Chapter 2019-136, Laws of Florida, eliminated the state's certificate of need review for the following tertiary health services: comprehensive rehabilitation; neonatal intensive care units; pediatric cardiac catheterization; pediatric open-heart surgery; and organ transplantation.
Tertiary services licensure standards involve complex, detailed requirements across a number of categories such as volume, outcomes, and professional competencies of staff. While there is consensus that volume of patients is positively related to successful outcomes for tertiary services, studies do not provide consistent minimum volume recommendations. Studies have concluded that numerous other factors, in addition to volume, are related to quality of tertiary health services.
Federal licensure requirements are relevant for comprehensive rehabilitation and organ transplants but not for other tertiary services. Other states' licensure standards for tertiary services vary considerably and do not provide reliable information on best practices.
Professional medical associations are a primary source of best practices for tertiary services licensure standards. Options for consideration by the Agency for Health Care Administration and the Legislature as the state is developing licensure standards for tertiary services are largely based on the standards and guidelines provided by the multiple professional medical associations relevant to each tertiary health service.

Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.