HB 1447 2003
1	A bill to be entitled
2	An act relating to St. Lucie County; providing legislative
3	intent; providing a popular name; providing for
4	consolidation of certain local hospital authority;
5	providing powers and duties of hospital governing boards;
6	providing an effective date.
7
8	Be It Enacted by the Legislature of the State of Florida:
9
10	Section 1. This act clarifies the delineation of authority
11	within each hospital within St. Lucie County. It is the intent
12	of the Legislature to provide consolidation of a hospital
13	corporation's board of directors' power, authority, duty, and
14	ultimate responsibility under existing statutes with respect to
15	the operation of a hospital, including, but not limited to, the
16	granting, denial, and discipline of medical staff and clinical
17	privileges, and for compliance with statutorily mandated peer
18	review, risk management, and quality assurance activities. This
19	act is not intended to supersede or terminate any existing
20	medical staff bylaws, but rather to clarify that in the event of
21	a conflict between bylaws of a hospital corporation's board of
22	directors and a hospital's medical staff bylaws, the hospital
23	board's bylaws shall prevail.
24	Section 2. This act may be known by the popular name the
25	"St. Lucie County Hospital Governance Law."
26	Section 3. The board of directors of each general hospital
27	operating in St. Lucie County whose license is held by a
28	corporation shall appoint or elect, in a manner and method of
29	its own choosing, a governing board for each hospital which may
30	be the board of directors of such corporation or a separate
31	governing board. The board of directors may delegate such
32	authority as it deems necessary to the governing board of a
33	hospital, but such delegation does not relieve the hospital
34	corporation of ultimate responsibility, and such delegation of
35	authority shall remain subject to amendment, rescission, or
36	revocation by the board of directors.
37	Section 4. The governing board shall also be ultimately
38	responsible for the administration of the hospital, including
39	managing the operations of the hospital, ensuring patient
40	welfare, conducting peer review, overseeing the risk management
41	program and quality assurance activities, and determining
42	eligibility for medical staff membership and clinical
43	privileges. This authority is granted subject to the provisions
44	of sections 395.0191 and 395.0193, Florida Statutes, and the
45	articles of incorporation and bylaws of the hospital
46	corporation.
47	Section 5. A governing board's authority for the
48	administration of the hospital is not limited by the authority
49	of its medical staff. Therefore, a governing board may reject or
50	modify a medical staff recommendation or may, if the medical
51	staff has failed to act, take action independent of the medical
52	staff concerning medical staff membership, clinical privileges,
53	peer review, and quality assurance in accordance with the
54	procedures specified in section 6. To the extent, if any, that
55	the bylaws or other regulations of the medical staff conflict
56	with the bylaws or other regulations of the governing board, the
57	bylaws or other regulations of the governing board shall
58	control, irrespective of the identity of the drafter of the
59	respective bylaws or regulations. Neither the governing board
60	nor a hospital's medical staff shall unilaterally amend a
61	hospital's medical staff bylaws and related manuals, rules, or
62	regulations. Any amendments or revisions proposed by the
63	governing board shall first be submitted to the medical staff
64	for its recommendations, including 30 days' notice for response,
65	and any response timely made shall be carefully considered by
66	the governing board prior to its approval of the proposed
67	amendments or revisions.
68	Section 6. To the extent a governing board seeks to modify
69	a medical staff recommendation, or where a medical staff has
70	failed to act within 60 days after a request from the governing
71	board to take action against an individual physician concerning
72	medical staff membership, clinical privileges, peer review, or
73	quality assurance, a governing board may take corrective or
74	disciplinary action against such physician. Any such action
75	shall be subject to a fair hearing process in which the
76	physician is entitled to be represented by counsel, to be
77	afforded an opportunity to present oral and written argument in
78	response to the corrective or disciplinary action proposed, and
79	to comment upon and cross-examine witnesses and evidence against
80	such physician. If, after the fair hearing, the governing board
81	determines that corrective or disciplinary action is necessary,
82	it shall recommend such action to a six-member joint conference
83	committee composed of three members of the governing board, to
84	be appointed by the chair of the governing board, and three
85	members of the medical staff, to be appointed by the chair or
86	president of the medical staff. The joint conference committee
87	shall, within 15 days after the governing board's decision after
88	the fair hearing process, review the fair hearing recommendation
89	and notify the governing board that the joint conference
90	committee accepts, rejects, or cannot reach a majority consensus
91	concerning the governing board's recommendation. If the joint
92	conference committee's recommendation is to accept the governing
93	board's recommendation, the governing board's decision shall be
94	final. The joint conference committee's recommendation shall be
95	entitled to deference. If the joint conference committee rejects
96	the governing board's recommendation and suggests an alternative
97	corrective or disciplinary action, or finds that no corrective
98	or disciplinary action is warranted, the governing board shall
99	not unreasonably reject the joint conference committee's
100	recommendation. If the joint conference committee cannot reach a
101	majority consensus to either accept or reject the governing
102	board's action concerning the fair hearing decision, the
103	governing board's action shall be final.
104	Section 7. This act shall take effect upon becoming a law.