Senate Bill sb0250c2
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Florida Senate - 2003 CS for CS for SB 250
By the Committees on Appropriations; Health, Aging, and
Long-Term Care; and Senators Peaden, Jones, Klein, Saunders
and Fasano
309-2343-03
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 new or replacement
8 facility for a rural hospital; providing
9 conditions for eligibility for the exemption;
10 creating s. 395.6063, F.S.; permitting any
11 statutory rural hospital to contract with the
12 Department of Management Services in order to
13 purchase coverage in the state group health
14 insurance plan for the hospital's employees;
15 requiring a participating hospital to pay a
16 fee; requiring the Department of Management
17 Services to obtain a private letter ruling;
18 expanding the definition of the term "infant
19 delivered" for the purposes of payment of an
20 initial assessment for each infant delivered in
21 a hospital; providing an effective date.
22
23 Be It Enacted by the Legislature of the State of Florida:
24
25 Section 1. Paragraph (e) of subsection (2) of section
26 395.602, Florida Statutes, is amended to read:
27 395.602 Rural hospitals.--
28 (2) DEFINITIONS.--As used in this part:
29 (e) "Rural hospital" means an acute care hospital
30 licensed under this chapter, having 100 or fewer licensed beds
31 and an emergency room, which is:
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Florida Senate - 2003 CS for CS for SB 250
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1 1. The sole provider within a county with a population
2 density of no greater than 100 persons per square mile;
3 2. An acute care hospital, in a county with a
4 population density of no greater than 100 persons per square
5 mile, which is at least 30 minutes of travel time, on normally
6 traveled roads under normal traffic conditions, from any other
7 acute care hospital within the same county;
8 3. A hospital supported by a tax district or
9 subdistrict whose boundaries encompass a population of 100
10 persons or fewer per square mile;
11 4. A hospital in a constitutional charter county with
12 a population of over 1 million persons that has imposed a
13 local option health service tax pursuant to law and in an area
14 that was directly impacted by a catastrophic event on August
15 24, 1992, for which the Governor of Florida declared a state
16 of emergency pursuant to chapter 125, and has 120 beds or less
17 that serves an agricultural community with an emergency room
18 utilization of no less than 20,000 visits and a Medicaid
19 in-patient utilization rate greater than 15 percent;
20 5. A hospital with a service area that has a
21 population of 100 persons or fewer per square mile. As used in
22 this subparagraph, the term "service area" means the fewest
23 number of zip codes that account for 75 percent of the
24 hospital's discharges for the most recent 5-year period, based
25 on information available from the hospital inpatient discharge
26 database in the State Center for Health Statistics at the
27 Agency for Health Care Administration; or
28 6. A hospital designated as a Critical Access Hospital
29 by the Department of Health in accordance with federal
30 regulations and state requirements.
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1 Population densities used in this paragraph must be based upon
2 the most recently completed United States census. A hospital
3 that received funds under s. 409.9116 for a quarter beginning
4 no later than July 1, 2002, is deemed to have been and shall
5 continue to be a rural hospital from that date through June
6 30, 2012, if the hospital continues to have 100 or fewer
7 licensed beds and an emergency room, or meets the criteria of
8 subparagraph 4. An acute care hospital that has not previously
9 been designated as a rural hospital and that meets the
10 criteria of this paragraph shall be granted such designation
11 upon application, including supporting documentation to the
12 Agency for Health Care Administration.
13 Section 2. Subsection (42) of section 408.07, Florida
14 Statutes, is amended to read:
15 408.07 Definitions.--As used in this chapter, with the
16 exception of ss. 408.031-408.045, the term:
17 (42) "Rural hospital" means an acute care hospital
18 licensed under chapter 395, having 100 or fewer licensed beds
19 and an emergency room, and which is:
20 (a) The sole provider within a county with a
21 population density of no greater than 100 persons per square
22 mile;
23 (b) An acute care hospital, in a county with a
24 population density of no greater than 100 persons per square
25 mile, which is at least 30 minutes of travel time, on normally
26 traveled roads under normal traffic conditions, from another
27 acute care hospital within the same county;
28 (c) A hospital supported by a tax district or
29 subdistrict whose boundaries encompass a population of 100
30 persons or fewer per square mile;
31
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1 (d) A hospital with a service area that has a
2 population of 100 persons or fewer per square mile. As used
3 in this paragraph, the term "service area" means the fewest
4 number of zip codes that account for 75 percent of the
5 hospital's discharges for the most recent 5-year period, based
6 on information available from the hospital inpatient discharge
7 database in the State Center for Health Statistics at the
8 Agency for Health Care Administration; or
9 (e) A hospital designated as a Critical Access
10 Hospital by the Department of Health in accordance with
11 federal regulations and state requirements.
12
13 Population densities used in this subsection must be based
14 upon the most recently completed United States census. A
15 hospital that received funds under s. 409.9116 for a quarter
16 beginning no later than July 1, 2002, is deemed to have been
17 and shall continue to be a rural hospital from that date
18 through June 30, 2012, if the hospital continues to have 100
19 or fewer licensed beds and an emergency room, or meets the
20 criteria of s. 395.602(2)(e)4. An acute care hospital that has
21 not previously been designated as a rural hospital and that
22 meets the criteria of this subsection shall be granted such
23 designation upon application, including supporting
24 documentation, to the Agency for Health Care Administration.
