72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
 
NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .
 
LC 1028
 
                         House Bill 2563
 
Sponsored by Representative KRUSE; Representatives BUTLER,
  FLORES, GALLEGOS, KNOPP, KROPF, WESTLUND, Senators ATKINSON,
  BEYER, GEORGE, MINNIS
 
 
                             SUMMARY
 
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
 
  Includes medical facility operated substantially for purpose of
performing abortions in definition of ambulatory surgical center.
 
                        A BILL FOR AN ACT
Relating to ambulatory surgical centers; amending ORS 442.015.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 442.015 is amended to read:
  442.015. As used in ORS chapter 441 and this chapter, unless
the context requires otherwise:
  (1) 'Acquire' or 'acquisition' refers to obtaining equipment,
supplies, components or facilities by any means, including
purchase, capital or operating lease, rental or donation, with
intention of using such equipment, supplies, components or
facilities to provide health services in Oregon.  When equipment
or other materials are obtained outside of this state,
acquisition is considered to occur when the equipment or other
materials begin to be used in Oregon for the provision of health
services or when such services are offered for use in Oregon.
  (2) 'Adjusted admission' means the sum of all inpatient
admissions divided by the ratio of inpatient revenues to total
patient revenues.
  (3) 'Affected persons' has the same meaning as given to '
party' in ORS 183.310 (6).
  (4) { + (a) + } 'Ambulatory surgical center' means { + :
  (A) + } A facility that performs outpatient surgery not
routinely or customarily performed in a physician's or dentist's
office, and is able to meet health facility licensure
requirements.
   { +  (B) A facility that operates substantially for the
purpose of performing abortions.
  (b) For purposes of this subsection, a facility operates
substantially for the purpose of performing abortions if:
  (A) Ten or more abortions in any calendar month or 100 or more
abortions per calendar year are performed on the premises of the
facility;
  (B) The facility holds itself out to the public as an abortion
provider by any public means, including but not limited to
newspaper, telephone directory, magazine or electronic media; and
 
  (C) The facility is open for any period of time during the day
and has at the facility or on call a physician licensed under ORS
chapter 677 to perform abortions.
  (c) As used in this subsection, 'abortion' means the use or
prescription of any instrument, medicine, drug or any other
substance or device approved by the United States Food and Drug
Administration to terminate the pregnancy of a woman known to be
pregnant, with the intention other than to:
  (A) Increase the probability of a live birth;
  (B) Preserve the life or health of a child after live birth; or
  (C) Remove a dead fetus. + }
  (5) 'Audited actual experience' means data contained within
financial statements examined by an independent, certified public
accountant in accordance with generally accepted auditing
standards.
  (6) 'Budget' means the projections by the hospital for a
specified future time period of expenditures and revenues with
supporting statistical indicators.
  (7) 'Case mix' means a calculated index for each hospital,
based on financial accounting and case mix data collection as set
forth in ORS 442.425, reflecting the relative costliness of that
hospital's mix of cases compared to a state or national mix of
cases.
  (8) 'Council' means the Oregon Health Council.
  (9) 'Department' means the Department of Human Services of the
State of Oregon.
  (10) 'Develop' means to undertake those activities which on
their completion will result in the offer of a new institutional
health service or the incurring of a financial obligation, as
defined under applicable state law, in relation to the offering
of such a health service.
  (11) 'Director' means the Director of Human Services.
  (12) 'Expenditure' or 'capital expenditure' means the actual
expenditure, an obligation to an expenditure, lease or similar
arrangement in lieu of an expenditure, and the reasonable value
of a donation or grant in lieu of an expenditure but not
including any interest thereon.
  (13) 'Freestanding birthing center' means a facility licensed
for the primary purpose of performing low risk deliveries.
  (14) 'Governmental unit' means the state, or any county,
municipality or other political subdivision, or any related
department, division, board or other agency.
  (15) 'Gross revenue' means the sum of daily hospital service
charges, ambulatory service charges, ancillary service charges
and other operating revenue. 'Gross revenue' does not include
contributions, donations, legacies or bequests made to a hospital
without restriction by the donors.
  (16)(a) 'Health care facility' means a hospital, a long term
care facility, an ambulatory surgical center, a freestanding
birthing center or an outpatient renal dialysis facility.
  (b) 'Health care facility' does not mean:
  (A) An establishment furnishing residential care or treatment
not meeting federal intermediate care standards, not following a
primarily medical model of treatment, prohibited from admitting
persons requiring 24-hour nursing care and licensed or approved
under the rules of the Department of Human Services or the
Department of Corrections; or
  (B) An establishment furnishing primarily domiciliary care.
  (17) 'Health maintenance organization' or 'HMO' means a public
organization or a private organization organized under the laws
of any state which:
  (a) Is a qualified HMO under section 1310 (d) of the U.S.
Public Health Services Act; or
  (b)(A) Provides or otherwise makes available to enrolled
participants health care services, including at least the
following basic health care services: Usual physician services,
hospitalization, laboratory, X-ray, emergency and preventive
services, and out-of-area coverage;
  (B) Is compensated, except for copayments, for the provision of
the basic health care services listed in subparagraph (A) of this
paragraph to enrolled participants on a predetermined periodic
rate basis; and
  (C) Provides physicians' services primarily directly through
physicians who are either employees or partners of such
organization, or through arrangements with individual physicians
or one or more groups of physicians organized on a group practice
or individual practice basis.
  (18) 'Health services' means clinically related diagnostic,
treatment or rehabilitative services, and includes alcohol, drug
or controlled substance abuse and mental health services that may
be provided either directly or indirectly on an inpatient or
ambulatory patient basis.
  (19) 'Hospital' means a facility with an organized medical
staff, with permanent facilities that include inpatient beds and
with medical services, including physician services and
continuous nursing services under the supervision of registered
nurses, to provide diagnosis and medical or surgical treatment
primarily for but not limited to acutely ill patients and
accident victims, to provide treatment for the mentally ill or to
provide treatment in special inpatient care facilities.
  (20) 'Institutional health services' means health services
provided in or through health care facilities and includes the
entities in or through which such services are provided.
  (21) 'Intermediate care facility' means a facility that
provides, on a regular basis, health-related care and services to
individuals who do not require the degree of care and treatment
that a hospital or skilled nursing facility is designed to
provide, but who because of their mental or physical condition
require care and services above the level of room and board that
can be made available to them only through institutional
facilities.
  (22) 'Long term care facility' means a facility with permanent
facilities that include inpatient beds, providing medical
services, including nursing services but excluding surgical
procedures except as may be permitted by the rules of the
director, to provide treatment for two or more unrelated
patients.  ' Long term care facility' includes skilled nursing
facilities and intermediate care facilities but may not be
construed to include facilities licensed and operated pursuant to
ORS 443.400 to 443.455.
  (23) 'Major medical equipment' means medical equipment that is
used to provide medical and other health services and that costs
more than $1 million. 'Major medical equipment' does not include
medical equipment acquired by or on behalf of a clinical
laboratory to provide clinical laboratory services, if the
clinical laboratory is independent of a physician's office and a
hospital and has been determined under Title XVIII of the Social
Security Act to meet the requirements of paragraphs (10) and (11)
of section 1861(s) of that Act.
  (24) 'Medically indigent' means a person who has insufficient
resources or assets to pay for needed medical care without
utilizing resources required to meet basic needs for shelter,
food and clothing.
  (25) 'Net revenue' means gross revenue minus deductions from
revenue.
  (26) 'New hospital' means a facility that did not offer
hospital services on a regular basis within its service area
within the prior 12-month period and is initiating or proposing
to initiate such services. 'New hospital' also includes any
replacement of an existing hospital that involves a substantial
increase or change in the services offered.
 
