The purpose of the commission is to facilitate development of a comprehensive statewide strategy for improving health care delivery systems and reduce health care-related errors.

The commission is comprised of membership from the following organizations: the Boards of Medicine, Osteopathic Medicine, Pharmacy, Dentistry, and Nursing; the Florida Dental Association, the Florida Medical Association, the Florida Osteopathic Medical Association, the Florida Chiropractic Association, the Florida Chiropractic Society, the Florida Podiatric Medical Association, the Florida Nurses Association, the Florida Organization of Nursing Executives, the Florida Pharmacy Association, the Florida Society of Health System Pharmacists, the Florida Hospital Association, the Association of Community Hospitals and Health Systems of Florida, the Florida League of Health Systems, the Florida Health Care Risk Management Advisory Council, the Florida Health Care Association, the Florida Statutory Teaching Hospital Council, the Florida Statutory Rural Hospital Council, the Florida Association of Homes for the Aging, and the Florida Society for Respiratory Care. Additionally, the commission will be comprised of two health lawyers, two representatives of the health insurance industry, five consumer advocates, two legislators, and one representative of a Florida medical school.

The commission is required to hold its first meeting no later than July 15, 2000, and is required to submit a report of its findings and recommendations to the Governor, President of the Senate, and Speaker of the House of Representatives no later than February 1, 2001. The commission is abolished effective June 1, 2001. The commission will hold its first meeting on Friday, July 14, 2000, at the Hyatt Hotel, which is located at the Orlando International Airport, 9300 Airport Blvd., Orlando, FL 32827, (407) 825-1234. The meeting is scheduled to begin at 10:00 a.m., and will last until 4:00 p.m. Discussion during this meeting will be limited to a discussion of organizational and administrative issues, in addition to focusing on educating the members on a variety of topics related to health care delivery systems and current efforts to reduce health care-related errors. Throughout the course of the coming year, ample opportunity will be afforded for public testimony, however, because of the full agenda, time will not be allotted during the first meeting for public input.

The full text of House Bill 2339, Section 33 follows:

Section 33. Florida Commission on Excellence in Health Care.--

(1) LEGISLATIVE FINDINGS AND INTENT.--The Legislature finds that the health care delivery industry is one of the largest and most complex industries in Florida. The Legislature finds that the current system of regulating health care practitioners and health care providers is one of blame and punishment and does not encourage voluntary admission of errors and immediate corrective action on a large scale. The Legislature finds that previous attempts to identify and address areas which impact the quality of care provided by the health care industry have suffered from a lack of coordination among the industry's stakeholders and regulators. The Legislature finds that additional focus on strengthening health care delivery systems by eliminating avoidable mistakes in the diagnosis and treatment of Floridians holds tremendous promise to increase the quality of health care services available to Floridians, thereby reducing the costs associated with medical mistakes and malpractice and in turn increasing access to health care in the state. To achieve this enhanced focus, it is the intent of the Legislature to create the Florida Commission on Excellence in Health Care to facilitate the development of a comprehensive statewide strategy for improving health care delivery systems through meaningful reporting standards, data collection and review, and quality measurement.

(2) DEFINITIONS.--As used in this act, the term:
(a) "Agency" means the Agency for Health Care Administration.
(b) "Commission" means the Florida Commission on Excellence in Health Care.
(c) "Department" means the Department of Health.
(d) "Error," with respect to health care, means an unintended act, by omission or commission.
(e) "Health care practitioner" means any person licensed under chapter 457; chapter 458; chapter 459; chapter 460; chapter 461; chapter 462; chapter 463; chapter 464; chapter 465; chapter 466; chapter 467; part I, part II, part III, part V, part X, part XIII, or part XIV of chapter 468; chapter 478; chapter 480; part III or part IV of chapter 483; chapter 484; chapter 486; chapter 490; or chapter 491, Florida Statutes.
(f) "Health care provider" means any health care facility or other health care organization licensed or certified to provide approved medical and allied health services in this state.

