Florida Senate - 2018                                    SB 1876
       
       
        
       By Senator Young
       
       
       
       
       
       18-01126C-18                                          20181876__
    1                        A bill to be entitled                      
    2         An act relating to trauma services; amending s.
    3         395.402, F.S.; revising the trauma service areas and
    4         provisions relating to the number and location of
    5         trauma centers; prohibiting the Department of Health
    6         from designating an additional Level I trauma center
    7         in a trauma service area where a Level I trauma center
    8         currently exists, from designating an existing Level
    9         II trauma center as a pediatric trauma center, and
   10         from designating an existing Level II trauma center as
   11         a Level I trauma center; reducing the total number of
   12         trauma centers authorized in this state; apportioning
   13         trauma centers within each trauma service area;
   14         requiring the department to establish the Florida
   15         Trauma System Advisory Council by a specified date;
   16         requiring the council to review specified materials;
   17         authorizing the council to submit certain
   18         recommendations to the department; providing
   19         membership of the council; requiring the council to
   20         meet no later than a specified date and to meet
   21         annually; requiring the council to submit by a
   22         specified date, and biennially thereafter, a report to
   23         the Legislature and the Governor which must assess
   24         whether an increase in the number of trauma centers
   25         within each trauma service area is recommended based
   26         on certain factors; requiring the report to include
   27         specified information; amending s. 395.4025, F.S.;
   28         conforming provisions to changes made by the act;
   29         requiring the department to select and designate
   30         certain hospitals as trauma centers based on statutory
   31         capacity; prohibiting the department from accepting a
   32         letter of intent or designating a trauma center unless
   33         a specified number of patients have been served by an
   34         existing Level I trauma center in the same or in a
   35         contiguous trauma service area; revising the
   36         department’s review process for hospitals seeking
   37         designation as a trauma center; providing that a
   38         proposed trauma center must be ready to operate by a
   39         specified date; requiring the department to select one
   40         or more hospitals for approval to prepare to operate
   41         as a trauma center; providing selection requirements;
   42         prohibiting the applicant from operating as a trauma
   43         center until a final evaluation has been completed by
   44         the department; requiring a specified review team to
   45         make onsite visits to all existing trauma centers
   46         within a certain timeframe; authorizing the department
   47         to designate a trauma center that is in compliance
   48         with specified requirements; deleting a provision
   49         authorizing an applicant to request an extension of
   50         its provisional status; deleting the date by which the
   51         department must select trauma centers; prohibiting an
   52         applicant from operating as a trauma center unless it
   53         has been designated and certain requirements are met;
   54         providing that only certain hospitals may protest a
   55         decision made by the department; providing that
   56         certain trauma centers that were verified by the
   57         department or determined by the department to be in
   58         substantial compliance with specified standards are
   59         deemed to have met application and operational
   60         requirements; requiring the department to designate a
   61         certain provisionally approved Level II trauma center
   62         as a trauma center if certain criteria are met;
   63         amending s. 395.404, F.S.; requiring trauma centers to
   64         participate in the National Trauma Data Bank;
   65         requiring trauma centers and acute care hospitals to
   66         report trauma patient transfer and outcome data to the
   67         department; deleting provisions relating to the
   68         department review of trauma registry data; providing
   69         an effective date.
   70          
   71  Be It Enacted by the Legislature of the State of Florida:
   72  
   73         Section 1. Section 395.402, Florida Statutes, is amended to
   74  read:
   75         395.402 Trauma service areas; number and location of trauma
   76  centers.—
   77         (1) The Legislature recognizes the need for a statewide,
   78  cohesive, uniform, and integrated trauma system. Within the
   79  trauma service areas, Level I and Level II trauma centers shall
   80  each be capable of annually treating a minimum of 1,000 and 500
   81  patients, respectively, with an injury severity score (ISS) of 9
   82  or greater. Level II trauma centers in counties with a
   83  population of more than 500,000 shall have the capacity to care
   84  for 1,000 patients per year.
   85         (2) Trauma service areas as defined in this section are to
   86  be utilized until the Department of Health completes an
   87  assessment of the trauma system and reports its finding to the
   88  Governor, the President of the Senate, the Speaker of the House
   89  of Representatives, and the substantive legislative committees.
   90  The report shall be submitted by February 1, 2005. The
   91  department shall review the existing trauma system and determine
   92  whether it is effective in providing trauma care uniformly
   93  throughout the state. The assessment shall:
   94         (a) Consider aligning trauma service areas within the
   95  trauma region boundaries as established in July 2004.
