Senate Bill 2344c1

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    Florida Senate - 2000                           CS for SB 2344

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




    317-1967-00

  1                      A bill to be entitled

  2         An act relating to health care; creating the

  3         Florida Commission on Excellence in Health

  4         Care; providing legislative findings and

  5         intent; providing definitions; providing duties

  6         and responsibilities; providing for membership,

  7         organization, meetings, procedures, and staff;

  8         providing for reimbursement of travel and

  9         related expenses of certain members; providing

10         certain evidentiary prohibitions; requiring a

11         report to the Governor, the President of the

12         Senate, and the Speaker of the House of

13         Representatives; providing for termination of

14         the commission; providing an appropriation;

15         providing an effective date.

16

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

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19         Section 1.  Florida Commission on Excellence in Health

20  Care.--

21         (1)  LEGISLATIVE FINDINGS AND INTENT.--The Legislature

22  finds that the health care delivery industry is one of the

23  largest and most complex industries in Florida. The

24  Legislature finds that additional focus on strengthening

25  health care delivery systems by eliminating avoidable mistakes

26  in the diagnosis and treatment of Floridians holds tremendous

27  promise to increase the quality of health care services

28  available to Floridians. To achieve this enhanced focus, it is

29  the intent of the Legislature to create the Florida Commission

30  on Excellence in Health Care to facilitate the development of

31  a comprehensive statewide strategy for improving health care

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1  delivery systems through meaningful reporting standards, data

  2  collection and review, and quality measurement.

  3         (2)  DEFINITIONS.--As used in this act, the term:

  4         (a)  "Agency" means the Agency for Health Care

  5  Administration.

  6         (b)  "Commission" means the Florida Commission on

  7  Excellence in Health Care.

  8         (c)  "Department" means the Department of Health.

  9         (d)  "Error," with respect to health care, means an

10  unintended act, by omission or commission.

11         (e)  "Health care practitioner" means any person

12  licensed under chapter 457; chapter 458; chapter 459; chapter

13  460; chapter 461; chapter 462; chapter 463; chapter 464;

14  chapter 465; chapter 466; chapter 467; part I, part II, part

15  III, part V, part X, part XIII, or part XIV of chapter 468;

16  chapter 478; chapter 480; part III or part IV of chapter 483;

17  chapter 484; chapter 486; chapter 490; or chapter 491, Florida

18  Statutes.

19         (f)  "Health care provider" means any health care

20  facility or other health care organization licensed or

21  certified to provide approved medical and allied health

22  services in this state, or any entity licensed by the

23  Department of Insurance as a prepaid health care plan or

24  health maintenance organization or as an insurer to provide

25  coverage for health care services through a network of

26  providers.

27         (3)  COMMISSION; DUTIES AND RESPONSIBILITIES.--There is

28  created the Florida Commission on Excellence in Health Care.

29  The commission shall:

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1         (a)  Identify existing data sources that evaluate

  2  quality of care in Florida and collect, analyze, and evaluate

  3  this data.

  4         (b)  Establish guidelines for data sharing and

  5  coordination.

  6         (c)  Identify core sets of quality measures for

  7  standardized reporting by appropriate components of the health

  8  care continuum.

  9         (d)  Recommend a framework for quality measurement and

10  outcome reporting.

11         (e)  Develop quality measures that enhance and improve

12  the ability to evaluate and improve care.

13         (f)  Make recommendations regarding research and

14  development needed to advance quality measurement and

15  reporting.

16         (g)  Evaluate regulatory issues relating to the

17  pharmacy profession and recommend changes necessary to

18  optimize patient safety.

19         (h)  Facilitate open discussion of a process to ensure

20  that comparative information on health care quality is valid,

21  reliable, comprehensive, understandable, and widely available

22  in the public domain.

23         (i)  Sponsor public hearings to share information and

24  expertise, identify "best practices," and recommend methods to

25  promote their acceptance.

26         (j)  Evaluate current regulatory programs to determine

27  what changes, if any, need to be made to facilitate patient

28  safety.

29         (k)  Review public and private health care purchasing

30  systems to determine if there are sufficient mandates and

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1  incentives to facilitate continuous improvement in patient

  2  safety.

  3         (l)  Analyze how effective existing regulatory systems

  4  are in ensuring continuous competence and knowledge of

  5  effective safety practices.