(3) COMMISSION; DUTIES AND RESPONSIBILITIES.--There is hereby created the Florida Commission on Excellence in Health Care. The commission shall:
(a) Identify existing data sources that evaluate quality of care in Florida and collect, analyze, and evaluate this data.
(b) Establish guidelines for data sharing and coordination.
(c) Identify core sets of quality measures for standardized reporting by appropriate components of the health care continuum.
(d) Recommend a framework for quality measurement and outcome reporting.
(e) Develop quality measures that enhance and improve the ability to evaluate and improve care.
(f) Make recommendations regarding research and development needed to advance quality measurement and reporting.
(g) Evaluate regulatory issues relating to the pharmacy profession and recommend changes necessary to optimize patient safety.
(h) Facilitate open discussion of a process to ensure that comparative information on health care quality is valid, reliable, comprehensive, understandable, and widely available in the public domain.
(i) Sponsor public hearings to share information and expertise, identify "best practices," and recommend methods to promote their acceptance.
(j) Evaluate current regulatory programs to determine what changes, if any, need to be made to facilitate patient safety.
(k) Review public and private health care purchasing systems to determine if there are sufficient mandates and incentives to facilitate continuous improvement in patient safety.
(l) Analyze how effective existing regulatory systems are in ensuring continuous competence and knowledge of effective safety practices.
(m) Develop a framework for organizations that license, accredit, or credential health care practitioners and health care providers to more quickly and effectively identify unsafe providers and practitioners and to take action necessary to remove the unsafe provider or practitioner from practice or operation until such time as the practitioner or provider has proven safe to practice or operate.
(n) Recommend procedures for development of a curriculum on patient safety and methods of incorporating such curriculum into training, licensure, and certification requirements.
(o) Develop a framework for regulatory bodies to disseminate information on patient safety to health care practitioners, health care providers, and consumers through conferences, journal articles and editorials, newsletters, publications, and Internet websites.
(p) Recommend procedures to incorporate recognized patient safety considerations into practice guidelines and into standards related to the introduction and diffusion of new technologies, therapies, and drugs.
(q) Recommend a framework for development of community-based collaborative initiatives for error reporting and analysis and implementation of patient safety improvements.
(r) Evaluate the role of advertising in promoting or adversely affecting patient safety.
(s) Evaluate and make recommendations regarding the need for licensure of additional persons who participate in the delivery of health care to Floridians, including, but not limited to, surgical technologists and pharmacy technicians.
(t) Evaluate the benefits and problems of the current disciplinary systems and make recommendations regarding alternatives and improvements.

(4) MEMBERSHIP, ORGANIZATION, MEETINGS, PROCEDURES, STAFF.--
(a) The commission shall consist of:
1. The State Surgeon General and the Executive Director of the Agency for Health Care Administration.
2. One representative each from the following agencies or organizations: the Board of Medicine, the Board of Osteopathic Medicine, the Board of Pharmacy, the Board of Nursing, the Board of Dentistry, the Florida Dental Association, the Florida Medical Association, the Florida Osteopathic Medical Association, the Florida Academy of Physician Assistants, the Florida Chiropractic Society, the Florida Chiropractic Association, the Florida Podiatric Medical Association, the Florida Society of Ambulatory Surgical Centers, the Florida Statutory Teaching Hospital Council, Inc., the Florida Statutory Rural Hospital Council, the Florida Nurses Association, the Florida Organization of Nursing Executives, the Florida Pharmacy Association, the Florida Society of Health System Pharmacists, Inc., the Florida Hospital Association, the Association of Community Hospitals and Health Systems of Florida, Inc., the Florida League of Health Care Systems, the Florida Health Care Risk Management Advisory Council, the Florida Health Care Association, and the Florida Association of Homes for the Aging;
3. One licensed clinical laboratory director, appointed by the Secretary of Health;
4. Two health lawyers, appointed by the State Surgeon General, one of whom shall be a member of The Florida Bar Health Law Section who defends physicians and one of whom shall be a member of the Florida Academy of Trial Lawyers;
5. One representative of the medical malpractice professional liability insurance industry, appointed by the State Surgeon General;
6. One representative of a Florida medical school appointed by the State Surgeon General;
7. Two representatives of the health insurance industry, appointed by the Executive Director of the Agency for Health Care Administration, one of whom shall represent indemnity plans and one of whom shall represent managed care;
8. Five consumer advocates, consisting of one from the Association for Responsible Medicine, two appointed by the Governor, one appointed by the President of the Senate, and one appointed by the Speaker of the House of Representatives; and
9. Two legislators, one appointed by the President of the Senate and one appointed by the Speaker of the House of Representatives.
Commission membership shall reflect the geographic and demographic diversity of the state.
(b) The State Surgeon General and the Executive Director of the Agency for Health Care Administration shall jointly chair the commission. Subcommittees shall be formed by the joint chairs, as needed, to make recommendations to the full commission on the subjects assigned. However, all votes on work products of the commission shall be at the full commission level, and all recommendations to the Governor, the President of the Senate, and the Speaker of the House of Representatives must pass by a two-thirds vote of the full commission. Sponsoring agencies and organizations may designate an alternative member who may attend and vote on behalf of the sponsoring agency or organization in the event the appointed member is unable to attend a meeting of the commission or any subcommittee. The commission shall be staffed by employees of the Department of Health and the Agency for Health Care Administration. Sponsoring agencies or organizations must fund the travel and related expenses of their appointed members on the commission. Travel and related expenses for the consumer members of the commission shall be reimbursed by the state pursuant to s. 112.061, Florida Statutes. The commission shall hold its first meeting no later than July 15, 2000.

