Department of Juvenile

30  Justice.

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                                         HB 2037, Second Engrossed



  1  Representatives of the Federal Government may serve without

  2  voting rights.

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

  4  395.0163, Florida Statutes, is amended to read:

  5         395.0163  Construction inspections; plan submission and

  6  approval; fees.--

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

  8  such construction inspections and investigations as it deems

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

10  or applicant desiring to make specified types of alterations

11  or additions to its facilities or to construct new facilities

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

13  construction, submit plans and specifications therefor to the

14  agency for preliminary inspection and approval or

15  recommendation with respect to compliance with agency rules

16  and standards.  The agency shall approve or disapprove the

17  plans and specifications within 60 days after receipt of the

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

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

20  period if the secretary director of the agency approves the

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

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

23  specifications.  When the agency disapproves plans and

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

25  its disapproval. Conferences and consultations may be provided

26  as necessary.

27         Section 10.  Section 395.10972, Florida Statutes, is

28  amended to read:

29         395.10972  Health Care Risk Manager Advisory

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

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


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                                         HB 2037, Second Engrossed



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

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

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

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

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

  6  members of the advisory council shall receive no compensation

  7  for their services, but shall be reimbursed for travel

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

  9  of individuals representing the following areas:

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

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

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

13  self-insurer of medical malpractice coverage.

14         (4)  One shall be a representative of the

15  health-care-consuming public.

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

17  400.0067, Florida Statutes, is amended to read:

18         400.0067  Establishment of State Long-Term Care

19  Ombudsman Council; duties; membership.--

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

21         (h)  Prepare an annual report describing the activities

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

23  Ombudsman Council in the year for which the report is

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

25  submit the report to the Commissioner of the United States

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

27  Senate, the Speaker of the House of Representatives, the

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

29  appropriate House and Senate committees, the Secretaries of

30  Elderly Affairs and Children and Family Services, and the

31  Secretary Director of Health Care Administration. The report


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                                         HB 2037, Second Engrossed



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

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

  3  minimum:

  4         1.  Contain and analyze data collected concerning

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

  6         2.  Evaluate the problems experienced by residents of

  7  long-term care facilities.

  8         3.  Contain recommendations for improving the quality

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

10  safety, welfare, and rights of the residents.

11         4.  Analyze the success of the ombudsman program during

12  the preceding year and identify the barriers that prevent the

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

14  successes shall also address the relationship between the

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

16  Elderly Affairs, the Agency for Health Care Administration,

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

18  assessment of how successfully the state long-term care

19  ombudsman program has carried out its responsibilities under

20  the Older Americans Act.

21         5.  Provide policy and regulatory and legislative

22  recommendations to solve identified problems; resolve

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

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

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

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

27         6.  Contain recommendations from the district ombudsman

28  councils regarding program functions and activities.

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

30  advocate and other legal advocates acting on behalf of the

31  district and state councils.


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                                         HB 2037, Second Engrossed



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

  2  400.235, Florida Statutes, is amended to read:

  3         400.235  Nursing home quality and licensure status;

  4  Gold Seal Program.--

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

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

  7  Care which shall operate under the authority of the Executive

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

  9  persons appointed by the Governor, to include a consumer

10  advocate for senior citizens and two persons with expertise in

11  the fields of quality management, service delivery excellence,

12  or public sector accountability; three persons appointed by

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

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

15  member of the University Consortium on Aging; the State

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

17  Life Care Residents Association; one person appointed by the

18  Secretary of Health; two persons appointed by the Secretary

19  Director of Health Care Administration, to include the Deputy

20  Director for State Health Purchasing; one person appointed by

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

22  appointed by the Florida Health Care Association. All members

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

24  panel shall hold its organizational meeting no later than

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

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

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

28  appointment.

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

30  Florida Statutes, is amended to read:

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                                         HB 2037, Second Engrossed



  1         400.4415  Assisted living facilities advisory

  2  committee.--

  3         (1)  There is created the assisted living facilities

  4  advisory committee, which shall assist the agency in

  5  developing and implementing a pilot rating system for

  6  facilities. The committee shall consist of nine members who

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

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

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

10         (b)  One representative from the Florida Health Care

11  Association.

12         (c)  One representative from the Florida Assisted

13  Living Association.

14         (d)  One representative from the Florida Association of

15  Homes for the Aging.

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

17  Administration.

18         (f)  One representative from the adult services program

19  of the Department of Children and Family Services.

