Senate Bill sb0250er

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    2003 Legislature           CS for CS for SB 250, 1st Engrossed



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  2         An act relating to rural hospitals; amending

  3         ss. 395.602 and 408.07, F.S.; revising the

  4         definition of the term "rural hospital";

  5         creating s. 395.6025, F.S.; authorizing

  6         exemptions from certificate-of-need review for

  7         the construction of a new or replacement

  8         facility for a rural hospital; providing

  9         conditions for eligibility for the exemption;

10         amending s. 766.314, F.S.; expanding the

11         definition of the term "infant delivered" for

12         the purposes of payment of an initial

13         assessment for each infant delivered in a

14         hospital; providing an effective date.

15  

16  Be It Enacted by the Legislature of the State of Florida:

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18         Section 1.  Paragraph (e) of subsection (2) of section

19  395.602, Florida Statutes, is amended to read:

20         395.602  Rural hospitals.--

21         (2)  DEFINITIONS.--As used in this part:

22         (e)  "Rural hospital" means an acute care hospital

23  licensed under this chapter, having 100 or fewer licensed beds

24  and an emergency room, which is:

25         1.  The sole provider within a county with a population

26  density of no greater than 100 persons per square mile;

27         2.  An acute care hospital, in a county with a

28  population density of no greater than 100 persons per square

29  mile, which is at least 30 minutes of travel time, on normally

30  traveled roads under normal traffic conditions, from any other

31  acute care hospital within the same county;


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 1         3.  A hospital supported by a tax district or

 2  subdistrict whose boundaries encompass a population of 100

 3  persons or fewer per square mile;

 4         4.  A hospital in a constitutional charter county with

 5  a population of over 1 million persons that has imposed a

 6  local option health service tax pursuant to law and in an area

 7  that was directly impacted by a catastrophic event on August

 8  24, 1992, for which the Governor of Florida declared a state

 9  of emergency pursuant to chapter 125, and has 120 beds or less

10  that serves an agricultural community with an emergency room

11  utilization of no less than 20,000 visits and a Medicaid

12  in-patient utilization rate greater than 15 percent;

13         5.  A hospital with a service area that has a

14  population of 100 persons or fewer per square mile. As used in

15  this subparagraph, the term "service area" means the fewest

16  number of zip codes that account for 75 percent of the

17  hospital's discharges for the most recent 5-year period, based

18  on information available from the hospital inpatient discharge

19  database in the State Center for Health Statistics at the

20  Agency for Health Care Administration; or

21         6.  A hospital designated as a Critical Access Hospital

22  by the Department of Health in accordance with federal

23  regulations and state requirements.

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25  Population densities used in this paragraph must be based upon

26  the most recently completed United States census. A hospital

27  that received funds under s. 409.9116 for a quarter beginning

28  no later than July 1, 2002, is deemed to have been and shall

29  continue to be a rural hospital from that date through June

30  30, 2012, if the hospital continues to have 100 or fewer

31  licensed beds and an emergency room, or meets the criteria of


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    2003 Legislature           CS for CS for SB 250, 1st Engrossed



 1  subparagraph 4. An acute care hospital that has not previously

 2  been designated as a rural hospital and that meets the

 3  criteria of this paragraph shall be granted such designation

 4  upon application, including supporting documentation to the

 5  Agency for Health Care Administration.

 6         Section 2.  Subsection (42) of section 408.07, Florida

 7  Statutes, is amended to read:

 8         408.07  Definitions.--As used in this chapter, with the

 9  exception of ss. 408.031-408.045, the term:

10         (42)  "Rural hospital" means an acute care hospital

11  licensed under chapter 395, having 100 or fewer licensed beds

12  and an emergency room, and which is:

13         (a)  The sole provider within a county with a

14  population density of no greater than 100 persons per square

15  mile;

16         (b)  An acute care hospital, in a county with a

17  population density of no greater than 100 persons per square

18  mile, which is at least 30 minutes of travel time, on normally

19  traveled roads under normal traffic conditions, from another

20  acute care hospital within the same county;

21         (c)  A hospital supported by a tax district or

22  subdistrict whose boundaries encompass a population of 100

23  persons or fewer per square mile;

24         (d)  A hospital with a service area that has a

25  population of 100 persons or fewer per square mile.  As used

26  in this paragraph, the term "service area" means the fewest

27  number of zip codes that account for 75 percent of the

28  hospital's discharges for the most recent 5-year period, based

29  on information available from the hospital inpatient discharge

30  database in the State Center for Health Statistics at the

31  Agency for Health Care Administration; or


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    2003 Legislature           CS for CS for SB 250, 1st Engrossed



 1         (e)  A hospital designated as a Critical Access

 2  Hospital by the Department of Health in accordance with

 3  federal regulations and state requirements.

