SB240: Bill Text

LRB-3472/1

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1995 - 1996 LEGISLATURE

1995 Senate BILL 240

June 1, 1995 - Introduced by Senators Leean, Ellis and Rude, by request of Governor Tommy G. Thompson. Referred to Committee on Health, Human Services and Aging.

SB240,1,4 An Act to repeal 50.02 (6); to amend 20.435 (1) (gm); and to create subchapter III of chapter 50 [precedes 50.50], 146.81 (1) (p) and 146.82 (2) (a) 17. of the statutes; relating to: regulating rural medical centers, granting rule-making authority, making an appropriation and providing penalties.

Analysis by the Legislative Reference Bureau

Under current law, the department of health and social services (DHSS) must investigate the concept of regulating a new category of health care providers known as rural medical centers.

This bill eliminates that provision and establishes rural medical centers as a category of health care providers that, beginning on January 1, 1997, must be licensed, inspected and otherwise regulated by DHSS. Under the bill, a facility may be regulated as a rural medical center if it is located in a county, city, town or village that has a population of less than 15,000 and in an area that the federal bureau of the census has not defined as an urbanized area and if it provides 2 or more health care services. The health care services are those provided by a hospital, a nursing home, a hospice, a rural health clinic or an ambulatory surgery center; or they are home health services, outpatient physical therapy services, end-stage renal disease services or services that are specified by DHSS by rule.

The bill establishes licensing procedures and requires that DHSS promulgate rules that establish standards for operation of rural medical centers, minimum requirements for license issuance, licensure fee amounts, and procedures and criteria for waiver of or variance from standards and requirements. The bill authorizes DHSS to conduct unannounced inspections of rural medical centers and requires a rural medical center to provide access to any patient health care records necessary to fulfill the purpose of any DHSS inspections or investigations. The bill prohibits an unlicensed entity from using the phrase "rural medical center" to describe itself, prohibits intentional interference with any investigation by DHSS of alleged violations, prohibits certain intentional retaliation or discrimination against employes or patients and prohibits intentional destruction or modification of original inspection reports.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB240, s. 1 Section 1 . 20.435 (1) (gm) of the statutes is amended to read:

SB240,2,9 20.435 (1) (gm) Licensing, review and certifying activities. The amounts in the schedule for the purposes specified in ss. 50.135, 50.49 (2) (b), 50.52 (2) (a), 146.50 (8), 250.05 (6), 252.22 (7), 254.176, 254.178, 254.20 (5) and (8), 254.31 to 254.39, 254.47, 254.61 to 254.89 and 255.08 (2), subch. IV of ch. 50 and ch. 150. All moneys received under ss. 50.135, 50.49 (2) (b), 50.52 (2) (a), 50.93 (1) (c), 146.50 (8) (d), 150.13, 250.05 (6), 252.22 (7), 254.176, 254.178, 254.20 (5) and (8), 254.31 to 254.39, 254.47, 254.61 to 254.89 and 255.08 (2) (b), less the amounts appropriated under s. 20.488 (1) (g), shall be credited to this appropriation.

SB240, s. 2 Section 2. 50.02 (6) of the statutes is repealed.

SB240, s. 3 Section 3. Subchapter III of chapter 50 [precedes 50.50] of the statutes is created to read:

SB240,2,13 CHAPTER 50

SB240,2,15 Subchapter III rural medical centers

SB240,2,16 50.50 Definitions. In this subchapter:

SB240,2,17 (1) "Ambulatory surgery center" has the meaning given in s. 49.45 (6r) (a) 1.

SB240,2,19 (2) "End-stage renal disease services" has the meaning given under 42 CFR 405.2102.

SB240,3,1 (3) "Health care services" means any of the following:

SB240,3,2 (a) Care that is provided in or by any of the following:

SB240,3,3 1. A hospital.

SB240,3,4 2. A nursing home.

SB240,3,5 3. A hospice.

SB240,3,6 4. A rural health clinic.

SB240,3,7 5. An ambulatory surgery center.

SB240,3,8 (b) Home health services.

SB240,3,9 (c) Outpatient physical therapy services.

SB240,3,10 (d) End-stage renal disease services.

SB240,3,11 (e) Services that are specified in rules that the department promulgates.

SB240,3,12 (4) "Home health services" has the meaning given in s. 50.49 (1) (b).

SB240,3,13 (5) "Hospice" has the meaning given in s. 50.90 (1).

SB240,3,14 (6) "Hospital" has the meaning given in s. 50.33 (2) (a) or (b).

SB240,3,15 (7) "Medicare" has the meaning given in s. 49.45 (3) (L) 1. b.

SB240,3,17 (8) "Outpatient physical therapy services" has the meaning given under 42 USC 1395x (p).

SB240,3,19 (9) "Patient" means an individual who receives services from a rural medical center.

SB240,3,20 (10) "Rural health clinic" has the meaning given under 42 USC 1395x (aa) (2).

SB240,3,22 (11) "Rural medical center" means a facility, building, structure, institution or place that meets all of the following conditions:

SB240,3,24 (a) Provides 2 or more health care services through the facility, building, structure, institution or place or through a related corporate entity.

SB240,4,3 (b) Is located in a county, city, town or village that has a population of less than 15,000 and that is in an area that is not an urbanized area, as defined by the federal bureau of the census.

SB240,4,4 50.51 Departmental powers. The department shall do all of the following:

SB240,4,6 (1) Provide uniform, statewide licensing, inspection and regulation of rural medical centers as specified in this subchapter.

SB240,4,7 (2) Promulgate rules that establish all of the following:

SB240,4,10 (a) For the operation of rural medical centers, standards that are designed to protect and promote the health, safety, rights and welfare of patients who receive health care services in rural medical centers.

SB240,4,12 (b) Minimum requirements for issuance of a provisional license, an initial regular license or a regular license renewal to rural medical centers.

SB240,4,15 (c) Provisional rural medical center licensure fees and regular rural medical center initial licensure and licensure renewal fees. The amounts of the fees shall be based on the health care services provided by the rural medical center.

SB240,4,17 (d) A procedure and criteria for waiver of or variance from standards under par. (a) or minimum requirements under par. (b).