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.