House Bill hb0243

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    Florida House of Representatives - 2001                 HB 243

        By Representative Rubio






  1                      A bill to be entitled

  2         An act relating to health care; repealing ss.

  3         408.031, 408.032, 408.033, 408.034, 408.035,

  4         408.036, 408.0361, 408.037, 408.038, 408.039,

  5         408.040, 408.041, 408.042, 408.043, 408.044,

  6         408.045, 408.0455, and 651.118, F.S., relating

  7         to requirements for certificate-of-need review

  8         and approval for health care facilities and

  9         services; repealing s. 154.245, F.S., relating

10         to certificates of need required as a condition

11         of certain bond validation; amending ss. 20.42,

12         154.205, 154.213, 154.219, 159.27, 164.1031,

13         186.503, 186.507, 186.511, 189.415, 383.216,

14         395.0191, 395.1055, 395.603, 395.604, 395.605,

15         400.071, 400.23, 400.602, 400.606, 400.6085,

16         408.05, 408.061, 408.063, 408.07, 408.09,

17         408.18, 409.9117, 430.705, 430.708, 458.345,

18         459.021, 641.60, and 651.021, F.S., to conform

19         to the repeal of certificate-of-need

20         requirements and the process of

21         certificate-of-need review, and the health

22         planning process related thereto; providing an

23         effective date.

24

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

26

27         Section 1.  Sections 154.245, 408.031, 408.032,

28  408.033, 408.034, 408.035, 408.036, 408.0361, 408.037,

29  408.038, 408.039, 408.040, 408.041, 408.042, 408.043, 408.044,

30  408.045, 408.0455, and 651.118, Florida Statutes, are

31  repealed.

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  1         Section 2.  Subsection (3) of section 20.42, Florida

  2  Statutes, is amended to read:

  3         20.42  Agency for Health Care Administration.--

  4         (3)  The department shall be the chief health policy

  5  and planning entity for the state. The department is

  6  responsible for health facility licensure, inspection, and

  7  regulatory enforcement; investigation of consumer complaints

  8  related to health care facilities and managed care plans; the

  9  implementation of the certificate of need program; the

10  operation of the State Center for Health Statistics; the

11  administration of the Medicaid program; the administration of

12  the contracts with the Florida Healthy Kids Corporation; the

13  certification of health maintenance organizations and prepaid

14  health clinics as set forth in part III of chapter 641; and

15  any other duties prescribed by statute or agreement.

16         Section 3.  Subsection (4) of section 154.205, Florida

17  Statutes, is amended to read:

18         154.205  Definitions.--The following terms, whenever

19  used in this part, shall have the following meanings unless a

20  different meaning clearly appears from the context:

21         (4)  "Certificate of need" means a written advisory

22  statement issued by the Agency for Health Care Administration,

23  having as its basis a written advisory statement issued by an

24  areawide council and, where there is no council, by the Agency

25  for Health Care Administration, evidencing community need for

26  a new, converted, expanded, or otherwise significantly

27  modified health facility.

28         Section 4.  Section 154.213, Florida Statutes, is

29  amended to read:

30         154.213  Agreements of lease.--In undertaking any

31  project pursuant to this part, the authority shall first

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  1  obtain a valid certificate of need evidencing need for the

  2  project and a statement that the project serves a public

  3  purpose by advancing the commerce, welfare, and prosperity of

  4  the local agency and its people.  No project financed under

  5  the provisions of this part shall be operated by the authority

  6  or any other governmental agency; however, the authority may

  7  temporarily operate or cause to be operated all or any part of

  8  a project to protect its interest therein pending any leasing

  9  of such project in accordance with the provisions of this

10  part.  The authority may lease a project or projects to a

11  health facility for operation and maintenance in such manner

12  as to effectuate the purposes of this part under an agreement

13  of lease in form and substance not inconsistent herewith.

14         (1)  Any such agreement of lease may provide, among

15  other provisions, that:

16         (a)  The lessee shall at its own expense operate,

17  repair, and maintain the project or projects leased

18  thereunder.

19         (b)  The rent payable under the lease shall in the

20  aggregate be not less than an amount sufficient to pay all of

21  the interest, principal, and redemption premiums, if any, on

22  the bonds that shall be issued by the authority to pay the

23  cost of the project or projects leased thereunder.

