Florida Senate - 2013 COMMITTEE AMENDMENT
Bill No. CS for SB 966
Senate . House
Comm: RCS .
The Committee on Appropriations (Bean) recommended the
1 Senate Amendment to Amendment (342762) (with title
4 Delete lines 458 - 535
5 and insert:
6 Section 14. Paragraph (a) of subsection (7) and subsection
7 (14) of section 395.4001, Florida Statutes, are amended to read:
8 395.4001 Definitions.—As used in this part, the term:
9 (7) “Level II trauma center” means a trauma center that:
10 (a) Is verified by the department to be in substantial
11 compliance with Level II trauma center standards and has been
12 approved by the department to operate as a Level II trauma
13 center or is designated pursuant to s. 395.4025(14).
14 (14) “Trauma center” means a hospital that has been
15 verified by the department to be in substantial compliance with
16 the requirements in s. 395.4025 and has been approved by the
17 department to operate as a Level I trauma center, Level II
18 trauma center, or pediatric trauma center, or is designated by
19 the department as a Level II trauma center pursuant to
20 s. 395.4025(14).
21 Section 15. Paragraph (b) of subsection (1) and paragraph
22 (3) of section 395.401, Florida Statutes, are amended to read:
23 395.401 Trauma services system plans; approval of trauma
24 centers and pediatric trauma centers; procedures; renewal.—
26 (b) The local and regional trauma agencies shall develop
27 and submit to the department plans for local and regional trauma
28 services systems. The plans must include, at a minimum, the
29 following components:
30 1. The organizational structure of the trauma system.
31 2. Prehospital care management guidelines for triage and
32 transportation of trauma cases.
33 3. Flow patterns of trauma cases and transportation system
34 design and resources, including air transportation services,
35 provision for interfacility trauma transfer, and the prehospital
36 transportation of trauma victims. The trauma agency shall plan
37 for the development of a system of transportation of trauma
38 alert victims to trauma centers where the distance or time to a
39 trauma center or transportation resources diminish access by
40 trauma alert victims.
4. The number and location of needed trauma centers based
42 on local needs, population, and location and distribution of
44 4. 5 . Data collection regarding system operation and patient
46 5. 6 . Periodic performance evaluation of the trauma system
47 and its components.
48 6. 7 . The use of air transport services within the
49 jurisdiction of the local trauma agency.
50 7. 8 . Public information and education about the trauma
52 8. 9 . Emergency medical services communication system usage
53 and dispatching.
54 9. 10 . The coordination and integration between the trauma
55 center and other acute care hospitals.
56 10. 11 . Medical control and accountability.
57 11. 12 . Quality control and system evaluation.
58 (3) The department may withdraw local or regional agency
59 authority, prescribe corrective actions, or use the
60 administrative remedies as provided in s. 395.1065 for the
61 violation of any provision of this section and ss. 395.4015,
62 395.402 , 395.4025, 395.403, 395.404, and 395.4045 or rules
63 adopted thereunder. All amounts collected pursuant to this
64 subsection shall be deposited into the Emergency Medical
65 Services Trust Fund provided in s. 401.34.
66 Section 16. Subsection (1) of section 395.4015, Florida
67 Statutes, is amended to read:
68 395.4015 State regional trauma planning; trauma regions.—
69 (1) The department shall establish a state trauma system
70 plan. As part of the state trauma system plan, the department
71 shall establish trauma regions that cover all geographical areas
72 of the state and have boundaries that are coterminous with the
73 boundaries of the regional domestic security task forces
74 established under s. 943.0312. These regions may serve as the
75 basis for the development of department-approved local or
76 regional trauma plans. However, such regional plans shall
77 recognize trauma service areas that reflect well established
78 patient flow patterns. The delivery of trauma services by or in
79 coordination with a trauma agency established before July 1,
80 2004, may continue in accordance with public and private
81 agreements and operational procedures entered into as provided
82 in s. 395.401.
83 Section 17. Section 395.402, Florida Statutes, is amended
84 to read:
85 395.402 Trauma service areas ; number and location of trauma
87 (1) The Legislature recognizes the need for a statewide,
88 cohesive, uniform, and integrated trauma system. Within the
89 trauma service areas, Level I and Level II trauma centers shall
90 each be capable of annually treating a minimum of 1,000 and 500
91 patients, respectively, with an injury severity score (ISS) of 9
92 or greater. Level II trauma centers in counties with a
93 population of more than 500,000 shall have the capacity to care
94 for 1,000 patients per year.
95 (2) Trauma service areas as defined in this section are to
96 be utilized until the Department of Health completes an
97 assessment of the trauma system and reports its finding to the
98 Governor, the President of the Senate, the Speaker of the House
99 of Representatives, and the substantive legislative committees.
100 The report shall be submitted by February 1, 2005. The
101 department shall review the existing trauma system and determine
102 whether it is effective in providing trauma care uniformly
103 throughout the state. The assessment shall:
104 (a) Consider aligning trauma service areas within the
105 trauma region boundaries as established in July 2004.
106 (b) Review the number and level of trauma centers needed
107 for each trauma service area to provide a statewide integrated
108 trauma system.
109 (c) Establish criteria for determining the number and level
110 of trauma centers needed to serve the population in a defined
111 trauma service area or region.
112 (d) Consider including criteria within trauma center
113 approval standards based upon the number of trauma victims
114 served within a service area.
