HB 1885

1	A bill to be entitled
2	An act relating to patient safety; creating s. 381.0271,
3	F.S.; providing definitions; creating the Florida Patient
4	Safety Corporation; authorizing the corporation to create
5	not-for-profit corporate subsidiaries; specifying that the
6	corporation and certain subsidiaries are not government
7	agencies; requiring the corporation and certain
8	subsidiaries to be subject to public meetings and records
9	requirements; exempting the corporation and certain
10	subsidiaries from certain provisions relating to
11	procurement of personal property and services; providing a
12	purpose for the corporation; establishing the membership
13	of the board of directors of the corporation; requiring
14	certain advisory committees for the corporation; requiring
15	the Agency for Health Care Administration to provide
16	assistance in establishing the corporation; specifying the
17	powers and duties of the corporation; requiring annual
18	reports; requiring the corporation to seek private-sector
19	funding and apply for grants for certain purposes;
20	requiring the Office of Program Policy Analysis and
21	Government Accountability, the Agency for Health Care
22	Administration, and the Department of Health to develop
23	performance measures for the corporation; requiring a
24	performance audit; providing an effective date.
25
26	Be It Enacted by the Legislature of the State of Florida:
27
28	Section 1.  Section 381.0271, Florida Statutes, is created
29	to read:
30	381.0271  Florida Patient Safety Corporation.--
31	(1)  DEFINITIONS.--As used in this section, the term:
32	(a)  "Adverse incident" has the meanings given to the term
33	in ss. 395.0197, 458.351, and 459.026.
34	(b)  "Corporation" means the Florida Patient Safety
35	Corporation created in this section.
36	(c)  "Patient safety data" has the meaning given to the
37	term in s. 766.1016.
38	(2)  CREATION.--
39	(a)  There is created a not-for-profit corporation, to be
40	known as the Florida Patient Safety Corporation, which shall be
41	registered, incorporated, organized, and operated in compliance
42	with chapter 617. The corporation is authorized to create not-
43	for-profit corporate subsidiaries that are organized under the
44	provisions of chapter 617, upon the prior approval of the board
45	of directors, as necessary, to fulfill its mission.
46	(b)  Neither the corporation nor any authorized and
47	approved subsidiary is an agency as defined in s. 20.03(11).
48	(c)  The corporation and any authorized and approved
49	subsidiary are subject to the public meetings and records
50	requirements of s. 24, Art. I of the State Constitution, chapter
51	119, and s. 286.011.
52	(d)  The corporation and any authorized and approved
53	subsidiary are not subject to the provisions of chapter 287.
54	(e)  The corporation is a patient safety organization as
55	defined in s. 766.1016.
56	(3)  PURPOSE.--
57	(a)  The purpose of the Florida Patient Safety Corporation
58	is to serve as a learning organization dedicated to assisting
59	health care providers in the state to improve the quality and
60	safety of health care rendered and to reduce harm to patients.
61	The corporation shall promote the development of a culture of
62	patient safety in the health care system in the state. The
63	corporation shall not regulate health care providers in the
64	state.
65	(b)  In the fulfillment of its purpose, the corporation
66	shall work with a consortium of patient safety centers within
67	the universities of the state and other patient safety centers
68	and programs.
69	(4)  BOARD OF DIRECTORS; MEMBERSHIP.--The corporation shall
70	be governed by a board of directors. The board of directors
71	shall consist of:
72	(a)  The chair of the Florida Council of Medical School
73	Deans.
74	(b)  The person responsible for patient safety issues for
75	the authorized health insurer with the largest market share as
76	measured by premiums written in the state for the most recent
77	calendar year, appointed by such insurer.
78	(c)  A representative of an authorized medical malpractice
79	insurer appointed by the insurers.
80	(d)  The president of the Florida Health Care Coalition.
81	(e)  A representative of a hospital in the state that is
82	implementing innovative patient safety initiatives, appointed by
83	the Florida Hospital Association.
84	(f)  A physician with expertise in patient safety,
85	appointed by the Florida Medical Association.
86	(g)  An osteopathic physician with expertise in patient
87	safety, appointed by the Florida Osteopathic Medical
88	Association.
89	(h)  A podiatric physician with expertise in patient
90	safety, appointed by the Florida Podiatric Medical Association.
