Florida Senate - 2019                          SENATOR AMENDMENT
       Bill No. CS for HB 843
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Floor: WD/2R          .                                
             04/26/2019 12:49 PM       .                                

       Senator Baxley moved the following:
    1         Senate Amendment to Amendment (623018) (with title
    2  amendment)
    4         Delete lines 175 - 487
    5  and insert:
    6         Section 6. Present subsections (10), (11), and (12) of
    7  section 395.1055, Florida Statutes, are redesignated as sections
    8  (11), (12), and (15), respectively, new subsections (10), (13),
    9  and (14) are added to that section, and subsection (9) and
   10  present subsection (10) of that section are amended, to read:
   11         395.1055 Rules and enforcement.—
   12         (9) The agency shall establish a pediatric cardiac
   13  technical advisory panel, pursuant to s. 20.052, to develop
   14  procedures and standards for measuring outcomes of pediatric
   15  cardiac catheterization programs and pediatric cardiovascular
   16  surgery programs.
   17         (a) Members of the panel must have technical expertise in
   18  pediatric cardiac medicine, shall serve without compensation,
   19  and may not be reimbursed for per diem and travel expenses.
   20         (b) Voting members of the panel shall include: 3 at-large
   21  members, and 3 alternate at-large members with different program
   22  affiliations, including 1 cardiologist who is board certified in
   23  caring for adults with congenital heart disease and 2 board
   24  certified pediatric cardiologists, neither of whom may be
   25  employed by any of the hospitals specified in subparagraphs 1.
   26  10. or their affiliates, each of whom is appointed by the
   27  Secretary of Health Care Administration, and 10 members, and an
   28  alternate for each member, each of whom is a pediatric
   29  cardiologist or a pediatric cardiovascular surgeon, each
   30  appointed by the chief executive officer of the following
   31  hospitals:
   32         1. Johns Hopkins All Children’s Hospital in St. Petersburg.
   33         2. Arnold Palmer Hospital for Children in Orlando.
   34         3. Joe DiMaggio Children’s Hospital in Hollywood.
   35         4. Nicklaus Children’s Hospital in Miami.
   36         5. St. Joseph’s Children’s Hospital in Tampa.
   37         6. University of Florida Health Shands Hospital in
   38  Gainesville.
   39         7. University of Miami Holtz Children’s Hospital in Miami.
   40         8. Wolfson Children’s Hospital in Jacksonville.
   41         9. Florida Hospital for Children in Orlando.
   42         10. Nemours Children’s Hospital in Orlando.
   44  Appointments made under subparagraphs 1.-10. are contingent upon
   45  the hospital’s maintenance of pediatric certificates of need and
   46  the hospital’s compliance with this section and rules adopted
   47  thereunder, as determined by the Secretary of Health Care
   48  Administration. A member appointed under subparagraphs 1.-10.
   49  whose hospital fails to maintain such certificates or comply
   50  with standards may serve only as a nonvoting member until the
   51  hospital restores such certificates or complies with such
   52  standards. A voting member may serve a maximum of two 2-year
   53  terms and may be reappointed to the panel after being retired
   54  from the panel for a full 2-year term.
   55         (c) The Secretary of Health Care Administration may appoint
   56  nonvoting members to the panel. Nonvoting members may include:
   57         1. The Secretary of Health Care Administration.
   58         2. The Surgeon General.
   59         3. The Deputy Secretary of Children’s Medical Services.
   60         4. Any current or past Division Director of Children’s
   61  Medical Services.
   62         5. A parent of a child with congenital heart disease.
   63         6. An adult with congenital heart disease.
   64         7. A representative from each of the following
   65  organizations: the Florida Chapter of the American Academy of
   66  Pediatrics, the Florida Chapter of the American College of
   67  Cardiology, the Greater Southeast Affiliate of the American
   68  Heart Association, the Adult Congenital Heart Association, the
   69  March of Dimes, the Florida Association of Children’s Hospitals,
   70  and the Florida Society of Thoracic and Cardiovascular Surgeons.
   71         (d) The panel shall meet biannually, or more frequently
   72  upon the call of the Secretary of Health Care Administration.
   73  Such meetings may be conducted telephonically, or by other
   74  electronic means.
