Senate Bill sb1936

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2005                                  SB 1936

    By Senator Sebesta

    16-1251A-05                                        See HB 1039

  1                      A bill to be entitled

  2         An act relating to access to emergency services

  3         and care; amending s. 395.1041, F.S.;

  4         authorizing a hospital to require payment from

  5         a person not suffering from an emergency

  6         medical condition and authorizing discharge if

  7         payment cannot be made, under certain

  8         circumstances; directing the Department of

  9         Health Services Research, Management and Policy

10         at the University of Florida to conduct an

11         Uninsured Noncitizen Care Study and providing

12         purposes thereof; providing an appropriation;

13         requiring a report; providing an effective

14         date.


16         WHEREAS, Florida hospitals are serving a growing number

17  of uninsured non-United States citizens, including

18  undocumented immigrants as well as legal noncitizens who are

19  in the United States on a tourist, work, or student visa, and

20         WHEREAS, there is no requirement, legal or otherwise,

21  for those visitors on tourist, work, or student visas to have

22  health insurance, and

23         WHEREAS, approximately 8 million people from other

24  countries visit Florida each year and, in 2001, approximately

25  800,000 uninsured legal noncitizens lived in Florida, and

26         WHEREAS, data from the United States Census Current

27  Population Survey shows that about half of the legal

28  noncitizens in Florida lack health insurance coverage, and

29         WHEREAS, because many of these patients have limited or

30  nonexistent resources to pay for health care, they place a

31  huge financial burden on Florida hospitals with the sickest


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    Florida Senate - 2005                                  SB 1936
    16-1251A-05                                        See HB 1039

 1  patients requiring lengthy hospital stays, expensive

 2  treatment, and long-term followup care, and

 3         WHEREAS, federal laws that require hospitals to treat

 4  anyone who requests emergency care regardless of ability to

 5  pay create an unfunded mandate to treat these patients despite

 6  the fact that they are not United States citizens, and

 7         WHEREAS, data from the Agency for Health Care

 8  Administration shows that 70 percent of patients who are not

 9  citizens of the United States are admitted through the

10  emergency room, and

11         WHEREAS, significant nonreimbursed costs associated

12  with caring for these individuals threaten the stability of

13  the already fragile safety net of Florida's health care system

14  and some of these nonreimbursed costs are shifted to those

15  with health insurance, thereby indirectly impacting health

16  care costs for all Florida citizens, NOW, THEREFORE,


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


20         Section 1.  Paragraph (h) of subsection (3) of section

21  395.1041, Florida Statutes, is amended to read:

22         395.1041  Access to emergency services and care.--



25         (h)  A hospital may request and collect insurance

26  information and other financial information from a patient, in

27  accordance with federal law, if emergency services and care

28  are not delayed. No hospital to which another hospital is

29  transferring a person in need of emergency services and care

30  may require the transferring hospital or any person or entity

31  to guarantee payment for the person as a condition of


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    Florida Senate - 2005                                  SB 1936
    16-1251A-05                                        See HB 1039

 1  receiving the transfer. In addition, a hospital may not

 2  require any contractual agreement, any type of preplanned

 3  transfer agreement, or any other arrangement to be made prior

 4  to or at the time of transfer as a condition of receiving an

 5  individual patient being transferred. However, the patient or

 6  the patient's legally responsible relative or guardian shall

 7  execute an agreement to pay for emergency services or care or

 8  otherwise supply insurance or credit information promptly

 9  after the services and care are rendered. If, after examining

10  and evaluating the patient, it is determined by a physician or

11  other qualified medical person that the patient is not

12  suffering from an emergency medical condition, the hospital

13  may require payment before proceeding with nonemergency

14  treatment and may discharge the patient if payment cannot be

15  obtained.

16         Section 2.  The Department of Health Services Research,

17  Management and Policy at the University of Florida shall

18  conduct a study entitled the Uninsured Noncitizen Care Study

19  to determine the extent to which:

20         (1)  Legal noncitizens, such as persons in the state on

21  tourist, student, or work visas, use the hospital emergency

22  departments for everything from basic to complex care.

23         (2)  Undocumented or illegal aliens involved in major

24  auto accidents are transported to trauma centers or emergency

25  rooms and may remain in hospitals for months.

26         (3)  Patient families refuse to authorize transfers

27  back to the home country, and deportation and appeals may take

28  years.

29         (4)  Noncitizens or their children with severe diseases

30  obtain tourist visas, either legally or illegally, and take

31  taxis directly from airports to hospital emergency rooms.


CODING: Words stricken are deletions; words underlined are additions.

    Florida Senate - 2005                                  SB 1936
    16-1251A-05                                        See HB 1039

 1         (5)  Hospitals typically assume the costs associated

 2  with the patient's trip home, such as the costs of airline

 3  tickets or air ambulances.

 4         (6)  When patients cannot be sent back to their country

 5  of origin, hospitals assume considerable costs for continued

 6  care, such as the costs of prescription drugs, oxygen,

 7  dialysis treatments, and skilled nursing or rehabilitative

 8  care.

 9         (7)  Federal and state emergency service laws need to

10  be clarified as to the extent of a hospital's obligation for

11  continuing care after stabilization of an emergency.

12         (8)  Tourist visas need to be issued on the condition

13  of documented health status and financial responsibility for

14  health care services and to clearly declare on all visas that

15  applicants, if they have to use health care facilities in the

16  United States, must accept transfer back to their home country

17  after they are stabilized.

18         (9)  More resources and better coordination for sick or

19  injured immigrants are needed among the federal Immigration

20  and Naturalization Service, international embassies,

21  immigration attorneys, and patient families.

22         (10)  More funding is needed for patients either

23  through federal and state programs or through diversion of

24  United States foreign aid to these countries.

25         Section 3.  The Legislature shall appropriate an amount

26  sufficient for the Department of Health Services Research,

27  Management and Policy at the University of Florida to complete

28  this study.

29         Section 4.  The Department of Health Services Research,

30  Management and Policy at the University of Florida shall

31  submit a report of its findings to the President of the Senate


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    Florida Senate - 2005                                  SB 1936
    16-1251A-05                                        See HB 1039

 1  and the Speaker of the House of Representatives by January 1,

 2  2006.

 3         Section 5.  This act shall take effect July 1, 2005.






























CODING: Words stricken are deletions; words underlined are additions.