24         (c)  The lessee shall pay all costs incurred by the

25  authority in connection with the acquisition, financing,

26  construction, and administration of the project or projects

27  leased, except as may be paid out of the proceeds of bonds or

28  otherwise, including, but without being limited to:  Insurance

29  costs, the cost of administering the bond resolution

30  authorizing such bonds and any trust agreement securing the

31

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  1  bonds, and the fees and expenses of trustees, paying agents,

  2  attorneys, consultants, and others.

  3         (d)  The terms of the lease shall terminate not earlier

  4  than the date on which all such bonds and all other

  5  obligations incurred by the authority in connection with the

  6  project or projects leased thereunder shall be paid in full,

  7  including interest, principal, and redemption premiums, if

  8  any, or adequate funds for such payment shall be deposited in

  9  trust.

10         (e)  The lessee's obligation to pay rent shall not be

11  subject to cancellation, termination, or abatement by the

12  lessee until such payment of the bonds or provision for such

13  payment shall be made.

14         (2)  Such lease agreement may contain such additional

15  provisions as in the determination of the authority are

16  necessary or convenient to effectuate the purposes of this

17  part, including provisions for extensions of the term and

18  renewals of the lease and vesting in the lessee an option to

19  purchase the project leased thereunder pursuant to such terms

20  and conditions consistent with this part as shall be

21  prescribed in the lease.  Except as may otherwise be expressly

22  stated in the agreement of lease, to provide for any

23  contingencies involving the damaging, destruction, or

24  condemnation of the project leased or any substantial portion

25  thereof, such option to purchase may not be exercised unless

26  all bonds issued for such project, including all principal,

27  interest, and redemption premiums, if any, and all other

28  obligations incurred by the authority in connection with such

29  project, shall have been paid in full or sufficient funds

30  shall have been deposited in trust for such payment.  The

31  purchase price of such project shall not be less than an

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  1  amount sufficient to pay in full all of the bonds, including

  2  all principal, interest, and redemption premiums, if any,

  3  issued for the project then outstanding and all other

  4  obligations incurred by the authority in connection with such

  5  project.

  6         Section 5.  Subsection (1) of section 154.219, Florida

  7  Statutes, is amended to read:

  8         154.219  Revenue bonds.--

  9         (1)  The authority is authorized from time to time to

10  issue its negotiable revenue bonds for the purpose of paying

11  all or any part of the cost of any project or projects for

12  which a certificate of need has been obtained, or pursuant to

13  subsections (12) and (13) of s. 154.209 for the purpose of

14  paying all or any part of the cost of acquiring existing or

15  completed health facilities projects.  In anticipation of the

16  sale of such revenue bonds, the authority may issue negotiable

17  bond anticipation notes and may renew the same from time to

18  time, but the maximum maturity of any such note, including

19  renewals thereof, shall not exceed 5 years from the date of

20  issue of the original note.  Such notes shall be paid from any

21  revenues of the authority available therefor and not otherwise

22  pledged or from the proceeds of sale of the revenue bonds of

23  the authority in anticipation of which they were issued. The

24  notes shall be issued in the same manner as the revenue bonds.

25  Such notes and the resolution or resolutions authorizing the

26  same may contain any provisions, conditions, or limitation

27  which a bond resolution of the authority may contain.

28         Section 6.  Subsection (16) of section 159.27, Florida

29  Statutes, is amended to read:

30

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  1         159.27  Definitions.--The following words and terms,

  2  unless the context clearly indicates a different meaning,

  3  shall have the following meanings:

  4         (16)  "Health care facility" means property operated in

  5  the private sector, whether operated for profit or not, used

  6  for or useful in connection with the diagnosis, treatment,

  7  therapy, rehabilitation, housing, or care of or for aged,

  8  sick, ill, injured, infirm, impaired, disabled, or handicapped

  9  persons, without discrimination among such persons due to

10  race, religion, or national origin; or for the prevention,

11  detection, and control of disease, including, without

12  limitation thereto, hospital, clinic, emergency, outpatient,

13  and intermediate care, including, but not limited to,

14  facilities for the elderly such as assisted living facilities,

15  facilities defined in s. 154.205(7)(8), day care and

16  share-a-home facilities, nursing homes, and the following

17  related property when used for or in connection with the

18  foregoing: laboratory; research; pharmacy; laundry; health

19  personnel training and lodging; patient, guest, and health

20  personnel food service facilities; and offices and office

21  buildings for persons engaged in health care professions or

22  services; provided, if required by ss. 400.601-400.611 and ss.