   96         (b) Review the number and level of trauma centers needed
   97  for each trauma service area to provide a statewide integrated
   98  trauma system.
   99         (c) Establish criteria for determining the number and level
  100  of trauma centers needed to serve the population in a defined
  101  trauma service area or region.
  102         (d) Consider including criteria within trauma center
  103  approval standards based upon the number of trauma victims
  104  served within a service area.
  105         (e) Review the Regional Domestic Security Task Force
  106  structure and determine whether integrating the trauma system
  107  planning with interagency regional emergency and disaster
  108  planning efforts is feasible and identify any duplication of
  109  efforts between the two entities.
  110         (f) Make recommendations regarding a continued revenue
  111  source which shall include a local participation requirement.
  112         (g) Make recommendations regarding a formula for the
  113  distribution of funds identified for trauma centers which shall
  114  address incentives for new centers where needed and the need to
  115  maintain effective trauma care in areas served by existing
  116  centers, with consideration for the volume of trauma patients
  117  served, and the amount of charity care provided.
  118         (3) In conducting such assessment and subsequent annual
  119  reviews, the department shall consider:
  120         (a) The recommendations made as part of the regional trauma
  121  system plans submitted by regional trauma agencies.
  122         (b) Stakeholder recommendations.
  123         (c) The geographical composition of an area to ensure rapid
  124  access to trauma care by patients.
  125         (d) Historical patterns of patient referral and transfer in
  126  an area.
  127         (e) Inventories of available trauma care resources,
  128  including professional medical staff.
  129         (f) Population growth characteristics.
  130         (g) Transportation capabilities, including ground and air
  131  transport.
  132         (h) Medically appropriate ground and air travel times.
  133         (i) Recommendations of the Regional Domestic Security Task
  134  Force.
  135         (j) The actual number of trauma victims currently being
  136  served by each trauma center.
  137         (k) Other appropriate criteria.
  138         (4) Annually thereafter, the department shall review the
  139  assignment of the 67 counties to trauma service areas, in
  140  addition to the requirements of paragraphs (2)(b)-(g) and
  141  subsection (3). County assignments are made for the purpose of
  142  developing a system of trauma centers. Revisions made by the
  143  department shall take into consideration the recommendations
  144  made as part of the regional trauma system plans approved by the
  145  department and the recommendations made as part of the state
  146  trauma system plan. In cases where a trauma service area is
  147  located within the boundaries of more than one trauma region,
  148  the trauma service area’s needs, response capability, and system
  149  requirements shall be considered by each trauma region served by
  150  that trauma service area in its regional system plan. Until the
  151  department completes the February 2005 assessment, the
  152  assignment of counties shall remain as established in this
  153  section.
  154         (a) The following trauma service areas are hereby
  155  established:
  156         1. Trauma service area 1 shall consist of Escambia,
  157  Okaloosa, Santa Rosa, and Walton Counties.
  158         2. Trauma service area 2 shall consist of Bay, Gulf,
  159  Holmes, and Washington Counties.
  160         3. Trauma service area 3 shall consist of Calhoun,
  161  Franklin, Gadsden, Jackson, Jefferson, Leon, Liberty, Madison,
  162  Taylor, and Wakulla Counties.
  163         4. Trauma service area 4 shall consist of Alachua,
  164  Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy,
  165  Putnam, Suwannee, and Union Counties.
  166         5. Trauma service area 5 shall consist of Baker, Clay,
  167  Duval, Nassau, and St. Johns Counties.
  168         6. Trauma service area 6 shall consist of Citrus, Hernando,
  169  and Marion Counties.
  170         7. Trauma service area 7 shall consist of Flagler and
  171  Volusia Counties.
  172         8. Trauma service area 8 shall consist of Lake, Orange,
  173  Osceola, Seminole, and Sumter Counties.
  174         9. Trauma service area 9 shall consist of Pasco and
  175  Pinellas Counties.
  176         10. Trauma service area 10 shall consist of Hillsborough
  177  County.
  178         11. Trauma service area 11 shall consist of Hardee,
  179  Highlands, and Polk Counties.
  180         12. Trauma service area 12 shall consist of Brevard and
  181  Indian River Counties.
  182         13. Trauma service area 13 shall consist of Charlotte,
  183  DeSoto, Manatee, and Sarasota Counties.
  184         14. Trauma service area 14 shall consist of Martin,
  185  Okeechobee, and St. Lucie Counties.
  186         15. Trauma service area 15 shall consist of Collier
  187  Charlotte, Glades, Hendry, and Lee Counties.
  188         16. Trauma service area 16 shall consist of Palm Beach
  189  County.
  190         17. Trauma service area 17 shall consist of Broward Collier
  191  County.
  192         18. Trauma service area 18 shall consist of Broward County.
