Chapter 2003-416, Laws of Florida, addressed Florida’s medical malpractice insurance crisis and strived to make quality health care available to Florida’s citizens.  Provisions of the law required changes in the health care practitioner disciplinary process within the Department of Health and the Division of Administrative Hearings.  For example, the law authorized the Department to issue citations that do not constitute discipline, and required the Division of Administrative Hearings to designate at least two Administrative Law Judges (ALJs), with appropriate health care law experience or certification, to specifically preside over Department of Health cases.  Further, the law directed the Auditor General and the Office of Program Policy Analysis and Government Accountability (OPPAGA) to conduct an audit of the Department of Health’s health care practitioner disciplinary process.  The audit primarily covered the period July 2002 through January 2004, and disclosed:

Auditor General Findings

Finding No. 1:    The Department often exceeded the six-month statutory timeframe for complaint investigation and determination of the existence of probable cause.  In some instances, the timeframe to close cases ranged from 1 to 6 years after the complaint date.

Finding No. 2:    Enhanced coordination is needed between the Department and the Agency for Health Care Administration to provide a more efficient process for reviewing and investigating adverse incident reports.

Finding No. 3:    Department use of non-disciplinary citations has not decreased the rate at which practitioners contest Department citations or lessened the length of time required to issue citations.

Finding No. 4:    The Division of Administrative Hearings had not documented the criteria used to evaluate and select ALJs assigned to Department of Health cases.  Additionally, as of March 2004, none of the assigned ALJs had attained certification in health care law.

Finding No. 5:    The Department did not properly record practitioner disciplinary fines or costs awarded to the State in its licensing system or in its accounting records.

OPPAGA Findings

Finding No. 6:    The Department has a reasonable process for verifying some profile information, but not verifying certain key information limits its usefulness to consumers.

Finding No. 7:    Some profile information may be confusing and many profiles are missing required information which may lead to consumer confusion and hinder the ability to make informed choices regarding practitioners.

Finding No. 8:    In the absence of a rule specifying which criminal convictions relate to a practitioner’s ability to competently practice, the Department has broadly interpreted statutes and established a policy to include all criminal history information in the profiles.  Additionally, expunging disciplinary histories at ten years and inconsistent reporting of bankruptcies may limit consumers’ ability to make appropriate decisions regarding the selection of a health care practitioner.

The Secretary's response to the findings and recommendations contained in this report can be viewed on the Auditor General's Web site.