23  408.031-408.045, a certificate of need therefor is obtained

24  prior to the issuance of the bonds.

25         Section 7.  Subsection (2) of section 164.1031, Florida

26  Statutes, is amended to read:

27         164.1031  Definitions.--For purposes of this act:

28         (2)  "Regional governmental entities" includes regional

29  planning councils, metropolitan planning organizations, water

30  supply authorities that include more than one county, local

31  health councils, water management districts, and other

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  1  regional entities that are authorized and created by general

  2  or special law that have duties or responsibilities extending

  3  beyond the jurisdiction of a single county.

  4         Section 8.  Subsection (7) of section 186.503, Florida

  5  Statutes, is amended to read:

  6         186.503  Definitions relating to Florida Regional

  7  Planning Council Act.--As used in this act, the term:

  8         (7)  "Local health council" means a regional agency

  9  established pursuant to s. 408.033.

10         Section 9.  Subsection (10) of section 186.507, Florida

11  Statutes, is amended to read:

12         186.507  Strategic regional policy plans.--

13         (10)  Each regional planning council shall enter into a

14  memorandum of agreement with each local health council in its

15  comprehensive planning district to ensure the coordination of

16  health planning, if the regional planning council elects to

17  address health issues in its strategic regional policy plan.

18  The memorandum of agreement shall specify the manner in which

19  each regional planning council and local health council will

20  coordinate their activities.

21         Section 10.  Section 186.511, Florida Statutes, is

22  amended to read:

23         186.511  Evaluation of strategic regional policy plan;

24  changes in plan.--The regional planning process shall be a

25  continuous and ongoing process.  Each regional planning

26  council shall prepare an evaluation and appraisal report on

27  its strategic regional policy plan at least once every 5

28  years; assess the successes or failures of the plan; address

29  changes to the state comprehensive plan; and prepare and adopt

30  by rule amendments, revisions, or updates to the plan as

31  needed.  Each regional planning council shall involve the

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  1  appropriate local health councils in its region if the

  2  regional planning council elects to address regional health

  3  issues.  The evaluation and appraisal report shall be prepared

  4  and submitted for review on a schedule established by the

  5  Executive Office of the Governor.  The schedule shall

  6  facilitate and be coordinated with, to the maximum extent

  7  feasible, the evaluation and revision of local comprehensive

  8  plans pursuant to s. 163.3191 for the local governments within

  9  each comprehensive planning district.

10         Section 11.  Subsection (3) of section 189.415, Florida

11  Statutes, is amended to read:

12         189.415  Special district public facilities report.--

13         (3)  A special district proposing to build, improve, or

14  expand a public facility which requires a certificate of need

15  pursuant to chapter 408 shall elect to notify the appropriate

16  local general-purpose government of its plans either in its

17  5-year plan or at the time the letter of intent is filed with

18  the Agency for Health Care Administration pursuant to s.

19  408.039.

20         Section 12.  Subsection (1) of section 383.216, Florida

21  Statutes, is amended to read:

22         383.216  Community-based prenatal and infant health

23  care.--

24         (1)  The Department of Health shall cooperate with

25  localities which wish to establish prenatal and infant health

26  care coalitions, and shall acknowledge and incorporate, if

27  appropriate, existing community children's services

28  organizations, pursuant to this section within the resources

29  allocated.  The purpose of this program is to establish a

30  partnership among the private sector, the public sector, state

31  government, local government, community alliances, and

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  1  maternal and child health care providers, for the provision of

  2  coordinated community-based prenatal and infant health care.

  3  The prenatal and infant health care coalitions must work in a

  4  coordinated, nonduplicative manner with local health planning

  5  councils established pursuant to s. 408.033.

  6         Section 13.  Subsection (10) of section 395.0191,

  7  Florida Statutes, is amended to read:

  8         395.0191  Staff membership and clinical privileges.--

  9         (10)  Nothing herein shall be construed by the agency

10  as requiring an applicant for a certificate of need to

11  establish proof of discrimination in the granting of or denial

12  of hospital staff membership or clinical privileges as a

13  precondition to obtaining such certificate of need under the

14  provisions of s. 408.043.

