With supporters pointing to a need to ensure health care access in rural areas, House and Senate committees Thursday moved forward with bills that would create a new category of “rural emergency hospitals” in the state.
The House Health & Human Services Committee approved the House version of the bill (HB 309), sponsored by Rep. Jason Shoaf, R-Port St. Joe, with the measure now positioned to go to the full House.
The Senate Appropriations Committee on Health and Human Services approved a similar bill (SB 644), sponsored by Sen. Corey Simon, R-Tallahassee.
Since last year, emergency care facilities in rural communities have been taking advantage of a federal program that gives rural hospitals extra money for the services they provide to low-income patients who have Medicaid.
In some cases, these additional payments can help keep hospitals out of the red and allow them to afford more prescription drugs and medical supplies. But states must first grant them a license to operate as a rural emergency hospital, or REH.
Under the Florida bills, facilities designated rural emergency hospitals could provide emergency services, observation care and outpatient services that do not exceed an average length of stay of 24 hours. But they would be exempted from requirements about providing inpatient care and such things as surgical care.
Shoaf and Simon represent sprawling rural districts in North Florida.
A Senate staff analysis said Florida has 22 rural hospitals and that rural hospitals in DeFuniak Springs, Williston and Lake City have closed since 2010. Also, it said 15 states have approved designations of rural emergency hospitals.
“Through the new REH Medicare enhancement reimbursement rate, the goal is to ensure hospitals in rural, underserved areas remain open and access to health care continues," Simon explained Thursday to the Senate Appropriations Committee.
Simon's bill says for facilities to be considered a rural facility, they must only have 100 or fewer beds and sit in an area where the population does not exceed 100 people per square mile.
Mary Mayhew, president and CEO of the Florida Hospital Association, told WFSU on Friday that while her organization supports the legislation, health care workers must understand the accompanying risks.
“The intent was to give rural hospitals another option in the event that they are struggling financially," said Mayhew, whose organization advocates for more than 200 hospitals and health systems in Florida.
In return for higher Medicaid reimbursements, hospitals that take on the rural designation would have to give up inpatient services. This would mean hospitals will be forced to find another reimbursement program when treating patients with life-threatening conditions, or surgeries that may require extensive care afterward.
“Patients can’t stay any longer than 24 hours. Medicare will provide additional enhanced reimbursement for those hospitals that concert to that rural emergency hospital status. So, it’s not the answer for all rural hospitals. It simply yet another option that a hospital may want to consider.”
The bill also presents some education benefits. Included in Simon’s package is a state-run loan program to help nursing students in Florida pay for classes and cover licensing fees.
Simon’s bill needs to clear one more committee before it could go to the full Senate.