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

21  and mental health program of the Department of Children and

22  Family Services.

23         (h)  One representative from the Department of Elderly

24  Affairs.

25         (i)  One consumer representative from a district

26  long-term care ombudsman council.

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

28  Statutes, is amended to read:

29         400.967  Rules and classification of deficiencies.--

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

31  and specifications within 60 days after receipt of the final


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                                         HB 2037, Second Engrossed



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

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

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

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

  5  specifications. When the agency disapproves plans and

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

  7  disapproval. Conferences and consultations may be provided as

  8  necessary.

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

10  Statutes, is amended to read:

11         408.036  Projects subject to review.--

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

13  documentation as the agency requires, the agency shall grant

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

15         (a)  For the initiation or expansion of obstetric

16  services.

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

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

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

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

21  facility being replaced.

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

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

24  without regard to inpatient requirements relating to admitting

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

26         (d)  For hospice services or home health services

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

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

29  exceed one-half of its licensed beds.

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

31  beds to Medicare and Medicaid certified skilled nursing beds


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                                         HB 2037, Second Engrossed



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

  2  conversion of the beds does not involve the construction of

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

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

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

  6  1993. Certified skilled nursing beds designated under this

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

  8  community nursing home bed inventory.  A rural hospital which

  9  subsequently decertifies any acute care beds exempted under

10  this paragraph shall notify the agency of the decertification,

11  and the agency shall adjust the community nursing home bed

12  inventory accordingly.

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

14  nursing facility that is part of a retirement community that

15  provides a variety of residential settings and supportive

16  services and that has been incorporated and operated in this

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

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

19  be for the exclusive use of the community residents.

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

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

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

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

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

25  facility has been continuously licensed since 1950 and has

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

27  licensure surveys.

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

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

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

31  residential facility that serves only retired military


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                                         HB 2037, Second Engrossed



  1  personnel, their dependents, and the surviving dependents of

  2  deceased military personnel. Medicare-reimbursed home health

  3  services provided through such agency shall be offered

  4  exclusively to residents of the facility or retirement

  5  community or to residents of facilities or retirement

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

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

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

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

10  community shall be a deceptive and unfair trade practice and

11  constitutes a violation of ss. 501.201-501.213.

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

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

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

15  Legislature occurring after the legislative session in which

16  the Legislature receives a report from the Secretary Director

17  of Health Care Administration certifying that the federal

18  Health Care Financing Administration has implemented a

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

20  health agencies.

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

22  the exclusive use of the Department of Corrections as provided

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

24  converted to other uses.

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

26  care facility to provide a health service exclusively on an

27  outpatient basis.

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

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

30  submitted under this paragraph must identify the number, the

31


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                                         HB 2037, Second Engrossed



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

  2  to be delicensed are located.

  3         (n)  For the provision of adult inpatient diagnostic

  4  cardiac catheterization services in a hospital.

  5         1.  In addition to any other documentation otherwise

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

  7  under this paragraph must comply with the following criteria:

  8         a.  The applicant must certify it will not provide

  9  therapeutic cardiac catheterization pursuant to the grant of

10  the exemption.

11         b.  The applicant must certify it will meet and

12  continuously maintain the minimum licensure requirements

13  adopted by the agency governing such programs pursuant to

14  subparagraph 2.

15         c.  The applicant must certify it will provide a

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

17  patients.

18         2.  The agency shall adopt licensure requirements by

19  rule which govern the operation of adult inpatient diagnostic

20  cardiac catheterization programs established pursuant to the

21  exemption provided in this paragraph. The rules shall ensure

22  that such programs:

23         a.  Perform only adult inpatient diagnostic cardiac

24  catheterization services authorized by the exemption and will

25  not provide therapeutic cardiac catheterization or any other

26  services not authorized by the exemption.

27         b.  Maintain sufficient appropriate equipment and

28  health personnel to ensure quality and safety.

29         c.  Maintain appropriate times of operation and

30  protocols to ensure availability and appropriate referrals in

31  the event of emergencies.