  193         19. Trauma service area 19 shall consist of Miami-Dade and
  194  Monroe Counties.
  195         (b) Each trauma service area must should have at least one
  196  Level I or Level II trauma center. The department may not
  197  designate an additional Level I trauma center in a trauma
  198  service area in which a Level I trauma center currently exists.
  199  The department may not designate an existing Level II trauma
  200  center as a pediatric trauma center. The department may not
  201  designate an existing Level II trauma center as a Level I trauma
  202  center The department shall allocate, by rule, the number of
  203  trauma centers needed for each trauma service area.
  204         (c) The total number of trauma centers in this state may
  205  not exceed 35. Trauma centers shall be apportioned as follows:
  206         1. Trauma service area 1 shall have three trauma centers.
  207         2. Trauma service area 2 shall have one trauma center.
  208         3. Trauma service area 3 shall have one trauma center.
  209         4. Trauma service area 4 shall have one trauma center.
  210         5. Trauma service area 5 shall have three trauma centers.
  211         6. Trauma service area 6 shall have one trauma center.
  212         7. Trauma service area 7 shall have one trauma center.
  213         8. Trauma service area 8 shall have three trauma centers.
  214         9. Trauma service area 9 shall have three trauma centers.
  215         10. Trauma service area 10 shall have two trauma centers.
  216         11. Trauma service area 11 shall have one trauma center.
  217         12. Trauma service area 12 shall have one trauma center.
  218         13. Trauma service area 13 shall have two trauma centers.
  219         14. Trauma service area 14 shall have one trauma center.
  220         15. Trauma service area 15 shall have one trauma center.
  221         16. Trauma service area 16 shall have two trauma centers.
  222         17. Trauma service area 17 shall have three trauma centers.
  223         18. Trauma service area 18 shall have five trauma centers.
  224  There shall be no more than a total of 44 trauma centers in the
  225  state.
  226         (2)(a)By October 1, 2018, the department shall establish
  227  the Florida Trauma System Advisory Council to determine the need
  228  for additional trauma centers. The advisory council shall review
  229  and consider materials submitted by the department and
  230  stakeholders, materials published by the American College of
  231  Surgeons Committee on Trauma, and other relevant materials as
  232  the council deems appropriate before issuing a recommendation.
  233  The advisory council may submit recommendations to the
  234  department on the adequacy and continuing development of the
  235  state’s trauma system, including the demand for new trauma
  236  centers.
  237         (b)1. The advisory council shall consist of 15
  238  representatives appointed by the Governor, including:
  239         a. The State Surgeon General;
  240         b. A representative from the Agency for Health Care
  241  Administration;
  242         c. A representative from an emergency medical services
  243  organization;
  244         d. A representative of a local or regional trauma agency;
  245         e. A trauma program manager or trauma medical director
  246  representing an investor-owned hospital with a trauma center;
  247         f. A trauma program manager recommended by the Teaching
  248  Hospital Council of Florida;
  249         g. A representative of the Florida Hospital Association;
  250         h. A trauma program manager or trauma medical director
  251  representing a public hospital;
  252         i. A trauma program manager or trauma medical director
  253  representing a nonprofit hospital with a trauma center;
  254         j. A trauma surgeon representing an investor-owned hospital
  255  with a trauma center;
  256         k. A trauma surgeon recommended by the Teaching Hospital
  257  Council of Florida;
  258         l. A trauma surgeon representing a not-for-profit hospital
  259  with a trauma center;
  260         m. A representative of the American College of Surgeons
  261  Committee on Trauma;
  262         n. A representative of Associated Industries of Florida;
  263  and
  264         o. A representative of the Safety Net Hospital Alliance of
  265  Florida.
  266         2. No two representatives may be employed by the same
  267  health care facility.
  268         3. Each representative of the council shall be appointed to
  269  a 3-year term; however, for the purpose of providing staggered
  270  terms, of the initial appointments, 5 representatives shall be
  271  appointed to 1-year terms, 5 representatives shall be appointed
  272  to 2-year terms, and 5 representatives shall be appointed to 3
  273  year terms.
  274         (3) The advisory council shall convene its first meeting no
  275  later than January 5, 2019, and shall meet at least annually.
