Section 124800 Of Chapter 6. Small And Rural Hospitals From California Health And Safety Code >> Division 106. >> Part 4. >> Chapter 6.
124800
. The Legislature finds and declares all of the following:
(a) Rural hospitals serve as the "hub of health," and through that
role attract and retain in their communities physicians, nurses, and
other primary care providers. Because of economies of scale
compounded by reimbursement reforms, many rural hospitals will close
before the end of this decade. This will result in the departure of
primary care providers and the loss of emergency medical services
both to residents and persons traveling through the area. The
smallest and most remote facilities are at highest risk.
(b) The rural hospital is often one of the largest employers in
the community. The closure of such a hospital means the loss of a
source of employment. This has an economic impact beyond the health
sector. Further, economic development of a rural area is, in part,
tied to the existence of a hospital. People, for example, tend not to
retire to areas where there is not reasonable access to physician
and hospital-based services.
(c) Rural hospitals, especially the smaller facilities, lack
access to the sophisticated expertise necessary to deal with current
reimbursement regulations and the associated bureaucracy.
(d) Most rural hospitals are unable to participate in programs
that provide access to short- and long-term financing due to lender
requirements for credit enhancement.
(e) Because of economies of scale compounded by regulations under
Title 22 of the California Code of Regulations and other regulations,
rural hospitals have high, fixed costs that, in the present
reimbursement environment, cannot be offset by revenues generated
from serving a relatively small population base. Further, in an
economically depressed rural area, community contributions are not
sufficient to offset deficits.
(f) Rural hospitals are an important link in the Medi-Cal program,
and without special consideration that takes into account their
unique circumstances, rural hospitals will be unable to continue
providing services to Medi-Cal patients. This is especially true for
outpatient services that are reimbursed at less than 60 percent of
costs.
(g) While only a very small percentage of the Medi-Cal budget for
inpatient and outpatient services is spent for services rendered by
rural hospitals, their participation is essential to preserve the
integrity of the entire Medi-Cal program.