HB 1639

CS

CHAMBER ACTION

1	The Committee on State Administration recommends the following:
2
3	Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to sovereign immunity; providing
7	legislative findings and intent; amending s. 766.1115,
8	F.S.; specifying nonapplicability to certain affiliation
9	agreements or contracts to provide certain comprehensive
10	health care services protected by sovereign immunity;
11	amending s. 768.28, F.S.; expanding a definition to
12	include certain health care providers; including under
13	sovereign immunity protection provisions certain colleges,
14	universities, and medical schools providing comprehensive
15	health care services to patients at public hospitals under
16	certain circumstances; providing definitions; providing an
17	exception; providing an effective date.
18
19	Be 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,
23	affordable health care for all residents of this state is a
24	necessary goal for the state and that public hospitals play an
25	essential role in providing access to comprehensive health care
26	services.
27	(2)  The Legislature further finds that access to quality
28	health care at public hospitals is enhanced when public
29	hospitals affiliate and coordinate their common endeavors with
30	medical schools. These affiliations have proven to be an
31	integral part of the delivery of more efficient and economical
32	health care services to patients of public hospitals by offering
33	quality graduate medical education programs to resident
34	physicians who provide patient services at public hospitals.
35	These affiliations ensure continued access to quality
36	comprehensive health care services for residents of this state
37	and therefore should be encouraged in order to maintain and
38	expand such services.
39	(3)  The Legislature finds that when medical schools
40	affiliate or enter into contracts with public hospitals to
41	provide comprehensive health care services to patients of public
42	hospitals, they greatly increase their exposure to claims
43	arising out of alleged medical malpractice and other allegedly
44	negligent acts because some colleges and universities and their
45	medical schools and employees do not have the same level of
46	protection against liability claims as governmental entities and
47	their public employees providing the same patient services to
48	the same public hospital patients.
49	(4)  The Legislature finds that the high cost of
50	litigation, unequal liability exposure, and increased medical
51	malpractice insurance premiums have adversely impacted the
52	ability of some medical schools to permit their employees to
53	provide patient services to patients of public hospitals. This
54	finding is consistent with the report issued in April 2002 by
55	the American Medical Association declaring this state to be one
56	of 12 states in the midst of a medical liability insurance
57	crisis. The crisis in the availability and affordability of
58	medical malpractice insurance is a contributing factor in the
59	reduction of access to quality health care in this state. In the
60	past 15 years, the number of public hospitals in this state has
61	declined significantly. In 1988, 33 hospitals were owned or
62	operated by the state and local governments or established as
63	taxing districts. In 1991, that number dropped to 28. In 2001,
64	only 18 remained, 7 of these concentrated in 1 county. Thus, 11
65	public hospitals serve the other 66 counties of this state. If
66	no corrective action is taken, this health care crisis will lead
67	to a continued reduction of patient services in public
68	hospitals.
69	(5)  The Legislature finds that the public is better served
70	and will benefit from corrective action to address the foregoing
71	concerns. It is imperative that the Legislature further the
72	public benefit by conferring sovereign immunity upon colleges
73	and universities, their medical schools, and their employees
74	when, pursuant to an affiliation agreement or a contract to
75	provide comprehensive health care services, they provide patient
76	services to patients of public hospitals.
77	(6)  It is the intent of the Legislature that colleges and
78	universities that affiliate with public hospitals be granted
79	sovereign immunity protection under s. 768.28, Florida Statutes,
80	in the same manner and to the same extent as the state and its
81	agencies and political subdivisions. It is also the intent of
82	the Legislature that employees of colleges and universities who
83	provide patient services to patients of a public hospital be
84	immune from lawsuits in the same manner and to the same extent
85	as employees and agents of the state and its agencies and
86	political subdivisions and, further, that they shall not be held
87	personally liable in tort or named as a party defendant in an
88	action while performing patient services except as provided in
89	s. 768.28(9)(a), Florida Statutes.
90	Section 2.  Subsection (11) of section 766.1115, Florida
91	Statutes, is amended to read:
92	766.1115  Health care providers; creation of agency
93	relationship with governmental contractors.--
94	(11)  APPLICABILITY.--This section applies to incidents
95	occurring on or after April 17, 1992. This section does not
96	apply to any health care contract entered into by the Department
97	of Corrections which is subject to s. 768.28(10)(a). This
98	section does not apply to any affiliation agreement or contract
99	entered into by a medical school to provide comprehensive health
100	care services to patients at public hospitals which is subject
101	to s. 768.28(10)(f). Nothing in this section in any way reduces
102	or limits the rights of the state or any of its agencies or
103	subdivisions to any benefit currently provided under s. 768.28.
104	Section 3.  Paragraph (b) of subsection (9) of section
105	768.28, Florida Statutes, is amended, and paragraph (f) is added
106	to subsection (10) of said section, to read:
107	768.28  Waiver of sovereign immunity in tort actions;
108	recovery limits; limitation on attorney fees; statute of
109	limitations; exclusions; indemnification; risk management
110	programs.--
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
115	limited to:
116	a.,  Any health care provider when providing services
117	pursuant to s. 766.1115.
118	b.,  Any member of the Florida Health Services Corps, as
119	defined in s. 381.0302, who provides uncompensated care to
120	medically indigent persons referred by the Department of Health.
121	c., and Any public defender or her or his employee or
122	agent, including, among others, an assistant public defender and
123	an investigator.
124	d.(I)  Any college or university or its medical school that
125	enters into an affiliation agreement or a contract to allow its
126	employees to provide comprehensive health care services to
127	patients treated at public statutory teaching hospitals, any
128	other health care facilities owned or used by a governmental
129	entity, or other locations under contract with the governmental
130	entity to provide comprehensive health care services to public
131	hospital patients pursuant to paragraph (10)(f).
132	(II)  Any faculty member or other health care professional,
133	practitioner, or ancillary caregiver or employee of a college or
134	university or its medical school that enters into an affiliation
135	agreement or a contract to provide comprehensive health care
136	services with a public hospital or its governmental owner and
137	who provides such services to patients of public hospitals
138	pursuant to paragraph (10)(f).
139	(10)
140	(f)1.  Any not-for-profit college or university with a
141	medical, dental, or nursing school, or any other academic
142	programs of medical education accredited by any association,
143	agency, council, commission, or accrediting body recognized by
144	this state as a condition for licensure of its graduates,
145	hereinafter collectively referred to as "medical school," that
146	has entered into an affiliation agreement or a contract to allow
147	its faculty, health care professionals, practitioners, and
148	ancillary caregivers and employees, hereinafter referred to as
149	"employees," to provide patient services to patients treated at
150	a public hospital, together with the employees of such medical
151	school, shall be deemed agents of the governmental entity for
152	purposes of this section and shall be immune from liability for
153	torts in the same manner and to the same extent as the state and
154	its 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
158	s. 641.19(4), including related administrative services to
159	patients of a public hospital.
160	(II)  Supervision of interns, residents, and fellows
161	providing any patient services to patients of a public hospital.
162	(III)  Access to participation in medical research
163	protocols.
164	b.  "Public hospital" means a statutory teaching hospital
165	and any other health care facility owned or used by the state, a
166	county, a municipality, a public authority, a special taxing
167	district with health care responsibilities, or any other local
168	governmental entity, or at any location under contract with the
169	governmental entity.
170	3.  No such employee or agent of such colleges or
171	universities or their medical schools shall be personally liable
172	in tort or named as a party defendant in any action arising from
173	the provision of any patient services to patients of a public
174	hospital, 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.