Florida Senate - 2024                              CS for SB 644
       By the Appropriations Committee on Health and Human Services;
       and Senator Simon
       603-03118-24                                           2024644c1
    1                        A bill to be entitled                      
    2         An act relating to rural emergency hospitals; amending
    3         s. 395.1041, F.S.; subjecting rural emergency
    4         hospitals to certain requirements for the provision of
    5         emergency services and care; amending s. 395.602,
    6         F.S.; revising the definition of the term “rural
    7         hospital”; creating s. 395.607, F.S.; defining the
    8         terms “rural emergency hospital” and “rural emergency
    9         services”; authorizing qualifying hospitals to apply
   10         to the Agency for Health Care Administration for
   11         designation as a rural emergency hospital; specifying
   12         requirements for such designation; exempting
   13         designated rural emergency hospitals from certain
   14         requirements for general hospitals; requiring the
   15         agency to suspend or revoke a rural emergency
   16         hospital’s designation if at any time it fails to meet
   17         specified requirements; providing an effective date.
   19  Be It Enacted by the Legislature of the State of Florida:
   21         Section 1. Paragraph (a) of subsection (3) of section
   22  395.1041, Florida Statutes, is amended to read
   23         395.1041 Access to and ensurance of emergency services;
   24  transfers; patient rights; diversion programs; reports of
   25  controlled substance overdoses.—
   28         (a) Every general hospital which has an emergency
   29  department and every rural emergency hospital as defined in s.
   30  395.607 shall provide emergency services and care for any
   31  emergency medical condition when:
   32         1. Any person requests emergency services and care; or
   33         2. Emergency services and care are requested on behalf of a
   34  person by:
   35         a. An emergency medical services provider who is rendering
   36  care to or transporting the person; or
   37         b. Another hospital, when such hospital is seeking a
   38  medically necessary transfer, except as otherwise provided in
   39  this section.
   40         Section 2. Paragraph (b) of subsection (2) of section
   41  395.602, Florida Statutes, is amended to read:
   42         395.602 Rural hospitals.—
   43         (2) DEFINITIONS.—As used in this part, the term:
   44         (b) “Rural hospital” means an acute care hospital licensed
   45  under this chapter, having 100 or fewer licensed beds and an
   46  emergency room, which is:
   47         1. The sole provider within a county with a population
   48  density of up to 100 persons per square mile;
   49         2. An acute care hospital, in a county with a population
   50  density of up to 100 persons per square mile, which is at least
   51  30 minutes of travel time, on normally traveled roads under
   52  normal traffic conditions, from any other acute care hospital
   53  within the same county;
   54         3. A hospital supported by a tax district or subdistrict
   55  whose boundaries encompass a population of up to 100 persons per
   56  square mile;
   57         4. A hospital classified as a sole community hospital under
   58  42 C.F.R. s. 412.92, regardless of the number of licensed beds;
   59         5. A hospital with a service area that has a population of
   60  up to 100 persons per square mile. As used in this subparagraph,
   61  the term “service area” means the fewest number of zip codes
   62  that account for 75 percent of the hospital’s discharges for the
   63  most recent 5-year period, based on information available from
   64  the hospital inpatient discharge database in the Florida Center
   65  for Health Information and Transparency at the agency; or
   66         6. A hospital designated as a critical access hospital, as
   67  defined in s. 408.07.
   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  2021, if the hospital continues to have up to 100 licensed beds
   75  and an emergency room. An acute care hospital that has not
   76  previously been designated as a rural hospital and that meets
   77  the criteria of this paragraph shall be granted such designation
   78  upon application, including supporting documentation, to the
   79  agency. A hospital that was licensed as a rural hospital during
   80  the 2010-2011 or 2011-2012 fiscal year shall continue to be a
   81  rural hospital from the date of designation through June 30,
   82  2031 2025, if the hospital continues to have up to 100 licensed
   83  beds and an emergency room.
   84         Section 3. Section 395.607, Florida Statutes, is created to
   85  read:
   86         395.607 Rural emergency hospitals.—
   87         (1)As used in this section, the term:
   88         (a)“Rural emergency hospital” means a rural hospital or
   89  critical access hospital as those terms are defined in s. 408.07
   90  designated by the agency as a rural emergency hospital under
   91  this section.
   92         (b)“Rural emergency services” means emergency services and
   93  other care that does not require treatment for more than 24
   94  hours, on average, provided in a rural emergency hospital;
   95  observation care; and, at the election of the hospital,
   96  outpatient services specified in regulations adopted by the
   97  United States Secretary of Health and Human Services.
   98         (2)A qualifying hospital may apply to the agency for
   99  designation as a rural emergency hospital on a form adopted by
  100  the agency. The agency may designate a hospital as a rural
  101  emergency hospital if it demonstrates that it meets all of the
  102  following criteria:
  103         (a)Meets the requirements of the Consolidated
  104  Appropriations Act of 2021, Pub. L. No. 116-260, and the
  105  regulations adopted and guidance issued thereunder.
  106         (b)Has no more than 50 beds.
  107         (c)Can adequately provide rural emergency services in the
  108  facility 24 hours a day and seven days a week.
  109         (d)Is sufficiently staffed and equipped to provide rural
  110  emergency services of the types indicated by the applicant.
  111         (e)Has a transfer agreement in effect with a Level I or
  112  Level II trauma center.
  113         (3)Notwithstanding s. 395.002(12), a rural emergency
  114  hospital is not required to offer acute inpatient care or care
  115  beyond 24 hours, or to make available treatment facilities for
  116  surgery, obstetrical care, or similar services in order to be
  117  deemed a hospital as long as it maintains its designation as a
  118  rural emergency hospital, and may be required to make such
  119  services available only if it ceases to be designated as a rural
  120  emergency hospital.
  121         (4)The agency must suspend or revoke a rural emergency
  122  hospital designation if at any time such a hospital fails to
  123  meet the requirements of this section.
  124         Section 4. This act shall take effect July 1, 2024.