Florida Senate - 2017 CS for SB 58
By the Committee on Appropriations; and Senator Grimsley
576-01981A-17 201758c1
1 A bill to be entitled
2 An act relating to cardiac programs; amending s.
3 395.1055, F.S.; requiring the Agency for Health Care
4 Administration to establish a technical advisory panel
5 to develop procedures and standards for measuring
6 outcomes of pediatric cardiac catheterization programs
7 and pediatric open-heart surgery programs;
8 establishing membership of the technical advisory
9 panel; requiring the agency to develop and adopt rules
10 for pediatric cardiac catheterization programs and
11 pediatric open-heart surgery programs based on
12 recommendations of the technical advisory panel;
13 amending s. 408.0361, F.S.; establishing additional
14 criteria that must be included by the Agency for
15 Health Care Administration in rules relating to adult
16 cardiovascular services at hospitals seeking licensure
17 for a Level I program; providing an appropriation;
18 providing an effective date.
19
20 Be It Enacted by the Legislature of the State of Florida:
21
22 Section 1. Present subsection (9) of section 395.1055,
23 Florida Statutes, is redesignated as subsection (10), and a new
24 subsection (9) is added to that section, to read:
25 395.1055 Rules and enforcement.—
26 (9) The agency shall establish a technical advisory panel
27 to develop procedures and standards for measuring outcomes of
28 pediatric cardiac catheterization programs and pediatric open
29 heart surgery programs.
30 (a) The panel shall include 1 at-large member who has
31 expertise in pediatric and adult congenital heart disease,
32 appointed by the Secretary of Health Care Administration, and 10
33 members, 1 appointed by each chief executive officer of the
34 following hospitals, who must be pediatric cardiologists or
35 pediatric cardiovascular surgeons:
36 1. Johns Hopkins All Children’s Hospital in St. Petersburg.
37 2. Arnold Palmer Hospital for Children in Orlando.
38 3. Joe DiMaggio Children’s Hospital in Hollywood.
39 4. Nicklaus Children’s Hospital in Miami.
40 5. St. Joseph’s Children’s Hospital in Tampa.
41 6. University of Florida Health Shands Hospital in
42 Gainesville.
43 7. University of Miami Holtz Children’s Hospital in Miami.
44 8. Wolfson Children’s Hospital in Jacksonville.
45 9. Florida Hospital for Children in Orlando.
46 10. Nemours Children’s Hospital in Orlando.
47 (b) Based on the recommendations of the panel, the agency
48 shall develop and adopt rules for pediatric cardiac
49 catheterization programs and pediatric open-heart surgery
50 programs which include at least the following:
51 1. A risk adjustment procedure that accounts for the
52 variations in severity and case mix found in hospitals in this
53 state;
54 2. Outcome standards specifying expected levels of
55 performance in pediatric cardiac programs. Such standards may
56 include, but are not limited to, in-hospital mortality,
57 infection rates, nonfatal myocardial infarctions, length of
58 postoperative bleeds, and returns to surgery; and
59 3. Specific steps to be taken by the agency and licensed
60 facilities that do not meet the outcome standards within a
61 specified time, including time required for detailed case
62 reviews and development and implementation of corrective action
63 plans.
64 Section 2. Paragraph (b) of subsection (3) of section
65 408.0361, Florida Statutes, is amended to read:
66 408.0361 Cardiovascular services and burn unit licensure.—
67 (3) In establishing rules for adult cardiovascular
68 services, the agency shall include provisions that allow for:
69 (b) For a hospital seeking a Level I program, demonstration
70 that, for the most recent 12-month period as reported to the
71 agency, it has provided a minimum of 300 adult inpatient and
72 outpatient diagnostic cardiac catheterizations or, for the most
73 recent 12-month period, has discharged or transferred at least
74 300 inpatients with the principal diagnosis of ischemic heart
75 disease and that it has a formalized, written transfer agreement
76 with a hospital that has a Level II program, including written
77 transport protocols to ensure safe and efficient transfer of a
78 patient within 60 minutes. However, a hospital located more than
79 100 road miles from the closest Level II adult cardiovascular
80 services program does not need to meet the 60-minute transfer
81 time protocol if the hospital demonstrates that it has a
82 formalized, written transfer agreement with a hospital that has
83 a Level II program. The agreement must include written transport
84 protocols to ensure the safe and efficient transfer of a
85 patient, taking into consideration the patient’s clinical and
86 physical characteristics, road and weather conditions, and
87 viability of ground and air ambulance service to transfer the
88 patient. At a minimum, the rules for adult cardiovascular
89 services must require nursing and technical staff to have
90 demonstrated experience in handling acutely ill patients
91 requiring percutaneous cardiac intervention in dedicated cardiac
92 interventional laboratories or surgical centers. If a staff
93 member’s previous experience was in a dedicated cardiac
94 interventional laboratory at a hospital that did not have an
95 approved adult open-heart-surgery program, the staff member’s
96 previous experience does not qualify unless, at the time the
97 staff member acquired his or her experience, the dedicated
98 cardiac interventional laboratory:
99 1. Had an annual volume of 500 or more percutaneous cardiac
100 intervention procedures;
101 2. Achieved a demonstrated success rate of 95 percent or
102 greater for percutaneous cardiac intervention procedures;
103 3. Experienced a complication rate of less than 5 percent
104 for percutaneous cardiac intervention procedures; and
105 4. Performed diverse cardiac procedures, including, but not
106 limited to, balloon angioplasty and stenting, rotational
107 atherectomy, cutting balloon atheroma remodeling, and procedures
108 relating to left ventricular support capability.
109 Section 3. For the 2017-2018 fiscal year, the sum of
110 $95,620 is appropriated from the Health Care Trust Fund to the
111 Agency for Health Care Administration for the purpose of
112 implementing s. 395.1055(9), Florida Statutes.
113 Section 4. This act shall take effect July 1, 2017.