Florida Senate - 2024                        COMMITTEE AMENDMENT
       Bill No. SB 644
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/09/2024           .                                

       The Appropriations Committee on Health and Human Services
       (Simon) recommended the following:
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (a) of subsection (3) of section
    6  395.1041, Florida Statutes, is amended to read
    7         395.1041 Access to and ensurance of emergency services;
    8  transfers; patient rights; diversion programs; reports of
    9  controlled substance overdoses.—
   12         (a) Every general hospital which has an emergency
   13  department and every rural emergency hospital as defined in s.
   14  395.607 shall provide emergency services and care for any
   15  emergency medical condition when:
   16         1. Any person requests emergency services and care; or
   17         2. Emergency services and care are requested on behalf of a
   18  person by:
   19         a. An emergency medical services provider who is rendering
   20  care to or transporting the person; or
   21         b. Another hospital, when such hospital is seeking a
   22  medically necessary transfer, except as otherwise provided in
   23  this section.
   24         Section 2. Paragraph (b) of subsection (2) of section
   25  395.602, Florida Statutes, is amended to read:
   26         395.602 Rural hospitals.—
   27         (2) DEFINITIONS.—As used in this part, the term:
   28         (b) “Rural hospital” means an acute care hospital licensed
   29  under this chapter, having 100 or fewer licensed beds and an
   30  emergency room, which is:
   31         1. The sole provider within a county with a population
   32  density of up to 100 persons per square mile;
   33         2. An acute care hospital, in a county with a population
   34  density of up to 100 persons per square mile, which is at least
   35  30 minutes of travel time, on normally traveled roads under
   36  normal traffic conditions, from any other acute care hospital
   37  within the same county;
   38         3. A hospital supported by a tax district or subdistrict
   39  whose boundaries encompass a population of up to 100 persons per
   40  square mile;
   41         4. A hospital classified as a sole community hospital under
   42  42 C.F.R. s. 412.92, regardless of the number of licensed beds;
   43         5. A hospital with a service area that has a population of
   44  up to 100 persons per square mile. As used in this subparagraph,
   45  the term “service area” means the fewest number of zip codes
   46  that account for 75 percent of the hospital’s discharges for the
   47  most recent 5-year period, based on information available from
   48  the hospital inpatient discharge database in the Florida Center
   49  for Health Information and Transparency at the agency; or
   50         6. A hospital designated as a critical access hospital, as
   51  defined in s. 408.07.
   53  Population densities used in this paragraph must be based upon
   54  the most recently completed United States census. A hospital
   55  that received funds under s. 409.9116 for a quarter beginning no
   56  later than July 1, 2002, is deemed to have been and shall
   57  continue to be a rural hospital from that date through June 30,
   58  2021, if the hospital continues to have up to 100 licensed beds
   59  and an emergency room. An acute care hospital that has not
   60  previously been designated as a rural hospital and that meets
   61  the criteria of this paragraph shall be granted such designation
   62  upon application, including supporting documentation, to the
   63  agency. A hospital that was licensed as a rural hospital during
   64  the 2010-2011 or 2011-2012 fiscal year shall continue to be a
   65  rural hospital from the date of designation through June 30,
   66  2031 2025, if the hospital continues to have up to 100 licensed
   67  beds and an emergency room.
   68         Section 3. Section 395.607, Florida Statutes, is created to
   69  read:
   70         395.607 Rural emergency hospitals.—
   71         (1)As used in this section, the term:
   72         (a)“Rural emergency hospital” means a rural hospital or
   73  critical access hospital as those terms are defined in s. 408.07
   74  designated by the agency as a rural emergency hospital under
   75  this section.
   76         (b)“Rural emergency services” means emergency services and
   77  other care that does not require treatment for more than 24
   78  hours, on average, provided in a rural emergency hospital;
   79  observation care; and, at the election of the hospital,
   80  outpatient services specified in regulations adopted by the
   81  United States Secretary of Health and Human Services.
   82         (2)A qualifying hospital may apply to the agency for
   83  designation as a rural emergency hospital on a form adopted by
   84  the agency. The agency may designate a hospital as a rural
   85  emergency hospital if it demonstrates that it meets all of the
   86  following criteria:
   87         (a)Meets the requirements of the Consolidated
   88  Appropriations Act of 2021, Pub. L. No. 116-260, and the
   89  regulations adopted and guidance issued thereunder.
   90         (b)Has no more than 50 beds.
   91         (c)Can adequately provide rural emergency services in the
   92  facility 24 hours a day and seven days a week.
   93         (d)Is sufficiently staffed and equipped to provide rural
   94  emergency services of the types indicated by the applicant.
   95         (e)Has a transfer agreement in effect with a Level I or
   96  Level II trauma center.
   97         (3)Notwithstanding s. 395.002(12), a rural emergency
   98  hospital is not required to offer acute inpatient care or care
   99  beyond 24 hours, or to make available treatment facilities for
  100  surgery, obstetrical care, or similar services in order to be
  101  deemed a hospital as long as it maintains its designation as a
  102  rural emergency hospital, and may be required to make such
  103  services available only if it ceases to be designated as a rural
  104  emergency hospital.
  105         (4)The agency must suspend or revoke a rural emergency
  106  hospital designation if at any time such a hospital fails to
  107  meet the requirements of this section.
  108         Section 4. This act shall take effect July 1, 2024.
  110  ================= T I T L E  A M E N D M E N T ================
  111  And the title is amended as follows:
  112         Delete everything before the enacting clause
  113  and insert:
  114                        A bill to be entitled                      
  115         An act relating to rural emergency hospitals; amending
  116         s. 395.1041, F.S.; subjecting rural emergency
  117         hospitals to certain requirements for the provision of
  118         emergency services and care; amending s. 395.602,
  119         F.S.; revising the definition of the term “rural
  120         hospital”; creating s. 395.607, F.S.; defining the
  121         terms “rural emergency hospital” and “rural emergency
  122         services”; authorizing qualifying hospitals to apply
  123         to the Agency for Health Care Administration for
  124         designation as a rural emergency hospital; specifying
  125         requirements for such designation; exempting
  126         designated rural emergency hospitals from certain
  127         requirements for general hospitals; requiring the
  128         agency to suspend or revoke a rural emergency
  129         hospital’s designation if at any time it fails to meet
  130         specified requirements; providing an effective date.