HB 0441 2003
1	CHAMBER ACTION
2
3
4
5
6	The Committee on Health Care recommends the following:
7
8	Committee Substitute
9	Remove the entire bill and insert:
10	A bill to be entitled
11	An act relating to rural hospitals; amending ss. 395.602
12	and 408.07, F.S.; revising the definition of the term
13	"rural hospital"; declaring and continuing such
14	designation for certain hospitals for a specified period;
15	authorizing the granting of such designation for certain
16	other hospitals upon application with supporting
17	documentation; creating s. 395.6025, F.S.; authorizing
18	exemptions from certificate-of-need review for the
19	construction of a replacement facility for a statutory
20	rural hospital; providing conditions for eligibility for
21	the exemption; creating s. 395.6063, F.S.; permitting any
22	statutory rural hospital to contract with the Department
23	of Management Services in order to purchase coverage in
24	the state group health insurance plan for the hospital's
25	employees; requiring a participating hospital to make the
26	employer contributions required and pay an annual
27	administrative fee; providing an effective date.
28
29	Be It Enacted by the Legislature of the State of Florida:
30
31	Section 1. Paragraph (e) of subsection (2) of section
32	395.602, Florida Statutes, is amended to read:
33	395.602 Rural hospitals.--
34	(2) DEFINITIONS.--As used in this part:
35	(e) "Rural hospital" means an acute care hospital licensed
36	under this chapter, having 100 or fewer licensed beds and an
37	emergency room, which is:
38	1. The sole provider within a county with a population
39	density of no greater than 100 persons per square mile;
40	2. An acute care hospital, in a county with a population
41	density of no greater than 100 persons per square mile, which is
42	at least 30 minutes of travel time, on normally traveled roads
43	under normal traffic conditions, from any other acute care
44	hospital within the same county;
45	3. A hospital supported by a tax district or subdistrict
46	whose boundaries encompass a population of 100 persons or fewer
47	per square mile;
48	4. A hospital in a constitutional charter county with a
49	population of over 1 million persons that has imposed a local
50	option health service tax pursuant to law and in an area that
51	was directly impacted by a catastrophic event on August 24,
52	1992, for which the Governor of Florida declared a state of
53	emergency pursuant to chapter 125, and has 120 beds or less that
54	serves an agricultural community with an emergency room
55	utilization of no less than 20,000 visits and a Medicaid in-
56	patient utilization rate greater than 15 percent;
57	5. A hospital with a service area that has a population of
58	100 persons or fewer per square mile. As used in this
59	subparagraph, the term "service area" means the fewest number of
60	zip codes that account for 75 percent of the hospital's
61	discharges for the most recent 5-year period, based on
62	information available from the hospital inpatient discharge
63	database in the State Center for Health Statistics at the Agency
64	for Health Care Administration; or
65	6. A hospital designated as a Critical Access Hospital by
66	the Department of Health in accordance with federal regulations
67	and state requirements.
68
69	Population densities used in this paragraph must be based upon
70	the most recently completed United States census. A hospital
71	that received funds under s. 409.9116 for a quarter beginning no
72	later than July 1, 2002, is deemed to have been and shall
73	continue to be a rural hospital from that date through June 30,
74	2012, if the hospital continues to have 100 or fewer licensed
75	beds and an emergency room, or meets the criteria of
76	subparagraph 4. An acute care hospital that has not previously
77	been designated as a rural hospital and that meets the criteria
78	of this paragraph shall be granted such designation upon
79	application, including supporting documentation, to the Agency
80	for Health Care Administration.
81	Section 2. Subsection (42) of section 408.07, Florida
82	Statutes, is amended to read:
83	408.07 Definitions.--As used in this chapter, with the
84	exception of ss. 408.031-408.045, the term:
85	(42) "Rural hospital" means an acute care hospital
86	licensed under chapter 395, having 100 or fewer licensed beds
87	and an emergency room, and which is:
88	(a) The sole provider within a county with a population
89	density of no greater than 100 persons per square mile;
90	(b) An acute care hospital, in a county with a population
91	density of no greater than 100 persons per square mile, which is
92	at least 30 minutes of travel time, on normally traveled roads
93	under normal traffic conditions, from another acute care
94	hospital within the same county;
95	(c) A hospital supported by a tax district or subdistrict
96	whose boundaries encompass a population of 100 persons or fewer
97	per square mile;
98	(d) A hospital with a service area that has a population
99	of 100 persons or fewer per square mile. As used in this
100	paragraph, the term "service area" means the fewest number of
101	zip codes that account for 75 percent of the hospital's
102	discharges for the most recent 5-year period, based on
103	information available from the hospital inpatient discharge
104	database in the State Center for Health Statistics at the Agency
105	for Health Care Administration; or
106	(e) A hospital designated as a Critical Access Hospital by
107	the Department of Health in accordance with federal regulations
108	and state requirements.
109
110	Population densities used in this subsection must be based upon
111	the most recently completed United States census. A hospital
112	that received funds under s. 409.9116 for a quarter beginning no
113	later than July 1, 2002, is deemed to have been and shall
114	continue to be a rural hospital from that date through June 30,
115	2012, if the hospital continues to have 100 or fewer licensed
116	beds and an emergency room, or meets the criteria of s.
117	395.602(2)(e)4. An acute care hospital that has not previously
118	been designated as a rural hospital and that meets the criteria
119	of this subsection shall be granted such designation upon
120	application, including supporting documentation, to the Agency
121	for Health Care Administration.
122	Section 3. Section 395.6025, Florida Statutes, is created
123	to read:
124	395.6025 Rural hospital replacement facilities.--
125	Notwithstanding the provisions of s. 408.036, a hospital defined
126	as a statutory rural hospital in accordance with s. 395.602 is
127	not required to obtain a certificate of need for the
128	construction of a replacement facility, provided that the
129	replacement facility is located within 10 miles of the site of
130	the currently licensed rural hospital and within the current
131	primary service area. As used in this section, the term "service
132	area" means the fewest number of zip codes that account for 75
133	percent of the hospital's discharges for the most recent 5-year
134	period, based on information available from the hospital
135	inpatient discharge database in the State Center for Health
136	Statistics at the Agency for Health Care Administration.
137	Section 4. Section 395.6063, Florida Statutes, is created
138	to read:
139	395.6063 Rural hospital employee health insurance.--
140	Effective July 1, 2003, any statutory rural hospital may
141	contract with the Department of Management Services in order to
142	purchase coverage in the state group health insurance plan for
143	the hospital's employees and qualified family members at the
144	same premium cost as that for retirees and surviving spouses.
145	The hospital shall collect payroll deductions or other
146	remuneration from qualified employees as may be required for the
147	employee contribution in accordance with the department's
148	regulations. The hospital shall also make the employer
149	contributions required and pay an annual administrative fee of
150	not less than $2.61 per enrollee per month.
151	Section 5. This act shall take effect July 1, 2003.