Christine Jordan Sexton
Florida hospitals would have the ability to use paramedics to offer inpatient services at patients’ homes under a bill that moved through the Senate Rules Committee Tuesday morning.
The bill (SB 1222) is now ready for full Senate consideration. Sponsored by Sen. Aaron Bean, the bill is similar to its House counterpart (HB 937), which will next be heard by the House Health & Human Services Committee.
The bills authorize certified paramedics working under the supervision of a physician to perform essential life support services, advanced life support services, and additional health care services to acute care at-home patients in nonemergency community settings. Only hospitals that have gotten a waiver from the Centers for Medicare & Medicaid Services could partner with paramedics to offer their patients at-home access to health care services that would otherwise be provided inside the walls of a hospital.
According to a CMS website, several Florida hospitals have received waivers from the federal government to provide inpatient care in community settings. That list includes Cleveland Clinic Hospital, Cleveland Clinic Martin North, Cleveland Clinic Indian River, Palm Bay Hospital, Holmes Regional Medical Center, Viera Hospital, Cape Canaveral Hospital, Tampa General Hospital and Keralty Hospital (formerly Westchester Hospital).
In addition to obtaining a CMS waiver, the facilities must also obtain a waiver from the state Agency for Health Care Administration, which regulates Florida hospitals and ensures they are meeting all the necessary rules and regulations.
Initially, the bills authorized hospitals to use paramedics in community settings and to provide nonemergency inpatient care outside the four walls of their facilities by working with paramedics in community settings. The goal of the initial bill was to put a state regulation into place so the at-home inpatient care could continue even after the CMS waivers expire.
Mayo Clinic Jacksonville Hospital has been offering inpatient services to its patients for more than a year after getting the necessary approval from the state and federal government.
Mayo Clinic Hospital Jacksonville Medical Director Michael Maniaci told Florida Politics last month that the facility has treated 1,500 patients, about 800 of whom were provided hospital inpatient care in the nearby Marriott Hotel. Some of the hotel’s rooms have virtual technology so the patients can be watched. The “Care Hotel” program, as Maniaci calls it, provides post-procedure watching of patients in a virtual environment.
Mayo also provides inpatient care at patients’ homes. Maniaci said ideal patients for the home program are medically stable but require lab work and treatment. They could be patients who have chronic medical conditions such as heart failure.
The House, though, narrowed the bill to only allow hospitals to provide inpatient care to patients at their permanent homes. It also narrowed the bill to only allow hospitals with waivers from CMS to provide the services. So when the CMS waivers expire, so does the authority to provide care at home.
According to House documents, 40 lobbyists have registered to lobby on HB 937.
