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