Florida Senate - 2016 COMMITTEE AMENDMENT Bill No. SB 1518 Ì503856@Î503856 LEGISLATIVE ACTION Senate . House Comm: RCS . 02/09/2016 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Grimsley) recommended the following: 1 Senate Amendment to Amendment (740310) (with title 2 amendment) 3 4 Between lines 4 and 5 5 insert: 6 Section 1. Section 391.224, Florida Statutes, is created to 7 read: 8 391.224 Pediatric Cardiac Advisory Council.— 9 (1) LEGISLATIVE FINDINGS AND INTENT.— 10 (a) The Legislature finds significant benefits in the 11 continued coordination of activities by several state agencies 12 regarding access to pediatric cardiac care in this state. It is 13 the intent of the Legislature that the Department of Health, the 14 department’s cardiac consultants, and the Agency for Health Care 15 Administration maintain their long-standing interagency teams 16 and agreements for the development and adoption of guidelines, 17 standards, and rules for those portions of the state cardiac 18 care system within the statutory authority of each agency. This 19 coordinated approach will continue to ensure the necessary 20 continuum of care for the pediatric cardiac patient. The 21 department has the leadership responsibility for this activity. 22 (b) It is further the intent of the Legislature to 23 establish the Pediatric Cardiac Advisory Council, a statewide, 24 inclusive council within the department. 25 (2) PEDIATRIC CARDIAC ADVISORY COUNCIL.— 26 (a) The State Surgeon General shall appoint the Pediatric 27 Cardiac Advisory Council for the purpose of advising the 28 department on the delivery of cardiac services to children. 29 (b) The chair of the council shall be elected from among 30 the council members every 2 years and may not serve more than 31 two consecutive terms. 32 (c) The council shall meet upon the call of the chair or 33 two or more voting members or upon the call of the State Surgeon 34 General, but must meet at least quarterly. Council meetings must 35 be conducted by teleconference or through other electronic means 36 when feasible. 37 (d) The council shall be composed of no more than 13 voting 38 members with technical expertise in cardiac medicine. Members 39 shall be appointed by the State Surgeon General for staggered 40 terms of 4 years. An employee of the department or a contracted 41 consultant paid by the department may not serve as an appointed 42 member or ex officio member of the council. Council members 43 shall include the following voting members: 44 1. Pediatric cardiologists or pediatric cardiovascular 45 surgeons who have been nominated by their respective chief 46 executive officers and approved by the State Surgeon General 47 from the following facilities for as long as such facilities 48 maintain their pediatric certificates of need: 49 a. All Children’s Hospital in St. Petersburg; 50 b. Arnold Palmer Hospital for Children in Orlando; 51 c. Joe DiMaggio Children’s Hospital in Hollywood; 52 d. Nicklaus Children’s Hospital in Miami; 53 e. St. Joseph’s Children’s Hospital in Tampa; 54 f. University of Florida Health Shands Hospital in 55 Gainesville; 56 g. University of Miami Holtz Children’s Hospital in Miami; 57 and 58 h. Wolfson Children’s Hospital in Jacksonville. 59 60 A hospital with a certificate of need for a pediatric cardiac 61 program that meets state and national standards as determined by 62 the council following an onsite visit by a panel from the 63 council shall have one of its pediatric cardiologists or 64 pediatric cardiovascular surgeons who has been nominated by its 65 chief executive officer and approved by the State Surgeon 66 General appointed to the council as a new voting member. The 67 voting privilege of a voting member of the council appointed 68 pursuant to this subparagraph shall be suspended if the facility 69 he or she represents no longer meets state and national 70 standards as adopted by the council. Such individual may remain 71 a member of the council in an advisory capacity but shall 72 relinquish voting privileges until his or her facility meets 73 such standards. 74 2. Two physicians at large, not associated with a facility 75 that has a representative appointed as a voting member of the 76 council, who are pediatric cardiologists or subspecialists with 77 special expertise or experience in dealing with children or 78 adults with congenital heart disease. These physicians shall be 79 selected by the State Surgeon General in consultation with the 80 Deputy Secretary for Children’s Medical Services and the 81 Director of Children’s Medical Services. 82 3. One community physician who has ongoing involvement with 83 and special interest in children with heart disease and who is 84 not associated with a facility represented in subparagraph 1. or 85 one community-based medical internist having experience with 86 adults with congenital heart disease. The community physician 87 shall be selected by the State Surgeon General in consultation 88 with the Deputy Secretary of Children’s Medical Services and the 89 Director of the Division of Children’s Medical Services. 90 (e) The State Surgeon General may appoint nonvoting 91 advisory members to the council in consultation with the Deputy 92 Secretary for Children’s Medical Services and the Director of 93 Children’s Medical Services. Among such nonvoting advisory 94 members appointed to the council shall be one representative 95 from a pediatric health advocacy group. Such members may 96 participate in council discussions and subcommittees created by 97 the council, but may not vote. 98 (f) The duties of the council include, but are not limited 99 to: 100 1. Recommending standards for personnel, diagnoses, 101 clinics, and facilities rendering cardiac services to the 102 department and the Division of Children’s Medical Services. 