HB 0441 2003
   
1 CHAMBER ACTION
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6          The Committee on State Administration recommends the following:
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8          Committee Substitute
9          Remove the entire bill and insert:
10 A bill to be entitled
11          An act relating to hospitals; amending ss. 395.602 and
12    408.07, F.S.; revising the definition of the term "rural
13    hospital"; declaring and continuing such designation for
14    certain hospitals for a specified period; authorizing the
15    granting of such designation for certain other hospitals
16    upon application with supporting documentation; creating
17    s. 395.6025, F.S.; providing exemption for a statutory
18    rural hospital or a not-for-profit operator of rural
19    hospitals from certificate-of-need review for the
20    construction of a new or replacement facility; providing
21    conditions for eligibility for the exemption; creating s.
22    395.6063, F.S.; permitting any statutory rural hospital to
23    contract with the Department of Management Services in
24    order to purchase coverage in the state group health
25    insurance plan for the hospital's employees; requiring a
26    participating hospital to make the employer contributions
27    required and pay an annual administrative fee; providing
28    exemption from nonprofit multiple-employer welfare
29    arrangements; requiring the request of an Internal Revenue
30    Service private letter ruling; providing for contingent
31    effect; amending s. 766.314, F.S.; excluding infants born
32    in certain family practice teaching hospitals from
33    assessments used to fund the Florida Birth-Related
34    Neurological Injury Compensation Plan; providing an
35    effective date.
36         
37          Be It Enacted by the Legislature of the State of Florida:
38         
39          Section 1. Paragraph (e) of subsection (2) of section
40    395.602, Florida Statutes, is amended to read:
41          395.602 Rural hospitals.--
42          (2) DEFINITIONS.--As used in this part:
43          (e) "Rural hospital" means an acute care hospital licensed
44    under this chapter, having 100 or fewer licensed beds and an
45    emergency room, which is:
46          1. The sole provider within a county with a population
47    density of no greater than 100 persons per square mile;
48          2. An acute care hospital, in a county with a population
49    density of no greater than 100 persons per square mile, which is
50    at least 30 minutes of travel time, on normally traveled roads
51    under normal traffic conditions, from any other acute care
52    hospital within the same county;
53          3. A hospital supported by a tax district or subdistrict
54    whose boundaries encompass a population of 100 persons or fewer
55    per square mile;
56          4. A hospital in a constitutional charter county with a
57    population of over 1 million persons that has imposed a local
58    option health service tax pursuant to law and in an area that
59    was directly impacted by a catastrophic event on August 24,
60    1992, for which the Governor of Florida declared a state of
61    emergency pursuant to chapter 125, and has 120 beds or less that
62    serves an agricultural community with an emergency room
63    utilization of no less than 20,000 visits and a Medicaid in-
64    patient utilization rate greater than 15 percent;
65          5. A hospital with a service area that has a population of
66    100 persons or fewer per square mile. As used in this
67    subparagraph, the term "service area" means the fewest number of
68    zip codes that account for 75 percent of the hospital's
69    discharges for the most recent 5-year period, based on
70    information available from the hospital inpatient discharge
71    database in the State Center for Health Statistics at the Agency
72    for Health Care Administration; or
73          6. A hospital designated as a Critical Access Hospital by
74    the Department of Health in accordance with federal regulations
75    and state requirements.
76         
77          Population densities used in this paragraph must be based upon
78    the most recently completed United States census. A hospital
79    that received funds under s. 409.9116 for a quarter beginning no
80    later than July 1, 2002, is deemed to have been and shall
81    continue to be a rural hospital from that date through June 30,
82    2012, if the hospital continues to have 100 or fewer licensed
83    beds and an emergency room, or meets the criteria of
84    subparagraph 4. An acute care hospital that has not previously
85    been designated as a rural hospital and that meets the criteria
86    of this paragraph shall be granted such designation upon
87    application, including supporting documentation, to the Agency
88    for Health Care Administration.
89          Section 2. Subsection (42) of section 408.07, Florida
90    Statutes, is amended to read:
91          408.07 Definitions.--As used in this chapter, with the
92    exception of ss. 408.031-408.045, the term:
93          (42) "Rural hospital" means an acute care hospital
94    licensed under chapter 395, having 100 or fewer licensed beds
95    and an emergency room, and which is:
96          (a) The sole provider within a county with a population
97    density of no greater than 100 persons per square mile;
98          (b) An acute care hospital, in a county with a population
99    density of no greater than 100 persons per square mile, which is
100    at least 30 minutes of travel time, on normally traveled roads
101    under normal traffic conditions, from another acute care
102    hospital within the same county;
103          (c) A hospital supported by a tax district or subdistrict
104    whose boundaries encompass a population of 100 persons or fewer
105    per square mile;
106          (d) A hospital with a service area that has a population
107    of 100 persons or fewer per square mile. As used in this
108    paragraph, the term "service area" means the fewest number of
109    zip codes that account for 75 percent of the hospital's
110    discharges for the most recent 5-year period, based on
111    information available from the hospital inpatient discharge
112    database in the State Center for Health Statistics at the Agency
113    for Health Care Administration; or
114          (e) A hospital designated as a Critical Access Hospital by
115    the Department of Health in accordance with federal regulations
116    and state requirements.
