ENTITLED, An Act to license and regulate freestanding emergency medical care facilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
    Section 1. That § 34-12-1.1 be amended to read:
    34-12-1.1. Terms used in this chapter mean:

            (1)    "Ambulatory surgery center," any facility which is not part of a hospital and which is not an office of a dentist, whether for individual or group practice, in which surgical procedures requiring the use of general anesthesia are performed upon patients;

            (2)    "Assisted living center," any institution, rest home, boarding home, place, building, or agency which is maintained and operated to provide personal care and services which meet some need beyond basic provision of food, shelter, and laundry;

            (3)    "Chemical dependency treatment facility," any facility which provides a structured inpatient treatment program for alcoholism or drug abuse;

            (4)    "Health care facility," any institution, birth center, ambulatory surgery center, chemical dependency treatment facility, hospital, nursing facility, assisted living center, rural primary care hospital, adult foster care home, inpatient hospice, residential hospice, freestanding emergency care facility, place, building, or agency in which any accommodation is maintained, furnished, or offered for the hospitalization, nursing care, or supervised care of the sick or injured;

            (5)    "Hospital," any establishment with an organized medical staff with permanent facilities that include inpatient beds and is primarily engaged in providing by or under the supervision of physicians, to inpatients, any of the following services: diagnostic or therapeutic services for the medical diagnosis, treatment, or care of injured, disabled, or sick persons; obstetrical services including the care of the newborn; or rehabilitation

services for injured, disabled, or sick persons. In no event may the inpatient beds include nursing facility beds or assisted living center beds unless the same are licensed as such pursuant to this chapter;

            (6)    "Nursing facility," any facility which is maintained and operated for the express or implied purpose of providing care to one or more persons whether for consideration or not, who are not acutely ill but require nursing care and related medical services of such complexity as to require professional nursing care under the direction of a physician on a twenty-four hour per day basis; or a facility which is maintained and operated for the express or implied purpose of providing care to one or more persons, whether for consideration or not, who do not require the degree of care and treatment which a hospital is designed to provide, but who because of their mental or physical condition require medical care and health services which can be made available to them only through institutional facilities;

            (7)    "Critical access hospital," any nonprofit or public hospital providing emergency care on a twenty-four hour basis located in a rural area which has limited acute inpatient services, focusing on primary and preventive care, and which has in effect an agreement with a general hospital that provides emergency and medical backup services and accepts patient referrals from the critical access hospital. For the purposes of this subdivision, a rural area is any municipality of under fifty thousand population;

            (8)    "Adult foster care home," a family-style residence which provides supervision of personal care, health services, and household services for no more than four aged, blind, physically disabled, developmentally disabled, or socially-emotionally disabled adults;

            (9)    "Inpatient hospice," any facility which is not part of a hospital or nursing home which is maintained and operated for the express or implied purpose of providing all levels of

hospice care to terminally ill individuals on a twenty-four hour per day basis;

            (10)    "Residential hospice," any facility which is not part of a hospital or nursing home which is maintained and operated for the express or implied purpose of providing custodial care to terminally ill individuals on a twenty-four hour per day basis;

            (11)    "Birth center," any health care facility at which a woman is scheduled to give birth following a normal, uncomplicated pregnancy, but does not include a hospital or the residence of the woman giving birth;

            (12)    "Freestanding emergency medical care facility," any facility structurally separate and distinct from a hospital that directly receives a person and provides emergency medical care.
    Section 2. That § 34-12-6 be amended to read:
    34-12-6. Any application for a license to operate a health care facility shall be accompanied by a fee. The annual license fee established for each licensure category of health care facilities shall be as follows:

            (1)    Nursing facility:

            (a)    Fifty beds or less, six hundred dollars;

            (b)    Fifty-one to one hundred beds, inclusive, nine hundred dollars;

            (c)    One hundred one to one hundred fifty beds, inclusive, one thousand two hundred dollars;

            (d)    One hundred fifty-one or more beds, one thousand five hundred dollars;

            (2)    Assisted living center:

            (a)    Sixteen beds or less, one hundred fifty dollars;

            (b)    Seventeen to fifty beds, inclusive, three hundred dollars;

            (c)    Fifty-one to one hundred beds, inclusive, four hundred fifty dollars;

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            (d)    One hundred one or more beds, six hundred dollars;

            (3)    Hospital:

            (a)    Twenty-five beds or less, one thousand dollars;

            (b)    Twenty-six to fifty beds, inclusive, one thousand five hundred dollars;

            (c)    Fifty-one to one hundred beds, inclusive, two thousand dollars;

