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A bill to be entitled

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An act relating to the Florida Patient Safety Corporation;

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amending s. 381.0271, F.S.; deleting provisions requiring

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that the corporation establish specific advisory

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committees; authorizing the corporation to create and

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dissolve advisory committees upon a majority vote of the

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board of directors; deleting obsolete organizational

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provisions; requiring that the corporation's board of

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directors conduct quarterly meetings; requiring the Agency

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for Health Care Administration to make available adverse

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incident reports to designated agents of the Florida

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Patient Safety Corporation; requiring the corporation to

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evaluate the effects of the sharing of electronic records

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on patient safety; deleting responsibilities related to

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the provision of access to a library of evidence-based

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medicine and patient safety practices; requiring a plan

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for the implementation of patient safety technologies;

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deleting obsolete provisions and reporting requirements;

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providing an effective date.

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Be It Enacted by the Legislature of the State of Florida:

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     Section 1.  Subsections (5), (6), (7), (8), (9), and (10) of

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section 381.0271, Florida Statutes, are amended to read:

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     381.0271  Florida Patient Safety Corporation.--

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     (5) ADVISORY COMMITTEES.--Subject to a majority vote of the

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corporation's board of directors, the corporation may establish

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and dissolve advisory committees in order to assist the

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corporation in carrying out its duties and responsibilities. In

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addition to any committees that the corporation may establish,

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the corporation shall establish the following advisory

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committees:

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     (a) A scientific research advisory committee that includes,

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at a minimum, a representative from each patient safety center or

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other patient safety program in the universities of the state who

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are physicians licensed pursuant to chapter 458 or chapter 459,

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with experience in patient safety and evidenced-based medicine.

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The duties of the advisory committee shall include, but not be

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limited to, the analysis of existing data and research to improve

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patient safety and encourage evidence-based medicine.

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     (b) A technology advisory committee that includes, at a

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minimum, a representative of a hospital that has implemented a

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computerized physician order entry system and a health care

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provider that has implemented an electronic medical records

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system. The duties of the advisory committee shall include, but

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not be limited to, implementation of new technologies, including

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electronic medical records.

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     (c) A health care provider advisory committee that

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includes, at a minimum, representatives of hospitals, ambulatory

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surgical centers, physicians, nurses, and pharmacists licensed in

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this state and a representative of the Veterans Integrated

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Service Network 8, Virginia Patient Safety Center. The duties of

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the advisory committee shall include, but not be limited to,

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promotion of a culture of patient safety that reduces errors.

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     (d) A health care consumer advisory committee that

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includes, at a minimum, representatives of businesses that

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provide health insurance coverage to their employees, consumer

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advocacy groups, and representatives of patient safety

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organizations. The duties of the advisory committee shall

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include, but not be limited to, incentives to encourage patient

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safety and the efficiency and quality of care.

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     (e) A state agency advisory committee that includes, at a

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minimum, a representative from each state agency that has

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regulatory responsibilities related to patient safety. The duties

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of the advisory committee shall include, but not be limited to,

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interagency coordination of patient safety efforts.

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     (f) A litigation alternatives advisory committee that

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includes, at a minimum, representatives of medical malpractice

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attorneys for plaintiffs and defendants and a representative of

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each law school in the state. The duties of the advisory

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committee shall include, but not be limited to, alternative

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systems to compensate for injuries.

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     (g) An education advisory committee that includes, at a

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minimum, the associate dean for education, or the equivalent

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position, as a representative from each medicine, nursing, public

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health, or allied health service to provide advice on the

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development, implementation, and measurement of core competencies

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for patient safety to be considered for incorporation in the

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educational programs of the universities and colleges of this

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state.

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     (6) ORGANIZATION; MEETINGS.--

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     (a) The Agency for Health Care Administration shall assist

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the corporation in its organizational activities required under

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chapter 617, including, but not limited to:

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     1. Eliciting appointments for the initial board of

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directors.

