| HB 1447, Engrossed 1 |
2003 |
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A bill to be entitled |
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An act relating to St. Lucie County; providing legislative |
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intent; providing a popular name; providing for |
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consolidation of certain local hospital authority; |
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providing powers and duties of hospital governing boards; |
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providing an effective date. |
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Be It Enacted by the Legislature of the State of Florida: |
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Section 1. This act clarifies the delineation of authority |
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within each hospital within St. Lucie County. It is the intent |
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of the Legislature to provide consolidation of a hospital |
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corporation's board of directors' power, authority, duty, and |
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ultimate responsibility under existing statutes with respect to |
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the operation of a hospital, including, but not limited to, the |
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granting, denial, and discipline of medical staff and clinical |
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privileges, and for compliance with statutorily mandated peer |
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review, risk management, and quality assurance activities. This |
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act is not intended to supersede, amend, or terminate any |
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existing medical staff bylaws, but rather to clarify that in the |
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event of a conflict between bylaws of a hospital corporation's |
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board of directors and a hospital's medical staff bylaws, the |
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hospital board's bylaws shall prevail with respect to medical |
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staff privileges, quality assurance, peer review, and contracts |
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for hospital-based services.
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Section 2. This act may be known by the popular name the |
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"St. Lucie County Hospital Governance Law." |
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Section 3. The board of directors of each general hospital |
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operating in St. Lucie County whose license is held by a |
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corporation shall appoint or elect, in a manner and method of |
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its own choosing, a governing board for each hospital which may |
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be the board of directors of such corporation or a separate |
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governing board. The board of directors may delegate such |
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authority as it deems necessary to the governing board of a |
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hospital, but such delegation does not relieve the hospital |
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corporation of ultimate responsibility, and such delegation of |
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authority shall remain subject to amendment, rescission, or |
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revocation by the board of directors.
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Section 4. The governing board shall also be ultimately |
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responsible for the administration of the hospital, including |
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managing the operations of the hospital, ensuring patient |
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welfare, conducting peer review, overseeing the risk management |
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program and quality assurance activities, and determining |
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eligibility for medical staff membership and clinical |
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privileges. This authority is granted subject to the provisions |
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of sections 395.0191 and 395.0193, Florida Statutes, and the |
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articles of incorporation and bylaws of the hospital |
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corporation. |
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Section 5. A governing board's authority for the |
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administration of the hospital is not limited by the authority |
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of its medical staff. Therefore, a governing board may reject or |
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modify a medical staff recommendation or may, if the medical |
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staff has failed to act, take action independent of the medical |
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staff concerning medical staff membership, clinical privileges, |
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peer review, and quality assurance in accordance with the |
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procedures specified in section 6. To the extent, if any, that |
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the bylaws or other regulations of the medical staff conflict |
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with the bylaws or other regulations of the governing board, the |
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bylaws or other regulations of the governing board shall control |
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with respect to medical staff privileges, quality assurance, |
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peer review, and contracts for hospital-based services, |
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irrespective of the identity of the drafter of the respective |
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bylaws or regulations. However, in no event shall a decision |
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regarding medical staff privileges be made by the governing |
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board entirely upon economic considerations. Neither the |
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governing board nor a hospital's medical staff shall |
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unilaterally amend a hospital's medical staff bylaws and related |
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manuals, rules, or regulations. Any amendments or revisions |
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proposed by the governing board shall first be submitted to the |
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medical staff for its recommendations, including 30 days' notice |
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for response, and any response timely made shall be carefully |
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considered by the governing board prior to its approval of the |
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proposed amendments or revisions. |
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Section 6. To the extent a governing board seeks to modify |
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a medical staff recommendation, or where a medical staff has |
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failed to act within 75 days after a request from the governing |
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board to take action against, or with regard to, an individual |
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physician concerning medical staff membership, clinical |
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privileges, peer review, or quality assurance, a governing board |
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may take action independent of the actions of the medical staff. |
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Any such action shall be subject to a fair hearing process, if |
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authorized by the medical staff bylaws, in which the physician |
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is entitled to be represented by counsel, to be afforded an |
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opportunity to present oral and written argument in response to |
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the corrective or disciplinary action proposed, and to comment |
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upon and cross-examine witnesses and evidence against such |
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physician. If, after any fair hearing, the governing board |
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determines that corrective or disciplinary action is necessary, |
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it shall recommend such action to a six-member joint conference |
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committee composed of three members of the governing board, to |
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be appointed by the chair of the governing board, and three |
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members of the medical staff, to be appointed by the chair or |
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president of the medical staff. The joint conference committee |
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shall, within 15 days after the governing board's decision after |
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the fair hearing process, review the fair hearing recommendation |
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and notify the governing board that the joint conference |
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committee accepts, rejects, or cannot reach a majority consensus |
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concerning the governing board's recommendation. If the joint |
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conference committee's recommendation is to accept the governing |
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board's recommendation, the governing board's decision shall be |
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final. If the joint conference committee rejects the governing |
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board's recommendation and suggests an alternative corrective or |
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disciplinary action, or finds that no corrective or disciplinary |
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action is warranted, the governing board shall not unreasonably |
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reject the joint conference committee's recommendation. If the |
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joint conference committee cannot reach a majority consensus to |
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either accept or reject the governing board's action concerning |
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the fair hearing decision, the governing board's action shall be |
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final. The governing board shall give full and complete |
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consideration to the joint conference committee’s |
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recommendations. |
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Section 7. This act shall take effect upon becoming a law. |
