Senate Bill sb0250c1

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    Florida Senate - 2003                            CS for SB 250

    By the Committee on Health, Aging, and Long-Term Care; and
    Senators Peaden, Jones, Klein, Saunders and Fasano




    317-1835-03

  1                      A bill to be entitled

  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 replacement facility for

  8         a rural hospital; providing conditions for

  9         eligibility for the exemption; creating s.

10         395.6063, F.S.; permitting any statutory rural

11         hospital to contract with the Department of

12         Management Services in order to purchase

13         coverage in the state group health insurance

14         plan for the hospital's employees; requiring a

15         participating hospital to pay a fee; providing

16         an effective date.

17

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

19

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

21  395.602, Florida Statutes, is amended to read:

22         395.602  Rural hospitals.--

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

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

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

26  and an emergency room, which is:

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

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

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

30  population density of no greater than 100 persons per square

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

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    Florida Senate - 2003                            CS for SB 250
    317-1835-03




  1  traveled roads under normal traffic conditions, from any other

  2  acute care hospital within the same county;

  3         3.  A hospital supported by a tax district or

  4  subdistrict whose boundaries encompass a population of 100

  5  persons or fewer per square mile;

  6         4.  A hospital in a constitutional charter county with

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

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

  9  that was directly impacted by a catastrophic event on August

10  24, 1992, for which the Governor of Florida declared a state

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

12  that serves an agricultural community with an emergency room

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

14  in-patient utilization rate greater than 15 percent;

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

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

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

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

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

20  on information available from the hospital inpatient discharge

21  database in the State Center for Health Statistics at the

22  Agency for Health Care Administration; or

23         6.  A hospital designated as a Critical Access Hospital

24  by the Department of Health in accordance with federal

25  regulations and state requirements.

26

27  Population densities used in this paragraph must be based upon

28  the most recently completed United States census. A hospital

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

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

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

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    Florida Senate - 2003                            CS for SB 250
    317-1835-03




  1  30, 2012, if the hospital continues to have 100 or fewer

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

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

  4  been designated as a rural hospital and that meets the

  5  criteria of this paragraph shall be granted such designation

  6  upon application, including supporting documentation to the

  7  Medicaid program office of the Agency for Health Care

  8  Administration.

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

10  Statutes, is amended to read:

11         408.07  Definitions.--As used in this chapter, with the

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

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

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

15  and an emergency room, and which is:

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

17  population density of no greater than 100 persons per square

18  mile;

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

20  population density of no greater than 100 persons per square

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

22  traveled roads under normal traffic conditions, from another

23  acute care hospital within the same county;

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

25  subdistrict whose boundaries encompass a population of 100

26  persons or fewer per square mile;

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

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

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

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

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

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    Florida Senate - 2003                            CS for SB 250
    317-1835-03




  1  on information available from the hospital inpatient discharge

  2  database in the State Center for Health Statistics at the

  3  Agency for Health Care Administration; or

  4         (e)  A hospital designated as a Critical Access

  5  Hospital by the Department of Health in accordance with

  6  federal regulations and state requirements.

  7

  8  Population densities used in this subsection must be based

  9  upon the most recently completed United States census. A

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

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

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

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

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

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

16  not previously been designated as a rural hospital and that

17  meets the criteria of this subsection shall be granted such

18  designation upon application, including supporting

19  documentation, to the Medicaid program office of the Agency

20  for Health Care Administration.

21         Section 3.  Section 395.6025, Florida Statutes, is

22  created to read:

23         395.6025 Rural hospital replacement facilities.--

24  Notwithstanding the provisions of s. 408.0356, hospitals

25  defined as statutory rural hospitals in accordance with s.

26  395.602 shall not be required to obtain a Certificate of Need

27  for the construction of a replacement facility, provided that

28  the replacement facility is located within 10 miles of the

29  site of the currently licensed rural hospital and within the

30  current primary service area.  As used in this subparagraph,

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

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    Florida Senate - 2003                            CS for SB 250
    317-1835-03




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

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

  3  from the hospital inpatient discharge database in the State

  4  Center for Health Statistics at the Agency for Health Care

  5  Administration.

  6         Section 4.  Section 395.6063, Florida Statutes, is

  7  created to read:

  8         395.6063 Rural hospital employee health

  9  insurance.--Effective July 1, 2003, any statutory rural

10  hospital may contract with the Department of Management

11  Services in order to purchase coverage in the state group

12  health insurance plan for the hospital's employees and

13  qualified family members at the same premium cost as that for

14  retirees and surviving spouses. The hospital shall collect

15  payroll deductions or other remuneration from qualified

16  employees as may be required for the employee contribution in

17  accordance with the department's regulations. The hospital

18  shall also make the employer contributions required and pay an

19  annual administrative fee of not less than $2.61 per enrollee

20  per month.

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

22

23          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
24                         Senate Bill 250

25
    The committee substitute differs from SB 250 in the following ways:
26
    1. The committee substitute creates s. 395.6025, F.S., to
27  permit a rural hospital to be exempt from certificate-of-need
    review for construction of a replacement facility provided
28  certain conditions are met.

29  2. The committee substitute creates s. 395.6063, F.S., to
    permit a rural hospital to contract with the Department of
30  Management Services to purchase coverage in the state group
    health insurance program for the hospital's employees and
31  their families.

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