15         Section 14.  Paragraph (h) of subsection (1) of section

16  395.1055, Florida Statutes, is amended to read:

17         395.1055  Rules and enforcement.--

18         (1)  The agency shall adopt rules pursuant to ss.

19  120.536(1) and 120.54 to implement the provisions of this

20  part, which shall include reasonable and fair minimum

21  standards for ensuring that:

22         (h)  All hospitals submit such data as necessary to

23  conduct certificate-of-need reviews required under ss.

24  408.031-408.045. Such data shall include, but shall not be

25  limited to, patient origin data, hospital utilization data,

26  type of service reporting, and facility staffing data.  The

27  agency shall not collect data that identifies or could

28  disclose the identity of individual patients. The agency shall

29  utilize existing uniform statewide data sources when available

30  and shall minimize reporting costs to hospitals.

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  1         Section 15.  Subsection (1) of section 395.603, Florida

  2  Statutes, is amended to read:

  3         395.603  Rules; rural hospital impact statement.--

  4         (1)  The agency shall establish, by rule, a process by

  5  which a rural hospital, as defined in s. 395.602, that seeks

  6  licensure as a rural primary care hospital or as an emergency

  7  care hospital, or becomes a certified rural health clinic as

  8  defined in Pub. L. No. 95-210, or becomes a primary care

  9  program such as a county health department, community health

10  center, or other similar outpatient program that provides

11  preventive and curative services, may deactivate general

12  hospital beds.  Rural primary care hospitals and emergency

13  care hospitals shall maintain the number of actively licensed

14  general hospital beds necessary for the facility to be

15  certified for Medicare reimbursement.  Hospitals that

16  discontinue inpatient care to become rural health care clinics

17  or primary care programs shall deactivate all licensed general

18  hospital beds.  All hospitals, clinics, and programs with

19  inactive beds shall provide 24-hour emergency medical care by

20  staffing an emergency room.  Providers with inactive beds

21  shall be subject to the criteria in s. 395.1041.  The agency

22  shall specify in rule requirements for making 24-hour

23  emergency care available.  Inactive general hospital beds

24  shall be included in the acute care bed inventory, maintained

25  by the agency for certificate-of-need purposes, for 10 years

26  from the date of deactivation of the beds. After 10 years have

27  elapsed, inactive beds shall be excluded from the inventory.

28  The agency shall, at the request of the licensee, reactivate

29  the inactive general beds upon a showing by the licensee that

30  licensure requirements for the inactive general beds are met.

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  1         Section 16.  Subsection (1) of section 395.604, Florida

  2  Statutes, is amended to read:

  3         395.604  Other rural hospital programs.--

  4         (1)  The agency may license rural primary care

  5  hospitals subject to federal approval for participation in the

  6  Medicare and Medicaid programs. Rural primary care hospitals

  7  shall be treated in the same manner as emergency care

  8  hospitals and rural hospitals with respect to s.

  9  395.605(2)-(6)(a) ss. 395.605(2)-(8)(a), 408.033(2)(b)3., and

10  408.038.

11         Section 17.  Subsections (5) and (7) of section

12  395.605, Florida Statutes, are amended to read:

13         395.605  Emergency care hospitals.--

14         (5)  Rural hospitals that make application under the

15  certificate-of-need program to be licensed as emergency care

16  hospitals shall receive expedited review as defined in s.

17  408.032. Emergency care hospitals seeking relicensure as acute

18  care general hospitals shall also receive expedited review.

19         (7)  Emergency care hospitals are exempt from

20  certificate-of-need requirements for home health and hospice

21  services and for swing beds in a number that does not exceed

22  one-half of the facility's licensed beds.

23         Section 18.  Subsection (9) of section 400.071, Florida

24  Statutes, is amended to read:

25         400.071  Application for license.--

26         (9)  The agency may not issue a license to a nursing

27  home that fails to receive a certificate of need under the

28  provisions of ss. 408.031-408.045. It is the intent of the

29  Legislature that, in reviewing an a certificate-of-need

30  application to add beds to an existing nursing home facility,

31  preference be given to the application of a licensee who has

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  1  been awarded a Gold Seal as provided for in s. 400.235, if the

  2  applicant otherwise meets the review criteria specified in s.

  3  408.035.

