HB 0865 2003
1	CHAMBER ACTION
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6	The Committee on Health Care recommends the following:
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8	Committee Substitute
9	Remove the entire bill and insert:
10	A bill to be entitled
11	An act relating to health care; amending s. 408.036, F.S.;
12	providing an exemption from certificate-of-need
13	requirements for certain open-heart-surgery programs;
14	providing criteria for qualifying for the exemption;
15	requiring the Agency for Health Care Administration to
16	report to the Legislature; providing an effective date.
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18	Be It Enacted by the Legislature of the State of Florida:
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20	Section 1. Paragraph (t) is added to subsection (3) of
21	section 408.036, Florida Statutes, to read:
22	408.036 Projects subject to review; exemptions.--
23	(3) EXEMPTIONS.--Upon request, the following projects are
24	subject to exemption from the provisions of subsection (1):
25	(t)1. For the provision of adult open-heart services in a
26	hospital located within the boundaries of Palm Beach, Polk,
27	Martin, St. Lucie, or Indian River Counties if the following
28	conditions are met: the exemption must be based upon objective
29	criteria and address and solve the twin problems of geographic
30	and temporal access. A hospital shall be exempt from the
31	certificate-of-need review for the establishment of an open-
32	heart-surgery program when the application for exemption
33	submitted under this paragraph complies with the following
34	criteria:
35	a. The applicant must certify that it will meet and
36	continuously maintain the minimum licensure requirements adopted
37	by the agency governing adult open-heart programs, including the
38	most current guidelines of the American College of Cardiology
39	and American Heart Association Guidelines for Adult Open Heart
40	Programs.
41	b. The applicant must certify that it will maintain
42	sufficient appropriate equipment and health personnel to ensure
43	quality and safety.
44	c. The applicant must certify that it will maintain
45	appropriate times of operation and protocols to ensure
46	availability and appropriate referrals in the event of
47	emergencies.
48	d. The applicant can demonstrate that it is referring 300
49	or more patients per year from the hospital, including the
50	emergency room, for cardiac services at a hospital with cardiac
51	services, or that the average wait for transfer for 50 percent
52	or more of the cardiac patients exceeds 4 hours.
53	e. The applicant is a general acute care hospital that has
54	been in operation for 3 years or more.
55	f. The applicant is performing more than 300 diagnostic
56	cardiac catheterization procedures per year, combined inpatient
57	and outpatient.
58	g. The applicant's payor mix at a minimum reflects the
59	community average for Medicaid, charity care, and self-pay
60	patients or the applicant must certify that it will provide a
61	minimum of 5 percent of Medicaid, charity care, and self-pay to
62	open-heart-surgery patients.
63	h. If the applicant fails to meet the established criteria
64	for open-heart programs or fails to reach 300 surgeries per year
65	by the end of its third year of operation, it must show cause
66	why its exemption should not be revoked.
67	2. By December 31, 2004, and annually thereafter, the
68	Agency for Health Care Administration shall submit a report to
69	the Legislature providing information concerning the number of
70	requests for exemption received under this paragraph and the
71	number of exemptions granted or denied.
72	Section 2. This act shall take effect upon becoming a law.