Florida Senate - 2017                               CS for SB 62
       By the Committee on Governmental Oversight and Accountability;
       and Senator Bean
       585-01718-17                                            201762c1
    1                        A bill to be entitled                      
    2         An act relating to pediatric cardiac care in the
    3         Children’s Medical Services program; creating s.
    4         391.224, F.S.; providing legislative findings and
    5         intent; creating the Pediatric Cardiac Care Advisory
    6         Council within the Department of Health; specifying
    7         the council membership; providing for election of the
    8         council chair and vice chair; providing for per diem
    9         and travel expenses; specifying the duties of the
   10         council; requiring the State Surgeon General to
   11         designate certain facilities as Pediatric and
   12         Congenital Cardiovascular Centers of Excellence;
   13         establishing prerequisites for the designation of a
   14         facility as a center of excellence; requiring that the
   15         council provide an annual report to the Governor, the
   16         Legislature, and the State Surgeon General; requiring
   17         the department to develop rules relating to pediatric
   18         cardiac care and facilities in the program;
   19         authorizing the department to adopt rules relating to
   20         the council and the designation of facilities as
   21         Pediatric and Congenital Cardiovascular Centers of
   22         Excellence; providing an effective date.
   24  Be It Enacted by the Legislature of the State of Florida:
   26         Section 1. Section 391.224, Florida Statutes, is created to
   27  read:
   28         391.224 Pediatric Cardiac Care Advisory Council.—
   29         (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds
   30  significant benefits in the continued coordination of the
   31  activities of state agencies regarding the delivery of pediatric
   32  cardiac care in this state. It is the intent of the Legislature
   33  that the Department of Health and its cardiac consultants and
   34  the Agency for Health Care Administration maintain their long
   35  standing interagency teams and agreements to support the
   36  coordinated development and adoption of guidelines, standards,
   37  and rules under the agencies’ existing statutory authority for
   38  the state pediatric cardiac care system to ensure the necessary
   39  continuum of care for pediatric cardiac patients. The
   40  Legislature also intends that the department take the lead in
   41  this process.
   43  COUNCIL.—The Pediatric Cardiac Care Advisory Council, an
   44  advisory council as defined in s. 20.03, is created within the
   45  department to advise it on the delivery of all types of cardiac
   46  care to children and adults with congenital heart disease. The
   47  council is subject to s. 20.052.
   48         (a) The council shall be composed of no more than 15 voting
   49  members with technical expertise in cardiac medicine, appointed
   50  by the State Surgeon General for staggered terms of 4 years. The
   51  State Surgeon General may appoint an alternate member for each
   52  voting member. An alternate member may participate in council
   53  discussions and subcommittees but is eligible to vote only in
   54  those instances when the voting member for whom he or she is the
   55  alternate cannot cast a vote. An employee of the department or a
   56  contracted consultant paid by the department may not serve as an
   57  appointed or ex officio member of the council. Council
   58  membership must include the following voting members:
   59         1. Pediatric cardiologists or pediatric cardiovascular
   60  surgeons nominated by the chief executive officers of the
   61  following hospitals:
   62         a. Johns Hopkins All Children’s Hospital in St. Petersburg.
   63         b. Arnold Palmer Hospital for Children in Orlando.
   64         c. Joe DiMaggio Children’s Hospital in Hollywood.
   65         d. Nicklaus Children’s Hospital in Miami.
   66         e. St. Joseph’s Children’s Hospital in Tampa.
   67         f. University of Florida Health Shands Hospital in
   68  Gainesville.
   69         g. University of Miami Holtz Children’s Hospital in Miami.
   70         h. Wolfson Children’s Hospital in Jacksonville.
   71         i. Florida Hospital for Children in Orlando.
   72         j. Nemours Children’s Hospital in Orlando.
   73         2. Pediatric cardiologists or pediatric cardiovascular
   74  surgeons nominated by the chief executive officer of a hospital
   75  that holds a current certificate of need for a pediatric cardiac
   76  program and that meets state and national standards as
   77  recommended by the council following an onsite visit by a panel
   78  from the council.
   79         3. Two physicians who are pediatric cardiologists or
   80  subspecialists with expertise in congenital heart disease; who
   81  are not associated with a facility otherwise represented by a
   82  voting member of the council; and who are appointed in
   83  consultation with the Deputy Secretary for Children’s Medical
   84  Services and the Director of Children’s Medical Services.
   85         4. A community physician who has ongoing involvement with
   86  and special interest in the treatment of children with heart
   87  disease and who is not associated with a facility represented in
   88  the membership of the council pursuant to subparagraph 1. or
   89  subparagraph 2. or a community-based medical internist who has
   90  experience in treating adults with congenital heart disease.
   91  Appointment of a community physician shall be made in
   92  consultation with the Deputy Secretary for Children’s Medical
   93  Services and the Director of Children’s Medical Services.
   94         5.Appointments made under subparagraphs 1. and 2. are
   95  contingent on the nominating hospital’s maintenance of pediatric
   96  certificates of need and the hospital’s compliance with the
   97  state and national standards identified by the council in
   98  exercising its duties under subparagraph (f)5. A member whose
   99  hospital fails to maintain such certificates or comply with such
  100  standards during his or her term, as determined by the State
  101  Surgeon General, may serve only in an advisory capacity as a
  102  nonvoting member until such time as the maintenance of such
  103  certificates and compliance with such standards are restored.
