Florida ERs face new regulations

Florida lawmakers are proposing a package of healthcare laws for the state's 2024 legislative session, including measures to redirect patients from hospital emergency departments. 

The bundle of legislation is called "Live Healthy." Florida Senate President Kathleen Passidomo led a trio of Republican lawmakers to unveil the proposal, which she described as a "robust package of policy enhancements and strategic investments," on Dec. 7. 

Lawmakers set their eyes on hospital ERs and EDs in the bill, which Ms. Passidomo described as "the most expensive real estate in our state." 

Under the legislation, all hospitals with EDs — including hospital-based off-campus EDs — would be required to submit a plan to the state that details how they will help patients access the appropriate care setting if and when they present to the ED with a non-emergent condition or do not have regular access to primary care. About 79 percent of Florida residents report having a personal physician or healthcare provider, according to 2022 CDC data.

Hospitals must obtain state approval for their ED diversion plans to secure initial licensure or renewal. After approval, hospitals must annually submit data to the state demonstrating the effectiveness of their diversion plan and update the plan as required by the state before license renewal.

Hospitals' ED diversion plans must include at least one of the following measures: 

a. A partnership agreement with one or more local federally qualified health centers or other primary care settings to establish a relationship between the patient and the appropriate care setting so that "the patient develops a medical home at such a setting for nonemergent and preventative health care services," according to the legislation.

b. The establishment, construction and operation of a hospital-owned urgent care center adjacent to the hospital ED location or an agreement with an urgent care center within a defined distance from the ED. If the latter, the urgent care center must be within 3 miles of the ED if in an urban area or within 10 miles of the ED if in a rural area. 

For patients enrolled in Medicaid, the hospital's ED diversion plan must include outreach to the patient's Medicaid managed care plan. 

"Live Healthy will help streamline emergency departments by creating partnerships with Community Health Centers and other primary care settings so care that is urgently needed, but not life threatening, can be handled outside of the hospital emergency room in a more efficient and appropriate setting," said Ms. Passidomo. 

The Florida Hospital Association applauded Live Healthy upon its proposal.

Some legislation within Live Healthy is up for consideration by a Senate committee this week, while other bills are set to be filed in coming weeks. The legislation currently available is SPB 7016, pertaining to the healthcare workforce, and SPB 7018, pertaining to healthcare innovation. Those two pieces of legislation, summarized in the takeaways here, call for approximately $873 million in appropriations.

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