   75         (e) The duties of the panel include recommending to the
   76  agency standards for quality of care, personnel, physical plant,
   77  equipment, emergency transportation, and data reporting for
   78  hospitals that provide pediatric cardiac services.
   79         (f) Beginning on January 1, 2020, and annually thereafter,
   80  the panel shall submit a report to the Governor, the President
   81  of the Senate, the Speaker of the House of Representatives, the
   82  Secretary of Health Care Administration, and the State Surgeon
   83  General. The report must summarize the panel’s activities during
   84  the preceding fiscal year and include data and performance
   85  measures on surgical morbidity and mortality for all pediatric
   86  cardiac programs.
   87         (g) Panel members are agents of the state for purposes of
   88  s. 768.28 throughout the good faith performance of the duties
   89  assigned to them by the Secretary of Health Care Administration.
   90         (10) The Secretary of Health Care Administration shall
   91  consult the pediatric cardiac technical advisory panel for an
   92  advisory recommendation on any certificate of need applications
   93  to establish pediatric cardiac surgical centers.
   94         (11)(10) Based on the recommendations of the pediatric
   95  cardiac technical advisory panel in subsection (9), the agency
   96  shall adopt rules for pediatric cardiac programs which, at a
   97  minimum, include:
   98         (a) Standards for pediatric cardiac catheterization
   99  services and pediatric cardiovascular surgery including quality
  100  of care, personnel, physical plant, equipment, emergency
  101  transportation, data reporting, and appropriate operating hours
  102  and timeframes for mobilization for emergency procedures.
  103         (b) Outcome standards consistent with nationally
  104  established levels of performance in pediatric cardiac programs.
  105         (c) Specific steps to be taken by the agency and licensed
  106  facilities when the facilities do not meet the outcome standards
  107  within a specified time, including time required for detailed
  108  case reviews and the development and implementation of
  109  corrective action plans.
  110         (13)(a) The Secretary of Health Care Administration may
  111  request announced or unannounced site visits to any existing
  112  pediatric cardiac surgical center or facility seeking licensure
  113  as a pediatric cardiac surgical center through the certificate
  114  of need process to ensure compliance with this section and rules
  115  adopted hereunder.
  116         (b) At the request of the Secretary of Health Care
  117  Administration, the pediatric cardiac technical advisory panel
  118  shall recommend in-state physician experts to conduct an onsite
  119  visit. The secretary may also appoint up to two out-of-state
  120  physician experts.
  121         (c) A site visit team shall conduct an on-site inspection
  122  of the designated hospital’s pediatric medical and surgical
  123  programs, and each member shall submit a written report of his
  124  or her findings to the panel. The panel shall discuss the
  125  written reports and present an advisory opinion to the Secretary
  126  of Health Care Administration which includes recommendations and
  127  any suggested actions for correction.
  128         (d) Each on-site inspection must include all of the
  129  following:
  130         1. An inspection of the program’s physical facilities,
  131  clinics, and laboratories.
  132         2. Interviews with support staff and hospital
  133  administrators.
  134         3.A review of:
  135         a. Randomly selected medical records and reports,
  136  including, but not limited to, advanced cardiac imaging,
  137  computed tomography, magnetic resonance imaging, cardiac
  138  ultrasound, cardiac catheterization, and surgical operative
  139  notes.
  140         b.The program’s clinical outcome data submitted to the
  141  Society of Thoracic Surgeons and the American College of
  142  Cardiology pursuant to s. 408.05(3)(k).
  143         c.Mortality reports from cardiac-related deaths that
  144  occurred in the previous year.
  145         d. Program volume data from the preceding year for
  146  interventional and electrophysiology catheterizations and
  147  surgical procedures.
  148         (14) The Surgeon General shall provide quarterly reports to
  149  the Secretary of Health Care Administration consisting of data
  150  from the Children’s Medical Services critical congenital heart
  151  disease screening program for review by the advisory panel.
  153  ================= T I T L E  A M E N D M E N T ================
  154  And the title is amended as follows:
  155         Delete lines 785 - 793
  156  and insert:
  157         discharge summary; amending s. 395.1055, F.S.;
  158         authorizing the reimbursement of per diem