25 Section 3. Section 395.6025, Florida Statutes, is
26 created to read:
27 395.6025 Rural hospital replacement facilities.--
28 Notwithstanding the provisions of s. 408.036, a hospital
29 defined as a statutory rural hospital in accordance with s.
30 395.602, or a not-for-profit operator of rural hospitals, is
31 not required to obtain a certificate of need for the
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1 construction of a new hospital located in a county with a
2 population of at least 15,000 but no more than 18,000 and a
3 density of less than 30 persons per square mile, or a
4 replacement facility, provided that the replacement, or new,
5 facility is located within 10 miles of the site of the
6 currently licensed rural hospital and within the current
7 primary service area. As used in this section, the term
8 "service area" means the fewest number of zip codes that
9 account for 75 percent of the hospital's discharges for the
10 most recent 5-year period, based on information available from
11 the hospital inpatient discharge database in the State Center
12 for Health Statistics at the Agency for Health Care
13 Administration.
14 Section 4. Section 395.6063, Florida Statutes, is
15 created to read:
16 395.6063 Rural hospital employee health insurance.--
17 (1) Effective July 1, 2003, any statutory rural
18 hospital may contract with the Department of Management
19 Services in order to purchase coverage in the state group
20 health insurance plan for the hospital's employees and
21 qualified family members at the same premium cost as that for
22 retirees and surviving spouses. The hospital shall collect
23 payroll deductions or other remuneration from qualified
24 employees as may be required for the employee contribution in
25 accordance with the department's regulations. The hospital
26 shall also make the employer contributions required and pay an
27 annual administrative fee of not less than $2.61 per enrollee
28 per month.
29 (2) The provisions of ss.624.436-624.446 do not apply
30 to the State Group Insurance Program for purposes of this
31 section.
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1 (3) The Department of Management Services shall
2 request a private letter ruling from the Internal Revenue
3 Service determining whether the inclusion of employees of
4 rural hospitals in the state group insurance program, in
5 accordance with this section, jeopardizes the qualified tax
6 status of the state group insurance program. The department
7 shall request this determination no later than July 31, 2003.
8 Implementation of this section is contingent upon receipt of a
9 favorable ruling by the Internal Revenue Service.
10 Section 5. Paragraph (a) of subsection (4) of section
11 766.314, Florida Statutes, is amended to read:
12 766.314 Assessments; plan of operation.--
13 (4) The following persons and entities shall pay into
14 the association an initial assessment in accordance with the
15 plan of operation:
16 (a) On or before October 1, 1988, each hospital
17 licensed under chapter 395 shall pay an initial assessment of
18 $50 per infant delivered in the hospital during the prior
19 calendar year, as reported to the Agency for Health Care
20 Administration; provided, however, that a hospital owned or
21 operated by the state or a county, special taxing district, or
22 other political subdivision of the state shall not be required
23 to pay the initial assessment or any assessment required by
24 subsection (5). The term "infant delivered" includes live
25 births and not stillbirths, but the term does not include
26 infants delivered by employees or agents of the Board of
27 Regents, or those born in a teaching hospital as defined in s.
28 408.07, or those born in a teaching hospital as defined in s.
29 395.806 that have been deemed by the association as being
30 exempt from assessments since fiscal year 1997 to fiscal year
31 2001. The initial assessment and any assessment imposed
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1 pursuant to subsection (5) may not include any infant born to
2 a charity patient (as defined by rule of the Agency for Health
3 Care Administration) or born to a patient for whom the
4 hospital receives Medicaid reimbursement, if the sum of the
5 annual charges for charity patients plus the annual Medicaid
6 contractuals of the hospital exceeds 10 percent of the total
7 annual gross operating revenues of the hospital. The hospital
8 is responsible for documenting, to the satisfaction of the
9 association, the exclusion of any birth from the computation
10 of the assessment. Upon demonstration of financial need by a
11 hospital, the association may provide for installment payments
12 of assessments.
13 Section 6. This act shall take effect July 1, 2003.
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15 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
16 CS for Senate Bill 250
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18 The Committee Substitute expands the definition of the term
"infant delivered" for the purposes of payment of an initial
19 assessment for each infant delivered in a hospital to exclude
infants born in a teaching hospital that have been deemed by
20 the association as being exempt from assessments since fiscal
year 1997 to 2001.
21
Provides that statutory rural hospitals, or a not-for-profit
22 operator of rural hospitals, are not required to obtain a
certificate-of-need for construction of a new hospital located
23 in a county with a population of at least 15,000, but no more
than 18,000, and a density of less than 30 persons per square
24 mile, or a replacement facility, provided that the replacement
or new facility is located within 10 miles and within the
25 current primary service area.
26 Provides that 1) statutory rural hospitals may contract with
the Department of Management Services in order to purchase
27 coverage in the State Group Insurance plan for their
employees; 2) provides that the provisions of ss.624.436 -
28 624.446 related to multiple employer welfare arrangement do
not apply to the State Group Insurance Program; and 3)
29 requires the Department of Management Services to request a
private letter ruling from the Internal Revenue Service to
30 determine if the inclusion of employees of rural hospitals
jeopardizes the qualified tax status of the State Group
31 Insurance Program.
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