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Minutes for HB2261 - Committee on Health and Human Services

Short Title

Enacting the rural emergency hospital act to provide for the licensure of rural emergency hospitals.

Minutes Content for Tue, Feb 16, 2021

Scott Abbott, Revisor of Statute, provided the committee with an overview of HB2261.

Tara May, Vice President, State Legislative Relations, Kansas Hospital Association (KHA), testified that HB2261 would allow hospitals to take advantage of action taken at the federal level establishing the Rural Emergency Hospital (REH) model. The model provides ambulatory, initial assessment and interventional services. The facilities are open in the community every day to provide the consistent array most needed in the community. The focus is on primary care needs, chronic disease management and emergency services. Since 2012, KHA has been looking at alternatives for rural hospitals, creating the Primary Health Center model which is almost identical to the REH model. In order for a hospital to convert to the REH model, it must be in a state that provides licensing for a Rural Emergency Hospital. In order to participate, the hospital must currently be a Critical Access Hospital or a Prospective Payment System Hospital with less than 50 beds in a rural designated area. This provides communities with an option especially those in a financially vulnerable situation.

Jennifer Findley, Vice President, Education and Special Projects, Kansas Hospital Association, continued KHA's testimony by providing additional information and background on the efforts KHA has made since 2012 to provide solutions to the issues rural hospitals encounter. HB2261 was crafted to mirror federal regulations regarding Rural Emergency Hospitals (Attachment 3).

Larry Van Der Wege, Administrator, Lindsborg Community Hospital, provided testimony on HB2261 can have a positive impact on small rural hospitals. Many factors are involved in the success of hospitals. Liker most businesses, hospitals are volume dependent. They are paid when services are provided. The loss of an aging population contributes to the problem. Improvements in treatment has also reduced the need for time in a hospital. Insurance reimbursements are dependent on the payer of services. Some pay more and some pay less. Small hospitals have little leverage in this matter.  Expenses continue to rise. Employees deserve raises and benefits. Recruiting staff is difficult in a competitive market. The challenges continue to mount. The Rural Emergency Hospital model, while not for all communities, is necessary to continue servicing the medical needs of rural Kansas (Attachment 4).

Kris Matthews, Chief Operating Officer, Decatur Health, provided testimony in support of HB2261. Kansas hospitals are struggling. Many factors contribute to this. The way that health care is delivered has changed. Many common procedures no longer require an overnight stay. Data shows that 37 Kansas hospitals have fewer than 2 patients staying overnight on a given day. Technology and specialists needed for complex procedures are delivered at the regional level, not the local. The biggest sources of revenue at rural hospitals is Medicare and Medicaid. These do not reimburse at a level that covers the cost of delivering the services. Some commercial carriers do not reimburse at a level to help cover the gap. Adding uncompensated care only adds to the gap. The Rural Emergency Hospital model allows for a place where emergency services are available 24/7. It also allows the keeping of a proactive approach to keeping people healthy so that they do not need in-patient acute care. The option is a good approach for some hospitals (Attachment 5).

The conferees responded to questions from the committee.

The following provided written only testimony:

Jerry Moran, U.S. Senator (Attachment 6)

Rachelle Colombo, Executive Director, Kansas Medical Society (Attachment 7)

Jay Hall, Legislative Policy Director and General Counsel, Kansas Association of Counties (Attachment 8)

David Jordan, President & CEO, United Methodist Health Ministry Fund (Attachment 9)

John Donley, Kansas Farm Bureau (Attachment 10)

Wendi Stark, Research Associate, The League of Kansas Municipalities (Attachment 11)

Vicki Whitaker, Executive Director, Kansas Association of Osteopathic Medicine (Attachment 12)

Alex Orel, Senior Vice President for Government Affairs, Kansas Bankers Association (Attachment 13)

The hearing was closed.

Representative Eplee motioned and Representative Kelly seconded to advance HB2261 favorably for passage. Motion carried.

The meeting was adjourned at 2:41 PM.