HB 1639CS

CHAMBER ACTION




1The Committee on State Administration recommends the following:
2
3     Committee Substitute
4     Remove the entire bill and insert:
5
A bill to be entitled
6An act relating to sovereign immunity; providing
7legislative findings and intent; amending s. 766.1115,
8F.S.; specifying nonapplicability to certain affiliation
9agreements or contracts to provide certain comprehensive
10health care services protected by sovereign immunity;
11amending s. 768.28, F.S.; expanding a definition to
12include certain health care providers; including under
13sovereign immunity protection provisions certain colleges,
14universities, and medical schools providing comprehensive
15health care services to patients at public hospitals under
16certain circumstances; providing definitions; providing an
17exception; providing an effective date.
18
19Be It Enacted by the Legislature of the State of Florida:
20
21     Section 1.  Legislative findings and intent.--
22     (1)  The Legislature finds that access to quality,
23affordable health care for all residents of this state is a
24necessary goal for the state and that public hospitals play an
25essential role in providing access to comprehensive health care
26services.
27     (2)  The Legislature further finds that access to quality
28health care at public hospitals is enhanced when public
29hospitals affiliate and coordinate their common endeavors with
30medical schools. These affiliations have proven to be an
31integral part of the delivery of more efficient and economical
32health care services to patients of public hospitals by offering
33quality graduate medical education programs to resident
34physicians who provide patient services at public hospitals.
35These affiliations ensure continued access to quality
36comprehensive health care services for residents of this state
37and therefore should be encouraged in order to maintain and
38expand such services.
39     (3)  The Legislature finds that when medical schools
40affiliate or enter into contracts with public hospitals to
41provide comprehensive health care services to patients of public
42hospitals, they greatly increase their exposure to claims
43arising out of alleged medical malpractice and other allegedly
44negligent acts because some colleges and universities and their
45medical schools and employees do not have the same level of
46protection against liability claims as governmental entities and
47their public employees providing the same patient services to
48the same public hospital patients.
49     (4)  The Legislature finds that the high cost of
50litigation, unequal liability exposure, and increased medical
51malpractice insurance premiums have adversely impacted the
52ability of some medical schools to permit their employees to
53provide patient services to patients of public hospitals. This
54finding is consistent with the report issued in April 2002 by
55the American Medical Association declaring this state to be one
56of 12 states in the midst of a medical liability insurance
57crisis. The crisis in the availability and affordability of
58medical malpractice insurance is a contributing factor in the
59reduction of access to quality health care in this state. In the
60past 15 years, the number of public hospitals in this state has
61declined significantly. In 1988, 33 hospitals were owned or
62operated by the state and local governments or established as
63taxing districts. In 1991, that number dropped to 28. In 2001,
64only 18 remained, 7 of these concentrated in 1 county. Thus, 11
65public hospitals serve the other 66 counties of this state. If
66no corrective action is taken, this health care crisis will lead
67to a continued reduction of patient services in public
68hospitals.
69     (5)  The Legislature finds that the public is better served
70and will benefit from corrective action to address the foregoing
71concerns. It is imperative that the Legislature further the
72public benefit by conferring sovereign immunity upon colleges
73and universities, their medical schools, and their employees
74when, pursuant to an affiliation agreement or a contract to
75provide comprehensive health care services, they provide patient
76services to patients of public hospitals.
77     (6)  It is the intent of the Legislature that colleges and
78universities that affiliate with public hospitals be granted
79sovereign immunity protection under s. 768.28, Florida Statutes,
80in the same manner and to the same extent as the state and its
81agencies and political subdivisions. It is also the intent of
82the Legislature that employees of colleges and universities who
83provide patient services to patients of a public hospital be
84immune from lawsuits in the same manner and to the same extent
85as employees and agents of the state and its agencies and
86political subdivisions and, further, that they shall not be held
87personally liable in tort or named as a party defendant in an
88action while performing patient services except as provided in