            (d)    One hundred one to one hundred fifty beds, inclusive, three thousand dollars;

            (e)    One hundred fifty-one to two hundred beds, inclusive, four thousand dollars;

            (f)    Two hundred one or more beds, five thousand dollars;

            (4)    Ambulatory surgery center, five hundred dollars;

            (5)    Chemical dependency treatment facility:

            (a)    Sixteen beds or less, one hundred fifty dollars;

            (b)    Seventeen to fifty beds, inclusive, three hundred dollars;

            (c)    Fifty-one or more beds, four hundred fifty dollars;

            (6)    Inpatient and residential hospice, two hundred dollars; and

            (7)    Freestanding emergency medical care facility, five hundred dollars.

    No such fee may be refunded. All fees received by the State Department of Health under the provisions of this chapter shall be paid into the general fund.
    Section 3. That § 34-12-52 be amended to read:
    34-12-52. Terms used in this section and §§ 34-12-53 to 34-12-55, inclusive, mean:

            (1)    "Department," the Department of Health;

            (2)    "Emergency medical services," health care provided to the patient at the scene, during transportation to a medical facility, between medical facilities, and upon entry at the medical facility;

            (3)    "Freestanding emergency medical care facility," a facility structurally separate and distinct

from a hospital that directly receives a person and provides emergency medical care;

            (4)    "Hospital," a hospital licensed pursuant to chapter 34-12;

            (5)    "Trauma," a sudden, severe injury or damage to the body caused by an external force that results in potentially life-threatening injuries or that could result in the following disabilities:

            (a)    Impairment of cognitive or mental abilities;

            (b)    Impairment of physical functioning; or

            (c)    Disturbance of behavioral or emotional functioning;

            (6)    "Trauma care system," a statewide system for the prevention of trauma and the provision of optimal medical care to trauma victims that includes both the provision of appropriate health care services and provision of emergency medical care, equipment, and personnel for effective and coordinated prehospital, hospital, inter-hospital, and rehabilitative care for trauma patients;

            (7)    "Trauma hospital," a hospital designated by the department as providing a specialized program in trauma care with appropriately trained personnel, equipment, and other facility resources that are specifically organized to provide optimal care to a trauma patient at the facility; and

            (8)    "Trauma registry," patient-specific trauma data that is maintained by a health care facility, in a format prescribed by rules promulgated pursuant to § 34-12-54.
    Section 4. That § 34-12-53 be amended to read:
    34-12-53. The department shall develop, implement, and administer a trauma care system including a statewide trauma registry that involves all hospitals, freestanding emergency medical care facilities, and emergency medical services within the state.
    Section 5. That § 34-12-54 be amended to read:

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    34-12-54. The department shall promulgate rules, pursuant to chapter 1-26, to provide for a trauma care system and statewide trauma registry. The rules shall include:

            (1)    Designation of the levels of trauma hospitals or freestanding emergency medical care facilities and the resources each hospital or freestanding emergency medical care facility is required to have concerning personnel, equipment, data collection, and organizational capacity for each level;

            (2)    Prehospital emergency medical services triage and treatment protocols for trauma patients; and

            (3)    Requirements for collection and release of trauma registry data.
    Section 6. That § 34-12-55 be amended to read:
    34-12-55. Each hospital or freestanding emergency medical care facility shall meet the requirements of one of the designated levels of trauma hospitals as provided for in § 34-12-54. The department may not direct a hospital or freestanding emergency medical care facility to establish a certain level of designation.
    Section 7. That chapter 34-12 be amended by adding a NEW SECTION to read:

    Any freestanding emergency medical care facility that is federally certified as a department of a hospital is exempt from the freestanding emergency medical care facility licensing and license fee provisions of this chapter.

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An Act to license and regulate freestanding emergency medical care facilities.

========================= I certify that the attached Act originated in the SENATE as Bill No. 49 ____________________________ Secretary of the Senate =========================     ____________________________ President of the Senate Attest: ____________________________ Secretary of the Senate ____________________________ Speaker of the House Attest: ____________________________ Chief Clerk Senate Bill No. 49 File No. ____ Chapter No. ______

========================= Received at this Executive Office this _____ day of _____________ , 20____ at ____________ M. By _________________________ for the Governor ========================= The attached Act is hereby approved this ________ day of ______________ , A.D., 20___ ____________________________ Governor ========================= STATE OF SOUTH DAKOTA, ss. Office of the Secretary of State Filed ____________ , 20___ at _________ o'clock __ M. ____________________________ Secretary of State By _________________________ Asst. Secretary of State