103 2. Analyzing reports on the periodic review of cardiac 104 personnel, diagnoses, clinics, and facilities to determine if 105 established state and national standards for cardiac services 106 are met. 107 3. Making recommendations to the Director of Children’s 108 Medical Services as to the approval or disapproval of reviewed 109 cardiac care personnel, diagnoses, clinics, and facilities. 110 4. Making recommendations as to the intervals for 111 reinspection of approved personnel, diagnoses, clinics, and 112 facilities for cardiac care. 113 5. Reviewing and inspecting hospitals upon the request of 114 the hospitals, the department, or the Agency for Health Care 115 Administration to determine if established state and national 116 standards for cardiac services are met. 117 6. Providing input on all aspects of the state’s Children’s 118 Medical Services cardiac programs, including rulemaking. 119 7. Addressing all components of the care of adults and 120 children with congenital heart disease and children with 121 acquired heart disease, as indicated and appropriate. 122 8. Abiding by the recognized state and national 123 professional standards of care for children with heart disease. 124 9. Making recommendations to the State Surgeon General for 125 legislation and appropriations for children’s cardiac services. 126 10. Providing advisory opinions to the Agency for Health 127 Care Administration before the agency approves a certificate of 128 need for children’s cardiac services. 129 (g) A council member shall serve without compensation, but 130 is entitled to reimbursement for per diem and travel expenses in 131 accordance with s. 112.061. 132 (h) At the recommendation of the Pediatric Cardiac Advisory 133 Council and with the approval of the Director of Children’s 134 Medical Services, the State Surgeon General shall designate 135 facilities meeting the council’s approved state and national 136 professional standards of care for children with heart disease 137 as “Pediatric and Congenital Cardiovascular Centers of 138 Excellence.” The designation is withdrawn automatically if a 139 particular center no longer meets such standards. 140 1. The council shall develop and recommend to the State 141 Surgeon General measurable performance standards and goals for 142 determining whether a facility meets the requirements for 143 designation as a “Pediatric and Congenital Cardiovascular Center 144 of Excellence.” 145 2. The council shall develop and recommend to the State 146 Surgeon General evaluation tools for measuring the goals and 147 performance standards of the facilities seeking and receiving 148 the “Pediatric and Congenital Cardiovascular Center of 149 Excellence” designation. 150 (3) ANNUAL REPORT.—The council shall submit an annual 151 report to the Governor, the President of the Senate, the Speaker 152 of the House of Representatives, and the State Surgeon General 153 by January 1 of each year, beginning in 2017. The report must 154 summarize the council’s activities for the preceding fiscal year 155 and include data and performance measures for all pediatric 156 cardiac facilities that participate in the Children’s Medical 157 Services Network relating to surgical morbidity and mortality. 158 The report must also recommend any policy or procedural changes 159 that would increase the council’s effectiveness in monitoring 160 the pediatric cardiovascular programs in the state. 161 (4) RULEMAKING.—The department, in coordination with the 162 Agency for Health Care Administration, shall develop rules 163 related to pediatric cardiac facilities that participate in the 164 Children’s Medical Services Network. The rules may establish 165 standards relating to the training and credentialing of medical 166 and surgical personnel, facility and physician minimum case 167 volumes, and data reporting requirements for monitoring and 168 enhancing quality assurance. The department may adopt rules 169 relating to the establishment, operations, and authority of the 170 Pediatric Cardiac Advisory Council and the establishment, goals, 171 performance standards, and evaluation tools for designating 172 facilities as Pediatric and Congenital Cardiovascular Centers of 173 Excellence. The rules relating to pediatric cardiac services and 174 facilities in effect on October 1, 2016, are authorized pursuant 175 to this subsection and shall remain in effect until amended 176 pursuant to this subsection. 177 178 ================= T I T L E A M E N D M E N T ================ 179 And the title is amended as follows: 180 Delete line 57 181 and insert: 182 An act relating to cardiovascular services; creating 183 s. 391.224, F.S.; providing legislative findings and 184 intent; creating the Pediatric Cardiac Advisory 185 Council; determining the chair of the advisory 186 council; establishing the membership of the advisory 187 council; identifying the duties of the advisory 188 council; setting the minimum qualifications for the 189 designation of a facility as a Pediatric and 190 Congenital Cardiovascular Center of Excellence; 191 requiring a report to the Governor, the Legislature, 192 and the State Surgeon General; requiring the 193 Department of Health to develop rules relating to 194 pediatric cardiac services and facilities in the 195 Children’s Medical Services Network; authorizing the 196 department to adopt rules relating to the council and 197 the designation of facilities as Pediatric and 198 Congenital Cardiovascular Centers of Excellence; 199 authorizing and preserving until amended specified 200 rules relating to pediatric cardiac services and 201 facilities;