TOPIC

DISCUSSION

RECOMMENDATIONS

FOLLOW-UP

Minutes reviewed.

Minutes reviewed and approved.

None.

None.

Financial Statement.

Current balance $7175.00.

None.

None.

OLD BUSINESS

Membership.

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Some of the membership continues to report that they are not receiving billings from the FSN. An effort has been made to maintain a current accurate listing.

Continue to update the mailing list by informing the officers of any changes..

None.

Bylaws

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What appears to be the most recent edition of the bylaws has been located. Copies were made available for those members who are interested in reviewing the current bylaws. Among topics that need to be addressed in updating the bylaws includes: 1) change of name to the Florida Society of Neonatologists, 2) the definition of an inactive member with voting rights [this issue was raised at the previous meeting in Orlando with regards to active members being current with dues], 3) the Florida Medical Association is now requiring that societies function within their bylaws

The bylaws have been updated to meet the current standards of the Florida Society of Neonatology. (Dr. Jeane McCarthy, St. Petersburg, FL has agreed to chair the committee which will attempt to update the current bylaws).

The proposed revised bylaws will be submitted to the members of the Society for their review.

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Guidelines for Level II/III.

This is a follow-up to the discussions in Miami and Orlando meetings with regards to the revision of guidelines for Level II/III. Agency for Health Care Administration (AHCA) continues to seek assistance from the FSN in establishing direction for guidelines in levels II/III. At the Orlando meeting (Spring 1997), the Society agreed on a moratorium on any proposed changes in level II/III guidelines until information is available regarding outcome under the current standards. At the present time the only Centers reporting data to AHCA are the RPICC programs. At the Orlando meeting, it was recommended that the member s of the Society of Neonatologist at all level II/III’s within the state of Florida voluntarily report the same information to AHCA that the RPICC programs are being requested to forward for a 1 year period of time. FSN cannot enforce voluntary participation from membership.

Discussion ensued at the present meeting regarding the recommendations from the Orlando meeting. AHCA is currently revising the data collection system that it is now for the RPICC programs. The new forms should be available in September. The members voted that for a period of 1 year, all members of the FSN at level II and III centers in the state of Florida should voluntarily participate with this data collection program. AHCA will be requested to tabulate this data and make it available to the FSN within year of collection so that recommendations for modifyng the current guidelines for level II and III units can be facilitated. AHCA will have the new data data collection forms available by the fall meeting.

A letter is to be sent to all members requesting that they voluntarily participate in the data collection system for a period of 1 year starting this fall.

A letter is to be sent to AHCA requesting that they work with FSN in tabulating this data.

The new data collection forms will be presented at the fall meeting of the FSN.

Florida Pediatric Society Bioethics Subcommittee statement on "Neonates with Anencephaly as Organ Donors"

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The Florida Society of Pediatrics Bioethic’s statement on anencephaly was presented to the Membership. There is currently no national policy in place. However the Pediatric Society would like to move ahead with a statement on anencephaly. The members were reminded that the Florida Supreme Court had recently rendered a decision on anencephaly as not being candidates for organ donation (case in south Florida). There is currently no criteria for brain death in newborn infants. The member voiced their support for the efforts of the Florida Pediatric Society in addressing this topic. However, the members felt that the Society should support the efforts to change the current laws, but until then to work within the frame of the law. Questions were raised with regards to the number of infants born at term within the State of Florida that have the diagnosis of anencephaly. Also the members raised questions with regards to the impact of these patients on the number of transplants currently taking place with the state. Members are not aware of documentation of the actual number of patients, as well as the actual impact on the number of transplants. The members requested a chance to review the statement and to gather more information from their associates and hospitals. .

The members recommends that the statement to again be discussed at the Fall meeting.

The mmbers feels that the response to this statement should be: 1) accept; 2) modify; 3) reject

Discuss at Fall meeting.

The Florida society of Neonatologist’s WEB site.

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The Society expressed their appreciation to Dr. Andy Kairalla for the efforts he has pursued in establishing a WEB site for the Society. Discussion ensured with regards to the WEB site providing access for 1) bulletin board; 2) communication; 3)E-mail; 4) chat groups; 5) education. The members discussed that the site should have 2 parts: 1) a public domain and 2) a secured site available only by password. The Society also requested that E-mail addresses for the membership be available only by password and not to the public. The possibility of active members voting through the WEB site was also thought to be of benefit. The members were advised that Dr. Kairalla would be sending a letter announcing the establishment of the WEB site and it’s address. Members are requested to sign and review the site. They will also be requested to submit E-mail addresses.

The members asked to visit the WEB site and establish their E-mail addresses. They are also requested that they comment to Dr. Kairalla with regards to the WEB site.

Dr. Kairalla will be presenting more information at the Fall meeting.

Florida Legislation.

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The members received a copy of the letter that the President of the FSN forwarded to Governor Chiles. Discussion ensured with regards to the relationship of the Florida Society of Neonatologists with AHCA versus the Department of Health. The question, "which of these agencies best serves the FSN" was raised. AHCA’s resources continue to be: 1) Medicaid financial support; 2) data base set up for health statistics. Both of these are important at this time. Currently the Society of Neonatologists have a good rapport and line of communication with AHCA. The Florida Pediatric Society is currently attempting to establish pediatric standards which are to be developed with the Department of Health. The FSN was not asked to participate in the development of these pediatric standards. Concerns were voiced that the FSN (which represents the neonatologists of the state of Florida) has a better understanding of the needs of its membership.

Discussion ensued with regards to legislation which would provide for the development of pediatric standards within the Department of Health. Members raised concerned that FSN should be consulted with regards to issues directly relating to developing standards which would impact on the neonatolgist. Discussion ensued regarding the need for more active participation by all active members of the Society. It was pointed out that the same few members are attending the meetings on a regular basis, the same members are addressing the problems. To meet the needs of the future, the whole membership must become more active..

1. Membership voted to support the letter sent to Governor Chilest from the FSN.

2. FSN supports current relationship with ACHA. At this time Membership feels that ACHA continues to have the resources which the society feels it is important and continues to support. The society does feel that communication will be necessary with the Department of Health.

All members are asked to read correspondence and E-mails in respond in a timely manner. There needs to be more commitment from the active members to participate in the meetings.

Reimbursement for Neonatal Nurse Practitioners.

"I have clarified with Medicaid that the delivery of all services must be done by or under their personal supervision of the physician. Personal supervision under Medicaid guidelines is: 1) that the physician is in the building when services are rendered, and 2) the physician signs and dates the medical record within 24 hours of providing the service. Unsupervised ARNP services can be billed to Medicaid under the practitioners Medicaid number, provided they are enrolled as members of our group. Reimbursement is at 80% of the Medicaid fee for service schedule for physicians."

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Dr. Auerbach expressed concerns with regards to the difficulty in reimbursement due to the lack of codes for neonatal nurse practitioner’s activities in the absence of neonatologists. Dr. Wyble has been requested by the Perinatal Section, American Academy of Pediatrics, to participate in developing codes for reimbursement. He would attempt to address this part of his involvement with this committee. Dr. Auerbach would be following with Tallahassee with regards to additional information on coding for neonatal nurse practitioners.

None.

Report at the next meeting.

Meeting Adjourned.