91	(i)  A chiropractic physician with expertise in patient
92	safety, appointed by the Florida Chiropractic Association.
93	(j)  A dentist with expertise in patient safety, appointed
94	by the Florida Dental Association.
95	(k)  A nurse with expertise in patient safety, appointed by
96	the Florida Nurses Association.
97	(l)  An institutional pharmacist, appointed by the Florida
98	Society of Health-System Pharmacists.
99	(m)  A representative of Florida AARP, appointed by the
100	state director of Florida AARP.
101	(n)  An independent consultant on health care information
102	systems, appointed jointly by the Central Florida Chapter and
103	the South Florida Chapter of the Healthcare Information and
104	Management Systems Society.
105	(5)  ADVISORY COMMITTEES.--In addition to any committees
106	that the corporation may establish, the corporation shall
107	establish the following advisory committees:
108	(a)  A scientific research advisory committee that
109	includes, at a minimum, a representative from each patient
110	safety center or other patient safety program in the
111	universities of the state. The duties of the scientific research
112	advisory committee shall include, but not be limited to, the
113	analysis of existing data and research to improve patient safety
114	and encourage evidence-based medicine.
115	(b)  A technology advisory committee that includes, at a
116	minimum, a representative of a hospital that has implemented a
117	computerized physician order entry system and a health care
118	provider that has implemented an electronic medical records
119	system. The duties of the technology advisory committee shall
120	include, but not be limited to, implementation of new
121	technologies, including electronic medical records.
122	(c)  A health care provider advisory committee that
123	includes, at a minimum, representatives of hospitals, ambulatory
124	surgical centers, physicians, nurses, and pharmacists licensed
125	in the state and a representative of the Veterans Integrated
126	Service Network 8. The duties of the health care provider
127	advisory committee shall include, but not be limited to,
128	promotion of a culture of patient safety that reduces errors.
129	(d)  A health care consumer advisory committee that
130	includes, at a minimum, representatives of businesses that
131	provide health insurance coverage to their employees, consumer
132	advocacy groups, and representatives of patient safety
133	organizations. The duties of the health care consumer advisory
134	committee shall include, but not be limited to, identification
135	of incentives to encourage patient safety and the efficiency and
136	quality of care.
137	(e)  A litigation alternatives advisory committee that
138	includes, at a minimum, representatives of medical malpractice
139	plaintiff's and defendant's attorneys and a representative of
140	each law school in the state. The duties of the litigation
141	alternatives advisory committee shall include, but not be
142	limited to, identification of alternative systems to compensate
143	for injuries.
144	(f)  An education advisory committee that includes, at a
145	minimum, the associate dean for education, or the equivalent
146	position, as a representative from each school of medicine and
147	nursing to provide advice on the development, implementation,
148	and measurement of core competencies for patient safety to be
149	considered for incorporation in the educational programs of the
150	universities and colleges of the state.
151	(6)  ORGANIZATION; MEETINGS.--
152	(a)  The Agency for Health Care Administration shall assist
153	the corporation in its organizational activities required under
154	chapter 617, including, but not limited to:
155	1.  Eliciting appointments for the initial board of
156	directors.
157	2.  Convening the first meeting of the board of directors
158	and assisting with other meetings of the board of directors,
159	upon request of the board of directors, during the first year of
160	operation of the corporation.
161	3.  Drafting articles of incorporation for the board of
162	directors and, upon request of the board of directors,
163	delivering articles of incorporation to the Department of State
164	for filing.
165	4.  Drafting proposed bylaws for the corporation.
166	5.  Paying fees related to incorporation.
167	6.  Providing office space and administrative support, at
168	the request of the board of directors, but not beyond July 1,
169	2005.
170	(b)  The board of directors must conduct its first meeting
171	no later than August 1, 2004, and shall meet thereafter as
172	frequently as necessary to carry out the duties of the
173	corporation.
174	(7)  POWERS AND DUTIES.--In addition to the powers and
175	duties prescribed in chapter 617, and the articles and bylaws
176	adopted under that chapter, the corporation shall, either
177	directly or through contract:
178	(a)  Secure staff necessary to properly administer the
179	corporation.