  6         (m)  Develop a framework for organizations that

  7  license, accredit, or credential health care practitioners and

  8  health care providers to more quickly and effectively identify

  9  unsafe providers and practitioners and to take action

10  necessary to remove the unsafe provider or practitioner from

11  practice or operation until such time as the practitioner or

12  provider has proven safe to practice or operate.

13         (n)  Recommend procedures for development of a

14  curriculum on patient safety and methods of incorporating such

15  curriculum into training, licensure, and certification

16  requirements.

17         (o)  Develop a framework for regulatory bodies to

18  disseminate information on patient safety to health care

19  practitioners, health care providers, and consumers through

20  conferences, journal articles and editorials, newsletters,

21  publications, and Internet websites.

22         (p)  Recommend procedures to incorporate recognized

23  patient safety considerations into practice guidelines and

24  into standards related to the introduction and diffusion of

25  new technologies, therapies, and drugs.

26         (q)  Recommend a framework for development of

27  community-based collaborative initiatives for error reporting

28  and analysis and implementation of patient safety

29  improvements.

30         (r)  Evaluate the role of advertising in promoting or

31  adversely affecting patient safety.

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1         (4)  MEMBERSHIP, ORGANIZATION, MEETINGS, PROCEDURES,

  2  STAFF.--

  3         (a)  The commission shall consist of:

  4         1.  The Secretary of Health and the Director of Health

  5  Care Administration;

  6         2.  One representative each from the following agencies

  7  or organizations:  the Board of Medicine, the Board of

  8  Osteopathic Medicine, the Board of Pharmacy, the Board of

  9  Dentistry, the Board of Nursing, the Florida Dental

10  Association, the Florida Medical Association, the Florida

11  Osteopathic Medical Association, the Florida Chiropractic

12  Association, the Florida Podiatric Medical Association, the

13  Florida Nurses Association, the Florida Organization of

14  Nursing Executives, the Florida Pharmacy Association, the

15  Florida Society of Health System Pharmacists, Inc., the

16  Florida Hospital Association, the Association of Community

17  Hospitals and Health Systems of Florida, Inc., the Florida

18  League of Health Systems, the Florida Health Care Risk

19  Management Advisory Council, the Florida Health Care

20  Association, the Florida Statutory Teaching Hospital Council,

21  Inc., the Florida Statutory Rural Hospital Council, and the

22  Florida Association of Homes for the Aging;

23         3.  Two health lawyers, appointed by the Secretary of

24  Health, one of whom must be a member of the Health Law Section

25  of The Florida Bar who defends physicians and one of whom must

26  be a member of the Academy of Florida Trial Lawyers;

27         4.  Two representatives of the health insurance

28  industry, appointed by the Director of Health Care

29  Administration, one of whom shall represent indemnity plans

30  and one of whom shall represent managed care;

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1         5.  Five consumer advocates, consisting of one from the

  2  Association for Responsible Medicine, two appointed by the

  3  Governor, one appointed by the President of the Senate, and

  4  one appointed by the Speaker of the House of Representatives;

  5         6.  Two legislators, one appointed by the President of

  6  the Senate and one appointed by the Speaker of the House of

  7  Representatives; and

  8         7.  One representative of a Florida medical school

  9  appointed by the Secretary of Health.

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11  Commission membership shall reflect the geographic and

12  demographic diversity of the state.

13         (b)  The Secretary of Health and the Director of Health

14  Care Administration shall jointly chair the commission.

15  Subcommittees shall be formed by the joint chairs, as needed,

16  to make recommendations to the full commission on the subjects

17  assigned. However, all votes on work products of the

18  commission shall be at the full commission level, and all

19  recommendations to the Governor, the President of the Senate,

20  and the Speaker of the House of Representatives must pass by a

21  two-thirds vote of the full commission. Sponsoring agencies

22  and organizations may designate an alternative member who may

23  attend and vote on behalf of the sponsoring agency or

24  organization in the event the appointed member is unable to

25  attend a meeting of the commission or any subcommittee. The

26  commission shall be staffed by employees of the Department of

27  Health and the Agency for Health Care Administration.

28  Sponsoring agencies or organizations must fund the travel and

29  related expenses of their appointed members on the commission.

30  Travel and related expenses for the consumer members of the

31  commission shall be reimbursed by the state pursuant to

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1  section 112.061, Florida Statutes. The commission shall hold

  2  its first meeting no later than July 15, 2000.