117         
118          Population densities used in this subsection must be based upon
119    the most recently completed United States census. A hospital
120    that received funds under s. 409.9116 for a quarter beginning no
121    later than July 1, 2002, is deemed to have been and shall
122    continue to be a rural hospital from that date through June 30,
123    2012, if the hospital continues to have 100 or fewer licensed
124    beds and an emergency room, or meets the criteria of s.
125    395.602(2)(e)4. An acute care hospital that has not previously
126    been designated as a rural hospital and that meets the criteria
127    of this subsection shall be granted such designation upon
128    application, including supporting documentation, to the Agency
129    for Health Care Administration.
130          Section 3. Section 395.6025, Florida Statutes, is created
131    to read:
132          395.6025 Rural hospitals; new or replacement
133    facilities.--Notwithstanding the provisions of s. 408.036, a
134    hospital defined as a statutory rural hospital in accordance
135    with s. 395.602, or a not-for-profit operator of rural
136    hospitals, is not required to obtain a certificate of need for
137    the construction of a new or replacement facility, provided that
138    the new or replacement facility is located within 10 miles of
139    the site of the currently licensed rural hospital and within the
140    current primary service area. As used in this section, the term
141    "service area" means the fewest number of zip codes that account
142    for 75 percent of the hospital's discharges for the most recent
143    5-year period, based on information available from the hospital
144    inpatient discharge database in the State Center for Health
145    Statistics at the Agency for Health Care Administration.
146          Section 4. Section 395.6063, Florida Statutes, is created
147    to read:
148          395.6063 Rural hospital employee health insurance.--
149          (1) Effective July 1, 2003, any statutory rural hospital
150    may contract with the Department of Management Services in order
151    to purchase coverage in the state group health insurance plan
152    for the hospital's employees and qualified family members at the
153    same premium cost as that for retirees and surviving spouses.
154    The hospital shall collect payroll deductions or other
155    remuneration from qualified employees as may be required for the
156    employee contribution in accordance with the department's
157    regulations. The hospital shall also make the employer
158    contributions required and pay an annual administrative fee of
159    not less than $2.61 per enrollee per month.
160          (2) The provisions of ss. 624.436-624.446 do not apply to
161    the state group insurance program for purposes of this section.
162          (3) The Department of Management Services shall request a
163    private letter ruling from the Internal Revenue Service
164    determining whether the inclusion of employees of rural
165    hospitals in the state group insurance program, in accordance
166    with this section, jeopardizes the qualified tax status of the
167    state group insurance program. The department shall request this
168    determination no later than July 31, 2003. Implementation of
169    this section is contingent upon receipt of a favorable ruling by
170    the Internal Revenue Service.
171          Section 5. Paragraph (a) of subsection (4) of section
172    766.314, Florida Statutes, is amended to read:
173          766.314 Assessments; plan of operation.--
174          (4) The following persons and entities shall pay into the
175    association an initial assessment in accordance with the plan of
176    operation:
177          (a) On or before October 1, 1988, each hospital licensed
178    under chapter 395 shall pay an initial assessment of $50 per
179    infant delivered in the hospital during the prior calendar year,
180    as reported to the Agency for Health Care Administration;
181    provided, however, that a hospital owned or operated by the
182    state or a county, special taxing district, or other political
183    subdivision of the state shall not be required to pay the
184    initial assessment or any assessment required by subsection (5).
185    The term "infant delivered" includes live births and not
186    stillbirths, but the term does not include infants delivered by
187    employees or agents of the Board of Regents,orthose born in a
188    teaching hospital as defined in s. 408.07, or those born in a
189    family practice teaching hospital designated pursuant to s.
190    395.806 that was exempted by the association from assessments
191    for fiscal years 1997-1998 through 2001-2002. The initial
192    assessment and any assessment imposed pursuant to subsection (5)
193    may not include any infant born to a charity patient (as defined
194    by rule of the Agency for Health Care Administration) or born to
195    a patient for whom the hospital receives Medicaid reimbursement,
196    if the sum of the annual charges for charity patients plus the
197    annual Medicaid contractuals of the hospital exceeds 10 percent
198    of the total annual gross operating revenues of the hospital.
199    The hospital is responsible for documenting, to the satisfaction
200    of the association, the exclusion of any birth from the
201    computation of the assessment. Upon demonstration of financial
202    need by a hospital, the association may provide for installment
203    payments of assessments.
204          Section 6. This act shall take effect July 1, 2003.