115 (e) Review the Regional Domestic Security Task Force
116 structure and determine whether integrating the trauma system
117 planning with interagency regional emergency and disaster
118 planning efforts is feasible and identify any duplication of
119 efforts between the two entities.
120 (f) Make recommendations regarding a continued revenue
121 source which shall include a local participation requirement.
122 (g) Make recommendations regarding a formula for the
123 distribution of funds identified for trauma centers which shall
124 address incentives for new centers where needed and the need to
125 maintain effective trauma care in areas served by existing
126 centers, with consideration for the volume of trauma patients
127 served, and the amount of charity care provided.
128 (3) In conducting such assessment and subsequent annual
129 reviews, the department shall consider:
130 (a) The recommendations made as part of the regional trauma
131 system plans submitted by regional trauma agencies.
132 (b) Stakeholder recommendations.
133 (c) The geographical composition of an area to ensure rapid
134 access to trauma care by patients.
135 (d) Historical patterns of patient referral and transfer in
136 an area.
137 (e) Inventories of available trauma care resources,
138 including professional medical staff.
139 (f) Population growth characteristics.
140 (g) Transportation capabilities, including ground and air
142 (h) Medically appropriate ground and air travel times.
143 (i) Recommendations of the Regional Domestic Security Task
145 (j) The actual number of trauma victims currently being
146 served by each trauma center.
147 (k) Other appropriate criteria.
148 (4) Annually thereafter, the department shall review the
149 assignment of the 67 counties to trauma service areas, in
150 addition to the requirements of paragraphs (2)(b)-(g) and
151 subsection (3). County assignments are made for the purpose of
152 developing a system of trauma centers. Revisions made by the
153 department shall take into consideration the recommendations
154 made as part of the regional trauma system plans approved by the
155 department and the recommendations made as part of the state
156 trauma system plan. In cases where a trauma service area is
157 located within the boundaries of more than one trauma region,
158 the trauma service area’s needs, response capability, and system
159 requirements shall be considered by each trauma region served by
160 that trauma service area in its regional system plan. Until the
161 department completes the February 2005 assessment, the
162 assignment of counties shall remain as established in this
164 (a) The following trauma service areas are hereby
166 (1) 1. Trauma service area 1 shall consist of Escambia,
167 Okaloosa, Santa Rosa, and Walton Counties.
168 (2) 2. Trauma service area 2 shall consist of Bay, Gulf,
169 Holmes, and Washington Counties.
170 (3) 3. Trauma service area 3 shall consist of Calhoun,
171 Franklin, Gadsden, Jackson, Jefferson, Leon, Liberty, Madison,
172 Taylor, and Wakulla Counties.
173 (4) 4. Trauma service area 4 shall consist of Alachua,
174 Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy,
175 Putnam, Suwannee, and Union Counties.
176 (5) 5. Trauma service area 5 shall consist of Baker, Clay,
177 Duval, Nassau, and St. Johns Counties.
178 (6) 6. Trauma service area 6 shall consist of Citrus,
179 Hernando, and Marion Counties.
180 (7) 7. Trauma service area 7 shall consist of Flagler and
181 Volusia Counties.
182 (8) 8. Trauma service area 8 shall consist of Lake, Orange,
183 Osceola, Seminole, and Sumter Counties.
184 (9) 9. Trauma service area 9 shall consist of Pasco and
185 Pinellas Counties.
186 (10) 10. Trauma service area 10 shall consist of
187 Hillsborough County.
188 (11) 11. Trauma service area 11 shall consist of Hardee,
189 Highlands, and Polk Counties.
190 (12) 12. Trauma service area 12 shall consist of Brevard and
191 Indian River Counties.
192 (13) 13. Trauma service area 13 shall consist of DeSoto,
193 Manatee, and Sarasota Counties.
194 (14) 14. Trauma service area 14 shall consist of Martin,
195 Okeechobee, and St. Lucie Counties.
196 (15) 15. Trauma service area 15 shall consist of Charlotte,
197 Glades, Hendry, and Lee Counties.
198 (16) 16. Trauma service area 16 shall consist of Palm Beach
200 (17) 17. Trauma service area 17 shall consist of Collier
202 (18) 18. Trauma service area 18 shall consist of Broward
204 (19) 19. Trauma service area 19 shall consist of Miami-Dade
205 and Monroe Counties.
206 (b) Each trauma service area should have at least one Level
207 I or Level II trauma center. The department shall allocate, by
208 rule, the number of trauma centers needed for each trauma
209 service area.
210 (c) There shall be no more than a total of 44 trauma
211 centers in the state.
214 ================= T I T L E A M E N D M E N T ================
215 And the title is amended as follows:
216 Delete lines 3392 - 3395
217 and insert:
218 flow patterns; amending s. 395.402, F.S., repealing
219 provisions relating to the Department of Health's
220 assignment of counties to trauma service areas;
221 repealing outdated provisions requiring the Department
222 of Health to conduct a study; repealing provisions
223 requiring the Department of Health to annually review
224 the assignment of counties to trauma service centers;
225 repealing provisions regarding the number of trauma
226 centers in each trauma service area and in the state;
227 amending s. 395.4025, F.S.; establishing criteria for
228 designating Level II trauma centers in areas with
229 limited access to trauma center services; amending
230 s. 395.405, F.S., removing rulemaking authority for
231 s. 395.402, F.S.; amending s.