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                                         HB 2037, Second Engrossed



  1         d.  Maintain appropriate program volumes to ensure

  2  quality and safety.

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

  4  charity and Medicaid patients each year.

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

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

  7  compliance with the requirements of subparagraph 1. and that

  8  the program will, after beginning operation, continuously

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

10  agency shall monitor such programs to ensure compliance with

11  the requirements of subparagraph 2.

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

13  immediately when the program fails to comply with the rules

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

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

16  treating patients, the exemption for a program shall expire

17  when the program fails to comply with the rules adopted

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

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

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

21  agency shall not grant an exemption pursuant to this paragraph

22  for an adult inpatient diagnostic cardiac catheterization

23  program located at the same hospital until 2 years following

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

25  failed to comply with the rules adopted pursuant to

26  subparagraph 2.

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

28  paragraph until the adoption of the rules required under this

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

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

31  1998, the proposed rules governing the exemptions shall be


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                                         HB 2037, Second Engrossed



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

  2  this paragraph until final rules become effective.

  3         (o)  For any expenditure to provide mobile surgical

  4  facilities and related health care services under contract

  5  with the Department of Corrections or a private correctional

  6  facility operating pursuant to chapter 957.

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

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

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

10  percent of the construction cost is federally funded and for

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

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

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

14  nursing home bed inventory.

15

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

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

18  this section.

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

20  408.05, Florida Statutes, is amended to read:

21         408.05  State Center for Health Statistics.--

22         (8)  STATE COMPREHENSIVE HEALTH INFORMATION SYSTEM

23  ADVISORY COUNCIL.--

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

25  Comprehensive Health Information System Advisory Council to

26  assist the center in reviewing the comprehensive health

27  information system and to recommend improvements for such

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

29         1.  An employee of the Executive Office of the

30  Governor, to be appointed by the Governor.

31


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                                         HB 2037, Second Engrossed



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

  2  appointed by the Insurance Commissioner.

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

  4  appointed by the Commissioner of Education.

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

  6  Director of Health Care Administration, representing other

  7  state and local agencies, state universities, the Florida

  8  Association of Business/Health Coalitions, local health

  9  councils, professional health-care-related associations,

10  consumers, and purchasers.

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

12  Statutes, is amended to read:

13         408.902  MedAccess program; creation; program title.--

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

15  the MedAccess program to be administered by the Agency for

16  Health Care Administration.  The MedAccess program shall not

17  be subject to the requirements of the Department of Insurance

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

19  appoint an administrator of the MedAccess program which shall

20  be located in the Division of State Health Purchasing.

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

22  Florida Statutes, is amended to read:

23         409.8132  Medikids program component.--

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

25  agency shall appoint an administrator of the Medikids program

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

27  Health Purchasing.  The Agency for Health Care Administration

28  is designated as the state agency authorized to make payments

29  for medical assistance and related services for the Medikids

30  program component of the Florida Kidcare program. Payments

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


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                                         HB 2037, Second Engrossed



  1  General Appropriations Act, only for covered services provided

  2  to eligible children by qualified health care providers under

  3  the Florida Kidcare program.

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

  5  Statutes, is amended to read:

  6         430.710  Long-term care interagency advisory council.--

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

  8  created within the Department of Elderly Affairs to advise the

  9  secretary of the department on matters related to the

10  long-term care community diversion pilot projects.  The

11  department and the agency shall provide staff support to the

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

13  the secretary director of the agency.

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

15  Family Services shall appoint four members, one each to

16  represent the following:

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

18  optional state supplementation, adult protective services,

19  developmental services, or mental health services from the

20  department.

21         2.  Providers of community-based services.

22         3.  Consumer advocacy organizations.

23         4.  Consumers, or representatives of consumers, who

24  have nonage related physical disabilities.

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

26  shall appoint five members, one each to represent the

27  following:

28         1.  The nursing home industry.

29         2.  The assisted living industry.

30         3.  Consumers of long-term care services.

31         4.  Providers of community-based services.


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                                         HB 2037, Second Engrossed



  1         5.  Area Agencies on Aging.

  2         (c)  The Commissioner of Insurance shall appoint one

  3  member to represent the insurance industry.