89s. 768.28(9)(a), Florida Statutes.
90     Section 2.  Subsection (11) of section 766.1115, Florida
91Statutes, is amended to read:
92     766.1115  Health care providers; creation of agency
93relationship with governmental contractors.--
94     (11)  APPLICABILITY.--This section applies to incidents
95occurring on or after April 17, 1992. This section does not
96apply to any health care contract entered into by the Department
97of Corrections which is subject to s. 768.28(10)(a). This
98section does not apply to any affiliation agreement or contract
99entered into by a medical school to provide comprehensive health
100care services to patients at public hospitals which is subject
101to s. 768.28(10)(f). Nothing in this section in any way reduces
102or limits the rights of the state or any of its agencies or
103subdivisions to any benefit currently provided under s. 768.28.
104     Section 3.  Paragraph (b) of subsection (9) of section
105768.28, Florida Statutes, is amended, and paragraph (f) is added
106to subsection (10) of said section, to read:
107     768.28  Waiver of sovereign immunity in tort actions;
108recovery limits; limitation on attorney fees; statute of
109limitations; exclusions; indemnification; risk management
110programs.--
111     (9)
112     (b)  As used in this subsection, the term:
113     1.  "Employee" includes any volunteer firefighter.
114     2.  "Officer, employee, or agent" includes, but is not
115limited to:
116     a.,  Any health care provider when providing services
117pursuant to s. 766.1115.
118     b.,  Any member of the Florida Health Services Corps, as
119defined in s. 381.0302, who provides uncompensated care to
120medically indigent persons referred by the Department of Health.
121     c., and Any public defender or her or his employee or
122agent, including, among others, an assistant public defender and
123an investigator.
124     d.(I)  Any college or university or its medical school that
125enters into an affiliation agreement or a contract to allow its
126employees to provide comprehensive health care services to
127patients treated at public statutory teaching hospitals, any
128other health care facilities owned or used by a governmental
129entity, or other locations under contract with the governmental
130entity to provide comprehensive health care services to public
131hospital patients pursuant to paragraph (10)(f).
132     (II)  Any faculty member or other health care professional,
133practitioner, or ancillary caregiver or employee of a college or
134university or its medical school that enters into an affiliation
135agreement or a contract to provide comprehensive health care
136services with a public hospital or its governmental owner and
137who provides such services to patients of public hospitals
138pursuant to paragraph (10)(f).
139     (10)
140     (f)1.  Any not-for-profit college or university with a
141medical, dental, or nursing school, or any other academic
142programs of medical education accredited by any association,
143agency, council, commission, or accrediting body recognized by
144this state as a condition for licensure of its graduates,
145hereinafter collectively referred to as "medical school," that
146has entered into an affiliation agreement or a contract to allow
147its faculty, health care professionals, practitioners, and
148ancillary caregivers and employees, hereinafter referred to as
149"employees," to provide patient services to patients treated at
150a public hospital, together with the employees of such medical
151school, shall be deemed agents of the governmental entity for
152purposes of this section and shall be immune from liability for
153torts in the same manner and to the same extent as the state and
154its agencies and subdivisions while providing patient services.
155     2.  For purposes of this paragraph, the term:
156     a.  "Patient services" means:
157     (I)  Any comprehensive health care services, as defined in
158s. 641.19(4), including related administrative services to
159patients of a public hospital.
160     (II)  Supervision of interns, residents, and fellows
161providing any patient services to patients of a public hospital.
162     (III)  Access to participation in medical research
163protocols.
164     b.  "Public hospital" means a statutory teaching hospital
165and any other health care facility owned or used by the state, a
166county, a municipality, a public authority, a special taxing
167district with health care responsibilities, or any other local
168governmental entity, or at any location under contract with the
169governmental entity.
170     3.  No such employee or agent of such colleges or
171universities or their medical schools shall be personally liable
172in tort or named as a party defendant in any action arising from
173the provision of any patient services to patients of a public
174hospital, except as provided in paragraph (9)(a).
175     Section 4.  This act shall take effect upon becoming a law.


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