  4         Section 19.  Subsection (5) of section 400.23, Florida

  5  Statutes, is amended to read:

  6         400.23  Rules; evaluation and deficiencies; licensure

  7  status.--

  8         (5)  The agency, in collaboration with the Division of

  9  Children's Medical Services of the Department of Health, must,

10  no later than December 31, 1993, adopt rules for minimum

11  standards of care for persons under 21 years of age who reside

12  in nursing home facilities.  The rules must include a

13  methodology for reviewing a nursing home facility under ss.

14  408.031-408.045 which serves only persons under 21 years of

15  age. A facility may be exempt from these standards for

16  specific persons between 18 and 21 years of age, if the

17  person's physician agrees that minimum standards of care based

18  on age are not necessary.

19         Section 20.  Subsection (6) of section 400.602, Florida

20  Statutes, is amended to read:

21         400.602  Licensure required; prohibited acts;

22  exemptions; display, transferability of license.--

23         (6)  Notwithstanding s. 400.601(3), at any time after

24  July 1, 1995, any entity entitled to licensure under

25  subsection (5) may obtain a license for up to two additional

26  hospices in accordance with the other requirements of this

27  part and upon receipt of any certificate of need that may be

28  required under the provisions of ss. 408.031-408.045.

29         Section 21.  Subsections (5) and (6) of section

30  400.606, Florida Statutes, are amended to read:

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  1         400.606  License; application; renewal; conditional

  2  license or permit; certificate of need.--

  3         (5)  The agency shall not issue a license to a hospice

  4  that fails to receive a certificate of need under the

  5  provisions of ss. 408.031-408.045. A licensed hospice is a

  6  health care facility as that term is used in s. 408.039(5) and

  7  is entitled to initiate or intervene in an administrative

  8  hearing.

  9         (5)(6)  A freestanding hospice facility that is

10  primarily engaged in providing inpatient and related services

11  and that is not otherwise licensed as a health care facility

12  shall be required to obtain a certificate of need. However, A

13  freestanding hospice facility with six or fewer beds shall not

14  be required to comply with institutional standards such as,

15  but not limited to, standards requiring sprinkler systems,

16  emergency electrical systems, or special lavatory devices.

17         Section 22.  Paragraph (b) of subsection (2) of section

18  400.6085, Florida Statutes, is amended to read:

19         400.6085  Contractual services.--A hospice may contract

20  out for some elements of its services.  However, the core

21  services, as set forth in s. 400.609(1), with the exception of

22  physician services, shall be provided directly by the hospice.

23  Any contract entered into between a hospice and a health care

24  facility or service provider must specify that the hospice

25  retains the responsibility for planning, coordinating, and

26  prescribing hospice care and services for the hospice patient

27  and family.  A hospice that contracts for any hospice service

28  is prohibited from charging fees for services provided

29  directly by the hospice care team that duplicate contractual

30  services provided to the patient and family.

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  1         (2)  With respect to contractual arrangements for

  2  inpatient hospice care:

  3         (b)  Licensed beds designated for inpatient hospice

  4  care through a contract Hospices contracting for inpatient

  5  care beds shall not be required to obtain an additional

  6  certificate of need for the number of such designated beds.

  7  Such beds shall remain licensed to the health care facility

  8  and be subject to the appropriate inspections.

  9         Section 23.  Paragraph (d) of subsection (3) and

10  paragraph (a) of subsection (8) of section 408.05, Florida

11  Statutes, are amended to read:

12         408.05  State Center for Health Statistics.--

13         (3)  COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order

14  to produce comparable and uniform health information and

15  statistics, the agency shall perform the following functions:

16         (d)  Develop written agreements with local, state, and

17  federal agencies for the sharing of health-care-related data

18  or using the facilities and services of such agencies.  State

19  agencies, local health councils, and other agencies under

20  contract with the Department of Health shall assist the center

21  in obtaining, compiling, and transferring health-care-related

22  data maintained by state and local agencies. Written

23  agreements must specify the types, methods, and periodicity of

24  data exchanges and specify the types of data that will be

25  transferred to the center.

26         (8)  STATE COMPREHENSIVE HEALTH INFORMATION SYSTEM

27  ADVISORY COUNCIL.--

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

29  Comprehensive Health Information System Advisory Council to

30  assist the center in reviewing the comprehensive health

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  1  information system and to recommend improvements for such

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

  3         1.  An employee of the Executive Office of the

  4  Governor, to be appointed by the Governor.

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

  6  appointed by the Insurance Commissioner.

