House Bill hb0339e1

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                                        CS/HB 339, First Engrossed



  1                      A bill to be entitled

  2         An act relating to certificate of need;

  3         amending s. 408.043, F.S.; providing criteria

  4         for review of a certificate-of-need application

  5         for establishment of an adult open heart

  6         surgery program in a county in which none of

  7         the hospitals has an existing or approved adult

  8         open heart surgery program; requiring an

  9         agreement that a certain percent of Medicaid

10         and charity patients be served; requiring a

11         specified number of operations; amending s. 15

12         of ch. 2000-318, Laws of Florida; providing for

13         additional appointments to the workgroup;

14         amending the scope of responsibility for the

15         workgroup; providing new dates for final report

16         to the Governor and Legislature and termination

17         of the certificate-of-need workgroup; providing

18         effective dates.

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

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22         Section 1.  Subsection (5) is added to section 408.043,

23  Florida Statutes, to read:

24         408.043  Special provisions.--

25         (5)  OPEN HEART SURGERY.

26         (a)  When an application is made for a certificate of

27  need to establish an adult open heart surgery program in a

28  county in which none of the hospitals has an existing or

29  approved adult open heart surgery program, need for one

30  program shall be evaluated under special circumstances to

31  promote reasonable access to such a program within the


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                                        CS/HB 339, First Engrossed



  1  county.  The criteria on which the certificate of need is

  2  reviewed in such circumstances shall favor approval in those

  3  counties that can generate at least 1,200 annual hospital

  4  discharges with a principal diagnosis of ischemic heart

  5  disease.  County-specific need identified under these

  6  circumstances shall exist independently of and in addition to

  7  any district need identified under the standard numeric need

  8  formula.

  9         (b)  An applicant for an adult open heart surgery

10  program who meets the special circumstances in paragraph (a)

11  shall, as a condition for approval, agree that the percentage

12  of admissions to its program which are Medicaid patients shall

13  be at least as great as the average percentage of Medicaid

14  patients admitted to open heart surgery programs in the

15  applicant's district; and shall also agree that the percentage

16  of admissions to its program which are charity patients shall

17  be at least as great as the average percentage of charity

18  patients admitted to open heart surgery programs in the

19  applicant's district.

20         (c)  An applicant approved for an adult open heart

21  surgery program consistent with this subsection shall perform

22  a 12-month total of at least 250 open heart surgery operations

23  during the third year that such procedures are being

24  performed. Failure to meet this requirement is subject to

25  agency action to terminate a hospital's authorization to

26  provide any open heart surgery operations.

27         Section 2.  Effective July 1, 2001, section 15 of

28  chapter 2000-318, Laws of Florida, is amended to read:

29         Section 15.

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                                        CS/HB 339, First Engrossed



  1         (1)(a)  There is created a certificate-of-need

  2  workgroup staffed by the Agency for Health Care

  3  Administration.

  4         (b)  Workgroup participants shall be responsible for

  5  only the expenses that they generate individually through

  6  workgroup participation.  The agency shall be responsible for

  7  expenses incidental to the production of any required data or

  8  reports.

  9         (2)  The workgroup shall consist of 32 30 members, 10

10  appointed by the Governor, 11 10 appointed by the President of

11  the Senate, and 11 10 appointed by the Speaker of the House of

12  Representatives. The workgroup chairperson shall be selected

13  by majority vote of a quorum present. Sixteen members shall

14  constitute a quorum. The membership shall include, but not be

15  limited to, representatives from health care provider

16  organizations, health care facilities, individual health care

17  practitioners, local health councils, and consumer

18  organizations, and persons with health care market expertise

19  as a private-sector consultant.

20         (3)  Appointment to the workgroup shall be as follows:

21         (a)  The Governor shall appoint one representative each

22  from the hospital industry; nursing home industry; hospice

23  industry; local health councils; a consumer organization; and

24  three health care market consultants, one of whom is a

25  recognized expert on hospital markets, one of whom is a

26  recognized expert on nursing home or long-term-care markets,

27  and one of whom is a recognized expert on hospice markets; one

28  representative from the Medicaid program; and one

29  representative from a health care facility that provides a

30  tertiary service.

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                                        CS/HB 339, First Engrossed



  1         (b)  The President of the Senate shall appoint a

  2  representative of a for-profit hospital, a representative of a

  3  not-for-profit hospital, a representative of a public

  4  hospital, two representatives of the nursing home industry,

  5  two representatives of the hospice industry, a representative

  6  of a consumer organization, a representative from the

  7  Department of Elderly Affairs involved with the implementation

  8  of a long-term-care community diversion program, and a health

  9  care market consultant with expertise in health care

10  economics, and a member of the Senate.

11         (c)  The Speaker of the House of Representatives shall

12  appoint a representative from the Florida Hospital

13  Association, a representative of the Association of Community

14  Hospitals and Health Systems of Florida, a representative of

15  the Florida League of Health Systems, a representative of the

16  Florida Health Care Association, a representative of the

17  Florida Association of Homes for the Aging, three

18  representatives of Florida Hospices and Palliative Care, one

19  representative of local health councils, and one

20  representative of a consumer organization, and a member of the

21  House.

22         (4)  The workgroup shall develop a plan for the reform

23  or elimination of the certificate of need program, which shall

24  include recommendations for required legislative action and

25  agency rule making. Such plan shall be implemented not sooner

26  than the effective date of any rules necessary for its

27  implementation. In developing the plan, the workgroup shall

28  seek input from all classes of health care consumers, health

29  care providers and health care facilities subject to

30  certificate of need review. All agencies, including, but not

31  limited to, the Agency for Health Care Administration and the


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                                        CS/HB 339, First Engrossed



  1  Department of Elder Affairs, shall provide assistance to the

  2  workgroup, upon request. The workgroup shall study issues

  3  pertaining to the certificate-of-need program, including the

  4  impact of trends in health care delivery and financing. The

  5  workgroup shall study issues relating to implementation of the

  6  certificate-of-need program.

  7         (5)  The workgroup shall meet at least annually, at the

  8  request of the chairperson. The workgroup shall submit an

  9  interim report by December 31, 2001, and a final report to the

10  Governor, the President of the Senate, and the Speaker of the

11  House of Representatives by January 7, by December 31, 2002.

12  The workgroup is abolished effective May 3, 2002 July 1, 2003.

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

14  law.

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