180	(b)  Collect, analyze, and evaluate patient safety data,
181	quality and patient safety indicators, medical malpractice
182	closed claims, and adverse incidents reported to the Agency for
183	Health Care Administration and the Department of Health for the
184	purpose of recommending changes in practices and procedures that
185	may be implemented by health care practitioners and health care
186	facilities to improve health care quality and to prevent future
187	adverse incidents. Notwithstanding any other law, the Agency for
188	Health Care Administration and the Department of Health shall
189	make available to the corporation any adverse incident report
190	submitted under ss. 395.0197, 458.351, and 459.026. To the
191	extent that adverse incident reports submitted under s. 395.0197
192	are confidential and exempt, the confidential and exempt status
193	of such reports must be maintained by the corporation.
194	(c)  Establish a 3-year pilot project of a near-miss
195	patient safety reporting system. The purpose of this system is
196	to identify potential systemic problems that could lead to
197	adverse incidents, enable publication of system-wide alerts of
198	potential harm, and facilitate development of both facility-
199	specific and statewide options to avoid adverse incidents and
200	improve patient safety. The reporting system shall record near-
201	misses submitted by hospitals, birthing centers, ambulatory
202	surgical facilities, and other providers. For the purpose of the
203	reporting system:
204	1.  The term "near miss" means any potentially harmful
205	event that could have had an adverse result, but, through chance
206	or intervention, harm was prevented.
207	2.  The near-miss reporting system shall be voluntary,
208	anonymous, and independent of mandatory reporting systems used
209	for regulatory purposes.
210	3.  Data submitted to the corporation shall be de-
211	identified and shall not be discoverable or admissible in any
212	civil or administrative action.
213	4.  Reports of near-miss data shall be published on a
214	regular basis and special alerts shall be published as needed
215	regarding newly identified, significant risks.
216	5.  Aggregated near-miss data shall be made publicly
217	available.
218	6.  The corporation shall report the performance and
219	results of the reporting system pilot project in its annual
220	report.
221	(d)  Foster the development of a statewide electronic
222	infrastructure, including implementation of statewide electronic
223	medical records systems, that may be implemented in phases over
224	a multiyear period and that is designed to improve patient care
225	and the delivery and quality of health care services by health
226	care facilities and health care practitioners. Support for
227	implementation of electronic medical records systems shall
228	include:
229	1.  A report to the Governor, the President of the Senate,
230	the Speaker of the House of Representatives, and the Agency for
231	Health Care Administration by January 1, 2005, identifying:
232	a.  Public and private-sector initiatives relating to
233	electronic medical records and the communication systems used to
234	share clinical information among caregivers.
235	b.  Regulatory barriers that interfere with the sharing of
236	clinical information among caregivers.
237	c.  Investment incentives that might be used to promote the
238	use of recommended technologies by health care providers.
239	d.  Educational strategies that may be implemented to
240	educate health care providers about the recommended technologies
241	for sharing clinical information.
242	2.  An implementation plan reported to the Governor, the
243	President of the Senate, the Speaker of the House of
244	Representatives, and the Agency for Health Care Administration
245	by September 1, 2005, that must include, but need not be limited
246	to, the capital investment required to begin implementing the
247	system, the costs of operating the system, the financial
248	incentives recommended to increase capital investment, data
249	concerning the providers initially committed to participating in
250	the system by region, the standards for systemic functionality
251	and features, any marketing plan to increase participation, and
252	implementation schedules for key components.
253	(e)  Provide for access to an active library of evidence-
254	based medicine and patient safety practices, including the
255	emerging evidence supporting their retention or modification,
256	and make this information available to health care
257	practitioners, health care facilities, and the public. Support
258	for implementation of evidence-based medicine shall include:
259	1.  A report to the Governor, the President of the Senate,
260	the Speaker of the House of Representatives, and the Agency for
261	Health Care Administration by January 1, 2005, identifying:
262	a.  The ability to join or support efforts for the use of
263	evidence-based medicine already underway, such as those of the
264	Leapfrog Group, the international group Bandolier, and the
265	Healthy Florida Foundation.
266	b.  The means by which to promote research using Medicaid
267	and other data collected by the Agency for Health Care
268	Administration to identify and quantify the most cost-effective
269	treatment and interventions, including disease management and
270	prevention programs.