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

  8  appointed by the Commissioner of Education.

  9         4.  Ten persons, to be appointed by the Secretary of

10  Health Care Administration, representing other state and local

11  agencies, state universities, the Florida Association of

12  Business/Health Coalitions, local health councils,

13  professional health-care-related associations, consumers, and

14  purchasers.

15         Section 24.  Subsection (12) of section 408.061,

16  Florida Statutes, is amended to read:

17         408.061  Data collection; uniform systems of financial

18  reporting; information relating to physician charges;

19  confidential information; immunity.--

20         (12)  The agency shall cooperate with local health

21  councils and the state health planning agency with regard to

22  health care data collection and dissemination and shall

23  cooperate with state agencies in any efforts to establish an

24  integrated health care database.

25         Section 25.  Subsection (1) of section 408.063, Florida

26  Statutes, is amended to read:

27         408.063  Dissemination of health care information.--

28         (1)  The agency, relying on data collected pursuant to

29  this chapter, shall establish a reliable, timely, and

30  consistent information system that distributes information and

31  serves as the basis for the agency's public education

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  1  programs.  The agency shall seek advice from consumers, health

  2  care purchasers, health care providers, health care

  3  facilities, and health insurers, and local health councils in

  4  the development and implementation of its information system.

  5  Whenever appropriate, the agency shall use the local health

  6  councils for the dissemination of information and education of

  7  the public.

  8         Section 26.  The introductory paragraph and subsection

  9  (31) of section 408.07, Florida Statutes, are amended to read:

10         408.07  Definitions.--As used in this chapter, with the

11  exception of ss. 408.031-408.045, the term:

12         (31)  "Local health council" means the agency defined

13  in s. 408.033.

14         Section 27.  Subsection (4) of section 408.09, Florida

15  Statutes, is amended to read:

16         408.09  Assistance on cost containment strategies.--The

17  agency shall:

18         (4)  Assist existing health coalitions and local health

19  councils as needed in carrying out their respective goals in

20  an efficient and effective manner.

21         Section 28.  Subsection (8) of section 408.18, Florida

22  Statutes, is amended to read:

23         408.18  Health Care Community Antitrust Guidance Act;

24  antitrust no-action letter; market-information collection and

25  education.--

26         (8)  The Agency for Health Care Administration shall

27  coordinate all existing data received, such as the hospital

28  patient discharge database, ambulatory patient database,

29  ambulatory facilities' financial data, health facility

30  licensure and certification tracking system, health facility

31  plans and construction data, local health council data,

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  1  Medicaid data, provider claims data, psychiatric hospital

  2  discharge data, pharmaceutical data, licensure data of health

  3  maintenance organizations, licensure data of health insurers,

  4  health care practitioner licensure data, hospital financial

  5  database, health facility utilization and projected need data,

  6  nursing home financial database, nursing home patient

  7  database, and joint venture database. This information shall

  8  be made available to the Attorney General's office, as needed.

  9         Section 29.  Paragraph (j) of subsection (2) of section

10  409.9117, Florida Statutes, is amended to read:

11         409.9117  Primary care disproportionate share

12  program.--

13         (2)  In the establishment and funding of this program,

14  the agency shall use the following criteria in addition to

15  those specified in s. 409.911, payments may not be made to a

16  hospital unless the hospital agrees to:

17         (j)  Work with the local health council to develop a

18  plan for promoting access to affordable health care services

19  for all persons who reside within the area, including, but not

20  limited to, public health services, primary care services,

21  inpatient services, and affordable health insurance generally.

22

23  Any hospital that fails to comply with any of the provisions

24  of this subsection, or any other contractual condition, may

25  not receive payments under this section until full compliance

26  is achieved.

27         Section 30.  Paragraph (b) of subsection (5) of section

28  430.705, Florida Statutes, is amended to read:

29         430.705  Implementation of the long-term care community

30  diversion pilot projects.--

31

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  1         (5)  In selecting the pilot project area, the

  2  department shall consider the following factors in the area:

  3         (b)  The number of certificates of need awarded for

  4  nursing home beds for which renovation, expansion, or

  5  construction has not begun.