(5) EVIDENTIARY PROHIBITIONS.--
(a) The findings, recommendations, evaluations, opinions, investigations, proceedings, records, reports, minutes, testimony, correspondence, work product, and actions of the commission shall be available to the public, but may not be introduced into evidence at any civil, criminal, special, or administrative proceeding against a health care practitioner or health care provider arising out of the matters which are the subject of the findings of the commission. Moreover, no member of the commission shall be examined in any civil, criminal, special, or administrative proceeding against a health care practitioner or health care provider as to any evidence or other matters produced or presented during the proceedings of this commission or as to any findings, recommendations, evaluations, opinions, investigations, proceedings, records, reports, minutes, testimony, correspondence, work product, or other actions of the commission or any members thereof. However, nothing in this section shall be construed to mean that information, documents, or records otherwise available and obtained from original sources are immune from discovery or use in any civil, criminal, special, or administrative proceeding merely because they were presented during proceedings of the commission. Nor shall any person who testifies before the commission or who is a member of the commission be prevented from testifying as to matters within his or her knowledge in a subsequent civil, criminal, special, or administrative proceeding merely because such person testified in front of the commission.
(b) The findings, recommendations, evaluations, opinions, investigations, proceedings, records, reports, minutes, testimony, correspondence, work product, and actions of the commission shall be used as a guide and resource and shall not be construed as establishing or advocating the standard of care for health care practitioners or health care providers unless subsequently enacted into law or adopted in rule. Nor shall any findings, recommendations, evaluations, opinions, investigations, proceedings, records, reports, minutes, testimony, correspondence, work product, or actions of the commission be admissible as evidence in any way, directly or indirectly, by introduction of documents or as a basis of an expert opinion as to the standard of care applicable to health care practitioners or health care providers in any civil, criminal, special, or administrative proceeding unless subsequently enacted into law or adopted in rule.
(c) No person who testifies before the commission or who is a member of the commission may specifically identify any patient, health care practitioner, or health care provider by name. Moreover, the findings, recommendations, evaluations, opinions, investigations, proceedings, records, reports, minutes, testimony, correspondence, work product, and actions of the commission may not specifically identify any patient, health care practitioner, or health care provider by name.

(6) REPORT; TERMINATION.--The commission shall provide a report of its findings and recommendations to the Governor, the President of the Senate, and the Speaker of the House of Representatives no later than February 1, 2001. After submission of the report, the commission shall continue to exist for the purpose of assisting the Department of Health, the Agency for Health Care Administration, and the regulatory boards in their drafting of proposed legislation and rules to implement its recommendations and for the purpose of providing information to the health care industry on its recommendations. The commission shall be terminated June 1, 2001.