  104         (b) The State Surgeon General may appoint nonvoting,
  105  advisory members to the council in consultation with the Deputy
  106  Secretary for Children’s Medical Services and the Director of
  107  Children’s Medical Services. Such members may participate in
  108  council discussions and subcommittees created by the council.
  109         (c) The chair and vice chair of the council shall be
  110  elected by the council members to 2-year terms and may not serve
  111  more than 2 consecutive terms.
  112         (d) The council shall meet upon the call of the chair or
  113  two or more voting members or upon the call of the State Surgeon
  114  General, but must meet at least quarterly. Council meetings must
  115  be conducted by teleconference or through other electronic means
  116  when feasible.
  117         (e) Council members shall serve without compensation, but
  118  are entitled to reimbursement for per diem and travel expenses
  119  in accordance with s. 112.061.
  120         (f) The duties of the council include, but are not limited
  121  to:
  122         1. Recommending standards for personnel, clinics, and
  123  facilities that provide cardiac services to clients of the
  124  department and the program and for the diagnosis of cardiac
  125  conditions.
  126         2. Analyzing reports on the periodic review of cardiac care
  127  personnel, clinics, facilities, and diagnoses to determine if
  128  established state and national standards for cardiac services
  129  are being met.
  130         3. Making recommendations to the Director of Children’s
  131  Medical Services regarding determinations of whether reviewed
  132  cardiac care personnel, clinics, facilities, and diagnoses meet
  133  established state and national standards for cardiac services.
  134         4. Making recommendations to the Director of Children’s
  135  Medical Services regarding the intervals for reinspection of
  136  cardiac care personnel, clinics, facilities, and diagnoses
  137  meeting established state and national standards for cardiac
  138  services.
  139         5. Reviewing and inspecting a hospital upon the request of
  140  the hospital, the department, or the Agency for Health Care
  141  Administration to analyze its compliance with established state
  142  and national standards for cardiac services.
  143         6. Advising the department and the Agency for Health Care
  144  Administration on all aspects of the provision of cardiac care
  145  under the program, including rulemaking, and on all components
  146  of providing care to adults and children with congenital heart
  147  disease and children with acquired heart disease.
  148         7. Reviewing and analyzing compliance by cardiac care
  149  personnel, clinics, and facilities with the recognized state and
  150  national professional standards of care for children with heart
  151  disease.
  152         8. Making recommendations to the State Surgeon General for
  153  legislation regarding and appropriations for pediatric cardiac
  154  services.
  155         9. Providing advisory opinions to the Agency for Health
  156  Care Administration before the agency approves a certificate of
  157  need for pediatric cardiac services.
  159  CENTERS OF EXCELLENCE.—Upon the recommendation of the council
  160  and the Director of Children’s Medical Services, the State
  161  Surgeon General shall designate facilities that the council
  162  recommends have met state and national professional standards of
  163  care for children with heart disease as Pediatric and Congenital
  164  Cardiovascular Centers of Excellence. The council shall
  165  recommend measurable performance standards and evaluation tools
  166  to be used in determining whether a facility qualifies for such
  167  designation. The designation of a facility as a center of
  168  excellence is automatically withdrawn if the facility no longer
  169  meets, as determined by the State Surgeon General, the
  170  performance standards that qualified it for such designation.
  171         (4) ANNUAL REPORT.—Beginning in January 1, 2019, and by
  172  each January 1 thereafter, the council shall submit an annual
  173  report to the Governor, the President of the Senate, the Speaker
  174  of the House of Representatives, and the State Surgeon General.
  175  The report must summarize the council’s activities during the
  176  preceding fiscal year and include data and performance measures
  177  on surgical morbidity and mortality for all the pediatric
  178  cardiac facilities that participated in the program. The report
  179  must also recommend any policy or procedural changes that would
  180  increase the council’s effectiveness in monitoring the
  181  performance of such facilities.
  182         (5) RULEMAKING.—
  183         (a) The department, in coordination with the Agency for
  184  Health Care Administration, shall develop rules related to
  185  pediatric cardiac care and facilities that participate in the
  186  program. The rules shall establish standards relating to the
  187  training and credentialing of medical and surgical personnel,
  188  minimum case volumes for facilities and physicians, and data
  189  reporting requirements for monitoring and enhancing quality
  190  assurance. The rules shall meet or exceed the standard of care
  191  provided in Children’s Medical Services Pediatric Cardiac
  192  Facilities Standards established in October 2012.
  193         (b) The department may also adopt rules relating to the
  194  establishment, operation, and authority of the council and the
  195  process, performance standards, and evaluation tools for
  196  designating facilities as Pediatric and Congenital
  197  Cardiovascular Centers of Excellence.
  198         Section 2. This act shall take effect upon becoming a law.