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     2. Convening the first meeting of the board of directors

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and assisting with other meetings of the board of directors, upon

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request of the board of directors, during the first year of

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operation of the corporation.

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     3. Drafting articles of incorporation for the board of

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directors and, upon request of the board of directors, delivering

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articles of incorporation to the Department of State for filing.

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     4. Drafting proposed bylaws for the corporation.

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     5. Paying fees related to incorporation.

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     6. Providing office space and administrative support, at

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the request of the board of directors, but not beyond July 1,

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2005.

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     (b) The board of directors shall must conduct its first

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meeting no later than August 1, 2004, and shall meet at least

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quarterly thereafter as frequently as necessary to carry out the

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duties of the corporation.

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     (7)  POWERS AND DUTIES.--

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     (a)  In addition to the powers and duties prescribed in

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chapter 617, and the articles and bylaws adopted under that

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chapter, the corporation shall, directly or through contract:

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     1.  Secure staff necessary to properly administer the

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corporation.

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     2.  Collect, analyze, and evaluate patient safety data and

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quality and patient safety indicators, medical malpractice closed

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claims, and adverse incidents reported to the Agency for Health

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Care Administration and the Department of Health for the purpose

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of recommending changes in practices and procedures that may be

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implemented by health care practitioners and health care

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facilities to improve health care quality and to prevent future

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adverse incidents. Notwithstanding any other provision of law,

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the Agency for Health Care Administration and the Department of

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Health shall make available to the corporation and its designated

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agents any adverse incident report submitted under ss. 395.0197,

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458.351, and 459.026. To the extent that adverse incident reports

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submitted under s. 395.0197 are confidential and exempt, the

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confidential and exempt status of such reports shall be

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maintained by the corporation and its designated agents.

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     3.  Establish a "near-miss" patient safety reporting system.

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The purpose of the near-miss reporting system is to: identify

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potential systemic problems that could lead to adverse incidents;

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enable publication of systemwide alerts of potential harm; and

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facilitate development of both facility-specific and statewide

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options to avoid adverse incidents and improve patient safety.

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The reporting system shall record "near misses" submitted by

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hospitals, birthing centers, and ambulatory surgical centers and

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other providers. For the purpose of the reporting system:

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     a.  The term "near miss" means any potentially harmful event

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that could have had an adverse result but, through chance or

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intervention in which, harm was prevented.

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     b.  The near-miss reporting system shall be voluntary and

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anonymous and independent of mandatory reporting systems used for

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regulatory purposes.

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     c.  Near-miss data submitted to the corporation is patient

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safety data as defined in s. 766.1016.

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     d.  Reports of near-miss data shall be published on a

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regular basis and special alerts shall be published as needed

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regarding newly identified, significant risks.

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     e.  Aggregated data shall be made available publicly.

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     f.  The corporation shall report the performance and results

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of the near-miss project in its annual report.

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     4.  Work collaboratively with the appropriate state agencies

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to evaluate the effects of the adoption and sharing of electronic

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health records on patient safety in the development of electronic

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health records.

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     5. Provide for access to an active library of evidence-

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based medicine and patient safety practices, together with the

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emerging evidence supporting their retention or modification, and

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make this information available to health care practitioners,

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health care facilities, and the public. Support for

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implementation of evidence-based medicine shall include:

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     a. A report to the Governor, the President of the Senate,

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the Speaker of the House of Representatives, and the Agency for

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Health Care Administration by January 1, 2005, on:

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     (I) The ability to join or support efforts for the use of

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evidence-based medicine already underway, such as those of the

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Leapfrog Group, the international group Bandolier, and the

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Healthy Florida Foundation.

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     (II) The means by which to promote research using Medicaid

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and other data collected by the Agency for Health Care

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Administration to identify and quantify the most cost-effective

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treatment and interventions, including disease management and

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prevention programs.