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

  5  Care Administration shall appoint three members, one each to

  6  represent the following:

  7         1.  The hospital industry.

  8         2.  The home health industry.

  9         3.  Health maintenance organizations.

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

11  478.44, Florida Statutes, is amended to read:

12         478.44  Electrolysis Council; creation; function;

13  powers and duties.--

14         (4)

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

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

17  official meeting of the council or participates in official

18  council business.  A council member is also entitled to

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

20  of state requires the prior approval of the Secretary Director

21  of Health Care Administration.

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

23  Florida Statutes, is amended to read:

24         627.4236  Coverage for bone marrow transplant

25  procedures.--

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

27  adopt rules specifying the bone marrow transplant procedures

28  that are accepted within the appropriate oncological specialty

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

30  rules must be based upon recommendations of an advisory panel

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                                         HB 2037, Second Engrossed



  1  appointed by the secretary director of the agency, composed

  2  of:

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

  4  names recommended by the Florida Medical Association;

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

  6  three names recommended by the Florida Pediatric Society;

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

  8  Center at the University of Florida;

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

10  Center and Research Institute, Inc.;

11         5.  One consumer representative, selected from a list

12  of three names recommended by the Insurance Commissioner;

13         6.  One representative of the Health Insurance

14  Association of America;

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

16  represents the insurer with the largest Florida health

17  insurance premium volume and one of whom represents the

18  insurer with the second largest Florida health insurance

19  premium volume; and

20         8.  One representative of the insurer with the largest

21  Florida small group health insurance premium volume.

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

23  advisory panel to serve as chairperson.

24         (c)  The agency shall provide, within existing

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

26  responsibilities under this section.

27         (d)  In making recommendations and adopting rules under

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

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

30  the federal Agency for Health Care Policy, National Cancer

31  Institute, National Academy of Sciences, Health Care Financing


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                                         HB 2037, Second Engrossed



  1  Administration, and Congressional Office of Technology

  2  Assessment, and any other relevant information.

  3         2.  Consider whether the federal Food and Drug

  4  Administration or National Cancer Institute are conducting or

  5  sponsoring assessment procedures to determine the safety and

  6  efficacy of the procedure or substantially similar procedures,

  7  or of any part of such procedures.

  8         3.  Consider practices of providers with respect to

  9  requesting or requiring patients to sign a written

10  acknowledgment that a bone marrow transplant procedure is

11  experimental.

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

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

14  recommendations are based on current research findings and

15  that insurance policies offer coverage for the latest

16  medically acceptable bone marrow transplant procedures.

17         Section 22.  Section 641.454, Florida Statutes, is

18  amended to read:

19         641.454  Civil action to enforce prepaid health clinic

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

21  brought to enforce the terms and conditions of a prepaid

22  health clinic contract, the prevailing party is entitled to

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

24  section shall not be construed to authorize a civil action

25  against the department, its employees, or the Insurance

26  Commissioner and Treasurer or against the Agency for Health

27  Care Administration, the employees of the Agency for Health

28  Care Administration, or the Secretary Director of Health Care

29  Administration.

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

31  641.60, Florida Statutes, is amended to read:


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                                         HB 2037, Second Engrossed



  1         641.60  Statewide Managed Care Ombudsman Committee.--

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

  3  committee:

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

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

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

  7  of three members.

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

  9  Statutes, is amended to read:

10         641.70  Agency duties relating to the Statewide Managed

11  Care Ombudsman Committee and the district managed care

12  ombudsman committees.--

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

14  the full cooperation and assistance of agency employees with

15  members of the statewide committee and district committees.

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

17  732.9216, Florida Statutes, are amended to read:

18         732.9216  Organ and tissue donor education panel.--

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

20  Secretary Director of Health Care Administration to serve a

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

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

23  for 2-year terms.

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

25  the call of the chairperson or the Secretary Director of

26  Health Care Administration.

27         Section 26.  Section 408.001, Florida Statutes, is

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

29  the Florida Health Care Purchasing Cooperative, whichever

30  occurs first.

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                                         HB 2037, Second Engrossed



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

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

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

  4  for Health Care Administration within the Department of

  5  Business and Professional Regulation are transferred by a type

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

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

  8  act.

  9         Section 28.  This act shall take effect October 1,

10  2000.

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