 4  

 5  Population densities used in this subsection must be based

 6  upon the most recently completed United States census. A

 7  hospital that received funds under s. 409.9116 for a quarter

 8  beginning no later than July 1, 2002, is deemed to have been

 9  and shall continue to be a rural hospital from that date

10  through June 30, 2012, if the hospital continues to have 100

11  or fewer licensed beds and an emergency room, or meets the

12  criteria of s. 395.602(2)(e)4. An acute care hospital that has

13  not previously been designated as a rural hospital and that

14  meets the criteria of this subsection shall be granted such

15  designation upon application, including supporting

16  documentation, to the Agency for Health Care Administration.

17         Section 3.  Section 395.6025, Florida Statutes, is

18  created to read:

19         395.6025 Rural hospital replacement facilities.--

20  Notwithstanding the provisions of s. 408.036, a hospital

21  defined as a statutory rural hospital in accordance with s.

22  395.602, or a not-for-profit operator of rural hospitals, is

23  not required to obtain a certificate of need for the

24  construction of a new hospital located in a county with a

25  population of at least 15,000 but no more than 18,000 and a

26  density of less than 30 persons per square mile, or a

27  replacement facility, provided that the replacement, or new,

28  facility is located within 10 miles of the site of the

29  currently licensed rural hospital and within the current

30  primary service area. As used in this section, the term

31  "service area" means the fewest number of zip codes that


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    2003 Legislature           CS for CS for SB 250, 1st Engrossed



 1  account for 75 percent of the hospital's discharges for the

 2  most recent 5-year period, based on information available from

 3  the hospital inpatient discharge database in the State Center

 4  for Health Statistics at the Agency for Health Care

 5  Administration.

 6         Section 4.  Paragraph (a) of subsection (4) of section

 7  766.314, Florida Statutes, is amended to read:

 8         766.314  Assessments; plan of operation.--

 9         (4)  The following persons and entities shall pay into

10  the association an initial assessment in accordance with the

11  plan of operation:

12         (a)  On or before October 1, 1988, each hospital

13  licensed under chapter 395 shall pay an initial assessment of

14  $50 per infant delivered in the hospital during the prior

15  calendar year, as reported to the Agency for Health Care

16  Administration; provided, however, that a hospital owned or

17  operated by the state or a county, special taxing district, or

18  other political subdivision of the state shall not be required

19  to pay the initial assessment or any assessment required by

20  subsection (5).  The term "infant delivered" includes live

21  births and not stillbirths, but the term does not include

22  infants delivered by employees or agents of the Board of

23  Regents, or those born in a teaching hospital as defined in s.

24  408.07, or those born in a teaching hospital as defined in s.

25  395.806 that have been deemed by the association as being

26  exempt from assessments since fiscal year 1997 to fiscal year

27  2001.  The initial assessment and any assessment imposed

28  pursuant to subsection (5) may not include any infant born to

29  a charity patient (as defined by rule of the Agency for Health

30  Care Administration) or born to a patient for whom the

31  hospital receives Medicaid reimbursement, if the sum of the


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    2003 Legislature           CS for CS for SB 250, 1st Engrossed



 1  annual charges for charity patients plus the annual Medicaid

 2  contractuals of the hospital exceeds 10 percent of the total

 3  annual gross operating revenues of the hospital.  The hospital

 4  is responsible for documenting, to the satisfaction of the

 5  association, the exclusion of any birth from the computation

 6  of the assessment. Upon demonstration of financial need by a

 7  hospital, the association may provide for installment payments

 8  of assessments.

 9         Section 5.  This act shall take effect July 1, 2003.

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