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     (III) The means by which to encourage development of

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systems to measure and reward providers who implement evidence-

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based medical practices.

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     (IV) The review of other state and private initiatives and

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published literature for promising approaches and the

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dissemination of information about them to providers.

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     (V) The encouragement of the Florida health care boards

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under the Department of Health to regularly publish findings

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related to the cost-effectiveness of disease-specific, evidence-

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based standards.

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     (VI) Public and private sector initiatives related to

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evidence-based medicine and communication systems for the sharing

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of clinical information among caregivers.

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     (VII) Regulatory barriers that interfere with the sharing

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of clinical information among caregivers.

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     b. An implementation plan reported to the Governor, the

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President of the Senate, the Speaker of the House of

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Representatives, and the Agency for Health Care Administration by

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September 1, 2005, that must include, but need not be limited to:

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estimated costs and savings, capital investment requirements,

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recommended investment incentives, initial committed provider

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participation by region, standards of functionality and features,

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a marketing plan, and implementation schedules for key

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components.

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     5.6. Develop and recommend core competencies in patient

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safety that can be incorporated into the undergraduate and

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graduate curricula in schools of medicine, nursing, and allied

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health in the state.

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     6.7. Develop and recommend programs to educate the public

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about the role of health care consumers in promoting patient

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safety.

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     7.8. Provide recommendations for interagency coordination

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of patient safety efforts in the state.

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     (b)  In carrying out its powers and duties, the corporation

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may also:

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     1.  Assess the patient safety culture at volunteering

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hospitals and recommend methods to improve the working

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environment related to patient safety at these hospitals.

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     2. Inventory the technological information technology

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capabilities related to patient safety of health care facilities

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and health care practitioners and recommend a plan for expediting

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the implementation of patient safety technologies statewide.

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     3.  Recommend continuing medical education regarding patient

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safety to practicing health care practitioners.

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     4.  Study and facilitate the testing of alternative systems

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of compensating injured patients as a means of reducing and

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preventing medical errors and promoting patient safety.

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     5.  Conduct other activities identified by the board of

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directors to promote patient safety in this state.

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     (8) ANNUAL REPORT.--By December 1, 2004, the corporation

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shall prepare a report on the startup activities of the

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corporation and any proposals for legislative action that are

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needed for the corporation to fulfill its purposes under this

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section. By December 1 of each year thereafter, the corporation

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shall prepare a report for the preceding fiscal year which

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includes. The report, at a minimum, must include:

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     (a)  A description of the activities of the corporation

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under this section.

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     (b) Progress made in improving patient safety, including

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the reduction of and reducing medical errors.

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     (c)  Policies and programs that have been implemented and

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their outcomes.

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     (d)  A compliance and financial audit of the accounts and

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records of the corporation at the end of the preceding fiscal

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year conducted by an independent certified public accountant.

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     (e)  Recommendations for legislative action needed to

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improve patient safety in the state.

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     (f)  An assessment of the ability of the corporation to

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fulfill the duties specified in this section and the

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appropriateness of those duties for the corporation.

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The corporation shall submit the report to the Governor, the

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President of the Senate, and the Speaker of the House of

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Representatives.

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     (9) FUNDING.--The corporation shall is required to seek

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private sector funding and apply for grants to accomplish its

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goals and duties.

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     (10) PERFORMANCE EXPECTATIONS.--The Office of Program

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Policy Analysis and Government Accountability, the Agency for

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Health Care Administration, and the Department of Health shall

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develop performance standards by which to measure the success of

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the corporation in fulfilling the purposes established in this

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section. Using the performance standards, the Office of Program

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Policy Analysis and Government Accountability shall conduct a

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performance audit of the corporation during 2006 and shall submit

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a report to the Governor, the President of the Senate, and the

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Speaker of the House of Representatives by January 1, 2007.

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     Section 2.  This act shall take effect July 1, 2008.