House Bill hb0581c1

    Florida House of Representatives - 2002              CS/HB 581

        By the Council for Healthy Communities and Representatives
    Mayfield and Farkas





  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         408.036, F.S.; revising the exemptions from

  4         certificate-of-need requirements for certain

  5         open heart surgery programs and for a satellite

  6         hospital; providing an effective date.

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

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10         Section 1.  Paragraphs (t) and (u) are added to

11  subsection (3) of section 408.036, Florida Statutes, to read:

12         408.036  Projects subject to review.--

13         (3)  EXEMPTIONS.--Upon request, the following projects

14  are subject to exemption from the provisions of subsection

15  (1):

16         (t)  For the provision of adult open heart services in

17  a hospital. When a clear problem exists in access to needed

18  cardiac services, consideration must be given to creating an

19  exemption. While such needs might be addressed by the changing

20  of the specific need criteria under the certificate-of-need

21  law, the problem of protracted administrative appeals would

22  still remain. The exemption must be based upon objective

23  criteria and address and solve the twin problems of geographic

24  and temporal access. A hospital shall be exempt from the

25  certificate-of-need review for the establishment of an open

26  heart surgery program when the application for exemption

27  submitted under this paragraph complies with the following

28  criteria:

29         1.  The applicant must certify it will meet and

30  continuously maintain the minimum licensure requirements

31  adopted by the agency governing adult open heart programs,

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    Florida House of Representatives - 2002              CS/HB 581

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  1  including the most current guidelines of the American College

  2  of Cardiology and American Heart Association Guidelines for

  3  Adult Open Heart Programs.

  4         2.  The applicant must certify it will maintain

  5  sufficient appropriate equipment and health personnel to

  6  ensure quality and safety.

  7         3.  The applicant must certify it will maintain

  8  appropriate times of operation and protocols to ensure

  9  availability and appropriate referrals in the event of

10  emergencies.

11         4.  The applicant can demonstrate that it is referring

12  300 or more cardiac patients from the hospital, including the

13  emergency room, per year to a hospital with cardiac services,

14  or that the average wait for transfer for 50 percent or more

15  of the cardiac patients exceeds 4 hours.

16         5.  The applicant is a general acute care hospital that

17  is in operation for 3 years or more.

18         6.  The applicant is performing more than 500

19  diagnostic cardiac catheterization procedures per year,

20  combined inpatient and outpatient.

21         7.  The applicant has a formal agreement with an

22  existing statutory teaching hospital or cardiac program

23  performing 750 open heart cases per year which creates at a

24  minimum an external peer review process. The peer review shall

25  be conducted quarterly the first year of operation and two

26  times a year in the succeeding years until either the program

27  reaches 350 cases per year or demonstrates consistency with

28  state-adopted quality and outcome standards for the service.

29         8.  The applicant payor-mix at a minimum reflects the

30  community average for Medicaid, charity care, and self-pay or

31  the applicant must certify that it will provide a minimum of 5

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    Florida House of Representatives - 2002              CS/HB 581

    404-146A-02






  1  percent of Medicaid, charity care, and self-pay to open heart

  2  surgery patients.

  3         9.  If the applicant fails to meet the established

  4  criteria for open heart programs or fails to reach 300

  5  surgeries per year by the end of year 3, it must show cause

  6  why its exemption should not be revoked.

  7         (u)  For the establishment of a satellite hospital

  8  through the relocation of 100 general acute care beds from an

  9  existing hospital located in the same district, as defined in

10  s. 408.032(5).

11         Section 2.  This act shall take effect upon becoming a

12  law.

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CODING: Words stricken are deletions; words underlined are additions.