Bill to allow overnight ambulatory surgical center stays moves forward in the Senate

The Senate Health Policy committee Tuesday voted to advance the bill, which would allow stays to up to 24 hours.
Rep. Gayle B. Harrell, R- Stuart, shares a laugh with Florida Governor Rick Scott during a joint session of the Florida Legislature, Tuesday, 1/9/18. SCOTT KEELER | Times
Rep. Gayle B. Harrell, R- Stuart, shares a laugh with Florida Governor Rick Scott during a joint session of the Florida Legislature, Tuesday, 1/9/18. SCOTT KEELER | Times
Published Feb. 19, 2019|Updated Feb. 19, 2019

A proposal to allow patients at ambulatory surgical centers to stay overnight was approved by the Senate Health Policy committee Tuesday, with a promise from its sponsor that she would not seek to further extend how long patients can remain at those facilities.

Patients at ambulatory surgical centers can currently only stay for the duration of the day but SB 434, which was passed unanimously, would allow patients to stay at such centers up to 24 hours, enabling them to remain overnight. Sen. Gayle Harrell, R-Stuart, the chair of the committee, said the change would help lower health care costs by preventing costly transfers to hospitals that are required to happen under the current statute if a patient needs more time before returning home.

Children are exempted for now from the bill, Harrell added, to allow the Agency for Health Care Administration to develop rules for their care in conjunction with medical boards.

“Many patients end up transferred to the hospital in order to wake up or get through a little bit of pain,” she said, noting that 39 other states allow 24-hour stays. Extending the time they can recuperate gives them a “patient-centered option.”

Increasing how long patients can stay at ambulatory surgical centers has been a regular issue in recent sessions, and proposals allowing the increase to 24-hour stays have been floated before. The House has proposed also allowing recovery care centers to house patients for up to 72 hours, though the Senate has not typically agreed.

Some members of the committee, including Democratic Sens. Darryl Rouson of St. Petersburg and Janet Cruz of Tampa, raised concerns that extending stays might negatively affect hospitals by increasing their burden of high-risk patients more disproportionately on Medicaid.

But Harrell said ambulatory surgical centers were the appropriate venue for such low-risk patients “to get the appropriate care” and that such centers take all patients, including Medicaid ones.

Michael Madewell, the administrator for the Panama City Surgery Center, urged lawmakers to support the bills.

When the current law was first written decades ago, he said, the only surgeries being performed were colonoscopies and cataract surgery. More advanced surgeries now being performed regularly at centers like his, he said, require more anesthesia and time to recover.

“We’re still stuck with a thirty-year old statute that doesn’t really apply to what we do anymore,” he told legislators. Patients call him to complain about more expensive stays when they are transferred to hospitals, but he said under the current law he does not have other options.

In response to some concerns the bill would change more before it reaches the Senate floor, Harrell promised that the 24-hour cap would stay in place before the bill passed out of committee Tuesday.

“We’re not going to 72 hours. This is 24 hours,” she said.