  3         (5)  EVIDENTIARY PROHIBITIONS.--

  4         (a)  The findings, recommendations, evaluations,

  5  opinions, investigations, proceedings, records, reports,

  6  minutes, testimony, correspondence, work product, and actions

  7  of the commission shall be available to the public, but may

  8  not be introduced into evidence at any civil, criminal,

  9  special, or administrative proceeding against a health care

10  practitioner or health care provider arising out of the

11  matters which are the subject of the findings of the

12  commission. Moreover, no member of the commission shall be

13  examined in any civil, criminal, special, or administrative

14  proceeding against a health care practitioner or health care

15  provider as to any evidence or other matters produced or

16  presented during the proceedings of this commission or as to

17  any findings, recommendations, evaluations, opinions,

18  investigations, proceedings, records, reports, minutes,

19  testimony, correspondence, work product, or other actions of

20  the commission or any members thereof. However, nothing in

21  this section shall be construed to mean that information,

22  documents, or records otherwise available and obtained from

23  original sources are immune from discovery or use in any

24  civil, criminal, special, or administrative proceeding merely

25  because they were presented during proceedings of the

26  commission. Nor shall any person who testifies before the

27  commission or who is a member of the commission be prevented

28  from testifying as to matters within his or her knowledge in a

29  subsequent civil, criminal, special, or administrative

30  proceeding merely because such person testified in front of

31  the commission.

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1         (b)  The findings, recommendations, evaluations,

  2  opinions, investigations, proceedings, records, reports,

  3  minutes, testimony, correspondence, work product, and actions

  4  of the commission shall be used as a guide and resource and

  5  shall not be construed as establishing or advocating the

  6  standard of care for health care practitioners or health care

  7  providers unless subsequently enacted into law or adopted in

  8  rule. Nor shall any findings, recommendations, evaluations,

  9  opinions, investigations, proceedings, records, reports,

10  minutes, testimony, correspondence, work product, or actions

11  of the commission be admissible as evidence in any way,

12  directly or indirectly, by introduction of documents or as a

13  basis of an expert opinion as to the standard of care

14  applicable to health care practitioners or health care

15  providers in any civil, criminal, special, or administrative

16  proceeding unless subsequently enacted into law or adopted in

17  rule.

18         (c)  No person who testifies before the commission or

19  who is a member of the commission may specifically identify

20  any patient, health care practitioner, or health care provider

21  by name. Moreover, the findings, recommendations, evaluations,

22  opinions, investigations, proceedings, records, reports,

23  minutes, testimony, correspondence, work product, and actions

24  of the commission may not specifically identify any patient,

25  health care practitioner, or health care provider by name.

26         (6)  REPORT; TERMINATION.--The commission shall provide

27  a report of its findings and recommendations to the Governor,

28  the President of the Senate, and the Speaker of the House of

29  Representatives no later than February 1, 2001. After

30  submission of the report, the commission shall continue to

31  exist for the purpose of assisting the Department of Health,

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    Florida Senate - 2000                           CS for SB 2344
    317-1967-00




  1  the Agency for Health Care Administration, and the regulatory

  2  boards in their drafting of proposed legislation and rules to

  3  implement its recommendations and for the purpose of providing

  4  information to the health care industry on its

  5  recommendations. The commission shall be terminated June 1,

  6  2001.

  7         Section 2.  The sum of $91,000 in nonrecurring general

  8  revenue is hereby appropriated from the General Revenue Fund

  9  to the Department of Health to cover costs of the Florida

10  Commission on Excellence in Health Care relating to the travel

11  and related expenses of staff and consumer members and the

12  reproduction and dissemination of documents.

13         Section 3.  This act shall take effect upon becoming a

14  law.

15

16          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
17                         Senate Bill 2344

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19  Creates the Florida Commission on Excellence in Health Care.
    Provides legislative findings and intent and defines terms
20  used in the act. Specifies the duties and responsibilities of
    the commission. Specifies commission membership. Prohibits use
21  of certain information, activities, testimony, or actions of
    the commission for evidentiary purposes and prohibits
22  commission members from providing certain specified
    information in legal or administrative proceedings. Requires
23  the commission to submit a report to the Governor, the
    President of the Senate, and the Speaker of the House of
24  Representatives by February 1, 2001. Provides for the
    continued existence of the commission to assist with drafting
25  proposed legislation and rules and to provide information to
    the health care industry about its recommendations. Terminates
26  the commission June 1, 2001.

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