  6         Section 31.  Section 430.708, Florida Statutes, is

  7  amended to read:

  8         430.708  Implementation of Medicaid community diversion

  9  pilot projects Certificate of need.--To ensure that Medicaid

10  community diversion pilot projects result in a reduction in

11  the projected average monthly nursing home caseload, the

12  agency shall, in accordance with the provisions of s.

13  408.034(4):

14         (1)  Reduce the projected nursing home bed need in each

15  certificate-of-need batching cycle in the community diversion

16  pilot project areas.

17         (1)(2)  Reduce the conditions imposed on existing

18  nursing homes or those to be constructed, in accordance with

19  the number of projected community diversion slots.

20         (2)(3)  Adopt rules to reduce the number of beds in

21  Medicaid-participating nursing homes eligible for Medicaid,

22  through a Medicaid-selective contracting process or some other

23  appropriate method.

24         (4)  Determine the feasibility of increasing the

25  nursing home occupancy threshold used in determining nursing

26  home bed needs under the certificate-of-need process.

27         Section 32.  Subsection (1) of section 458.345, Florida

28  Statutes, is amended to read:

29         458.345  Registration of resident physicians, interns,

30  and fellows; list of hospital employees; prescribing of

31  medicinal drugs; penalty.--

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  1         (1)  Any person desiring to practice as a resident

  2  physician, assistant resident physician, house physician,

  3  intern, or fellow in fellowship training which leads to

  4  subspecialty board certification in this state, or any person

  5  desiring to practice as a resident physician, assistant

  6  resident physician, house physician, intern, or fellow in

  7  fellowship training in a teaching hospital in this state as

  8  defined in s. 408.07(43)(44) or s. 395.805(2), who does not

  9  hold a valid, active license issued under this chapter shall

10  apply to the department to be registered and shall remit a fee

11  not to exceed $300 as set by the board.  The department shall

12  register any applicant the board certifies has met the

13  following requirements:

14         (a)  Is at least 21 years of age.

15         (b)  Has not committed any act or offense within or

16  without the state which would constitute the basis for refusal

17  to certify an application for licensure pursuant to s.

18  458.331.

19         (c)  Is a graduate of a medical school or college as

20  specified in s. 458.311(1)(f).

21         Section 33.  Subsection (1) of section 459.021, Florida

22  Statutes, is amended to read:

23         459.021  Registration of resident physicians, interns,

24  and fellows; list of hospital employees; penalty.--

25         (1)  Any person who holds a degree of Doctor of

26  Osteopathic Medicine from a college of osteopathic medicine

27  recognized and approved by the American Osteopathic

28  Association who desires to practice as a resident physician,

29  assistant resident physician, house physician, intern, or

30  fellow in fellowship training which leads to subspecialty

31  board certification in this state, or any person desiring to

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  1  practice as a resident physician, assistant resident

  2  physician, house physician, intern, or fellow in fellowship

  3  training in a teaching hospital in this state as defined in s.

  4  408.07(43)(44) or s. 395.805(2), who does not hold an active

  5  license issued under this chapter shall apply to the

  6  department to be registered, on an application provided by the

  7  department, within 30 days of commencing such a training

  8  program and shall remit a fee not to exceed $300 as set by the

  9  board.

10         Section 34.  Paragraph (c) of subsection (1) of section

11  641.60, Florida Statutes, is amended to read:

12         641.60  Statewide Managed Care Ombudsman Committee.--

13         (1)  As used in ss. 641.60-641.75:

14         (c)  "District" means one of the health service

15  planning districts as defined in s. 408.032.

16         Section 35.  Paragraph (a) of subsection (2) of section

17  651.021, Florida Statutes, is amended to read:

18         651.021  Certificate of authority required.--

19         (2)(a)  Before commencement of construction or

20  marketing for any expansion of a certificated facility

21  equivalent to the addition of at least 20 percent of existing

22  units, written approval must be obtained from the department.

23  This provision does not apply to construction for which a

24  certificate of need from the Agency for Health Care

25  Administration is required.

26         Section 36.  This act shall take effect July 1, 2001.

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  2                          HOUSE SUMMARY

  3
      Repeals the "Health Facility and Services Development
  4    Act."  Removes requirements for certificate-of-need
      review and approval for health facilities and services.
  5    Conforms provisions relating to health planning and
      certificate-of-need review of proposed and existing
  6    health facilities and services.

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