271	c.  The means by which to encourage development of systems
272	to measure and reward providers who implement evidence-based
273	medical practices.
274	d.  The review of other state and private initiatives and
275	published literature for promising approaches and the
276	dissemination of information about such initiatives and
277	literature to providers.
278	e.  The encouragement of the state health care boards under
279	the Department of Health to regularly publish findings related
280	to the cost-effectiveness of disease-specific evidence-based
281	standards.
282	f.  Public and private-sector initiatives related to
283	evidence-based medicine and communication systems for the
284	sharing of clinical information among caregivers.
285	g.  Regulatory barriers that interfere with the sharing of
286	clinical information among caregivers.
287	2.  An implementation plan reported to the Governor, the
288	President of the Senate, the Speaker of the House of
289	Representatives, and the Agency for Health Care Administration
290	by September 1, 2005, that must include, but need not be limited
291	to, estimated costs and savings, capital investment
292	requirements, recommended investment incentives, initial
293	committed provider participation by region, standards of
294	functionality and features, a marketing plan, and implementation
295	schedules for key components.
296	(f)  Develop and recommend core competencies in patient
297	safety that can be incorporated into the curriculums in schools
298	of medicine, nursing, and allied health in the state.
299	(g)  Develop programs to educate the public about the role
300	of health care consumers in promoting patient safety.
301	(h)  Provide recommendations for interagency coordination
302	of patient safety efforts in the state.
303	(8)  ADDITIONAL POWERS.--In carrying out its powers and
304	duties, the corporation may also:
305	(a)  Assess the patient safety culture at volunteering
306	hospitals and recommend methods to improve the working
307	environment related to patient safety at these hospitals.
308	(b)  Inventory the information technology capabilities
309	related to patient safety of health care facilities and health
310	care practitioners and recommend a plan for expediting the
311	implementation of patient safety technologies statewide.
312	(c)  Recommend continuing medical education regarding
313	patient safety to practicing health care practitioners.
314	(d)  Study and facilitate the testing of litigation
315	alternative systems, including risk management, best practices,
316	and systems of compensating injured patients, as a means of
317	reducing and preventing medical errors and promoting patient
318	safety.
319	(9)  ANNUAL REPORT.--By December 1, 2004, the corporation
320	shall prepare a report on the startup activities of the
321	corporation and any proposals for legislative action that are
322	needed for the corporation to fulfill its purposes under this
323	section. By December 1 of each year thereafter, the corporation
324	shall prepare a report for the preceding fiscal year. The
325	report, at a minimum, must include:
326	(a)  A description of the activities of the corporation
327	under this section.
328	(b)  Progress made in improving patient safety and reducing
329	medical errors.
330	(c)  Policies and programs that have been implemented and
331	their outcomes.
332	(d)  A compliance and financial audit of the accounts and
333	records of the corporation at the end of the preceding fiscal
334	year conducted by an independent certified public accountant.
335	(e)  Recommendations for legislative action needed to
336	improve patient safety in the state.
337
338	The corporation shall submit the report to the Governor, the
339	President of the Senate, and the Speaker of the House of
340	Representatives.
341	(10)  PRIVATE-SECTOR FUNDING AND GRANTS.--The corporation
342	is required to seek private-sector funding and apply for grants
343	to accomplish its goals and duties.
344	(11)  PERFORMANCE EXPECTATIONS.--The Office of Program
345	Policy Analysis and Government Accountability, the Agency for
346	Health Care Administration, and the Department of Health shall
347	develop performance standards by which to measure the success of
348	the corporation in fulfilling the purposes established in this
349	section. Using the performance standards, the Office of Program
350	Policy Analysis and Government Accountability shall conduct a
351	performance audit of the corporation during 2006 and shall
352	submit a report to the Governor, the President of the Senate,
353	and the Speaker of the House of Representatives by January 1,
354	2007.
355	Section 2.  This act shall take effect July 1, 2004.

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