  (27) 'New skilled nursing or intermediate care service or
facility' means a service or facility that did not offer long
term care services on a regular basis by or through the facility
within the prior 12-month period and is initiating or proposing
to initiate such services. A 'new skilled nursing or intermediate
care service or facility' also includes the rebuilding of a long
term care facility, the relocation of buildings which are a part
of a long term care facility, the relocation of long term care
beds from one facility to another or an increase in the number of
beds of more than 10 or 10 percent of the bed capacity, whichever
is the lesser, within a two-year period.
  (28) 'Offer' means that the health care facility holds itself
out as capable of providing, or as having the means for the
provision of, specified health services.
  (29) 'Operating expenses' means the sum of daily hospital
service expenses, ambulatory service expenses, ancillary expenses
and other operating expenses, excluding income taxes.
  (30) 'Outpatient renal dialysis facility' means a facility that
provides renal dialysis services directly to outpatients.
  (31) 'Person' means an individual, a trust or estate, a
partnership, a corporation (including associations, joint stock
companies and insurance companies), a state, or a political
subdivision or instrumentality, including a municipal
corporation, of a state.
  (32) 'Skilled nursing facility' means a facility or a distinct
part of a facility, that is primarily engaged in providing to
inpatients skilled nursing care and related services for patients
who require medical or nursing care, or an institution that
provides rehabilitation services for the rehabilitation of
injured, disabled or sick persons.
  (33) 'Special inpatient care facility' means a facility with
permanent inpatient beds and other facilities designed and
utilized for special health care purposes, including but not
limited to a rehabilitation center, a college infirmary, a
chiropractic facility, a facility for the treatment of alcoholism
or drug abuse, an inpatient care facility meeting the
requirements of ORS 441.065, and any other establishment falling
within a classification established by the Department of Human
Services, after determination of the need for such classification
and the level and kind of health care appropriate for such
classification.
  (34) 'Total deductions from gross revenue' or 'deductions from
revenue' means reductions from gross revenue resulting from
inability to collect payment of charges. Such reductions include
bad debts; contractual adjustments; uncompensated care;
administrative, courtesy and policy discounts and adjustments and
other such revenue deductions. The deduction shall be net of the
offset of restricted donations and grants for indigent care.
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