  276         (4)(a)By January 5, 2020, and at least every 2 years
  277  thereafter, the advisory council shall submit a report to the
  278  Governor, the President of the Senate, and the Speaker of the
  279  House of Representatives which assesses whether an increase in
  280  the number of trauma centers within each trauma service area is
  281  recommended based on all of the following factors:
  282         1. Population changes within a trauma service area;
  283         2. The impact of tourism on a trauma service area;
  284         3. The number of patients with an injury severity score of
  285  less than 0.9 who are treated in hospitals that are not trauma
  286  centers;
  287         4. Ground and air transport times to a trauma center within
  288  each service area;
  289         5. The number of patients treated in existing trauma
  290  centers;
  291         6. The capacity of existing trauma centers to treat
  292  additional trauma patients;
  293         7. The potential financial impact on existing trauma
  294  centers of the designation of additional trauma centers;
  295         8. The financial impact on commercial and government payors
  296  of health care insurance and on Florida taxpayers caused by the
  297  designation of additional trauma centers;
  298         9. A cost comparison of the charges of existing trauma
  299  centers as contrasted with the charges of any prospective trauma
  300  centers;
  301         10. Any impacts on graduate medical education programs and
  302  resident training for trauma and surgical specialties in the
  303  state;
  304         11. The negative impacts, if any, of the designation of new
  305  trauma centers on the ability of existing centers to meet
  306  standards established by the American College of Surgeons
  307  Committee on Trauma;
  308         12. A survey of literature relating to trauma center
  309  allocation, including peer-reviewed and academic publications;
  310  and
  311         13. Any other factor the advisory council deems
  312  appropriate.
  313         (b) The report must state whether each Level I trauma
  314  center within the trauma service areas is capable of annually
  315  treating at least 1,000 patients with an injury severity score
  316  of 9 or greater and whether each Level II trauma center is
  317  capable of annually treating 500 patients with an injury
  318  severity score of 9 or greater. The report must state whether
  319  each Level II trauma center located in a county with a
  320  population greater than 500,000 has the capacity to care for at
  321  least 1,000 patients per year.
  322         Section 2. Subsections (1) through (7) of section 395.4025,
  323  Florida Statutes, are amended, and subsection (15) is added to
  324  that section, to read:
  325         395.4025 Trauma centers; selection; quality assurance;
  326  records.—
  327         (1) For purposes of developing a system of trauma centers,
  328  the department shall use the 18 19 trauma service areas
  329  established in s. 395.402. Within each service area and based on
  330  the state trauma system plan, the local or regional trauma
  331  services system plan, and recommendations of the local or
  332  regional trauma agency, the department shall establish the
  333  approximate number of trauma centers needed to ensure reasonable
  334  access to high-quality trauma services. The department shall
  335  select those hospitals that are to be recognized as trauma
  336  centers.
  337         (2)(a) If there is statutory capacity for an additional
  338  trauma center in accordance with s. 395.402(1), the department
  339  shall annually notify each acute care general hospital and each
  340  local and each regional trauma agency in the state that the
  341  department is accepting letters of intent from hospitals that
  342  are interested in becoming trauma centers. The department may
  343  not accept a letter of intent from an applicant and may not
  344  designate an applicant a trauma center if the applicant has
  345  applied to locate the trauma center in a trauma service area
  346  where the number of patients served by an existing Level I
  347  trauma center in that area or in a contiguous trauma service
  348  area fails to exceed 1,000 patients annually. In order to be
  349  considered by the department, a hospital that operates within
  350  the geographic area of a local or regional trauma agency must
  351  certify that its intent to operate as a trauma center is
  352  consistent with the trauma services plan of the local or
  353  regional trauma agency, as approved by the department, if such
  354  agency exists. The department may accept a letter of intent only
  355  if there is statutory capacity for an additional trauma center
  356  in accordance with s. 395.402(1). Letters of intent must be
  357  postmarked no later than midnight October 1.
  358         (b) By October 15, the department shall send to all
  359  hospitals that submitted a letter of intent an application
  360  package that will provide the hospitals with instructions for
  361  submitting information to the department for selection as a
  362  trauma center. The standards for trauma centers provided for in
  363  s. 395.401(2), as adopted by rule of the department, shall serve
  364  as the basis for these instructions.
  365         (c) In order to be considered by the department,
  366  applications from those hospitals seeking selection as trauma
  367  centers, including those current verified trauma centers that
  368  seek a change or redesignation in approval status as a trauma
  369  center, must be received by the department no later than the
  370  close of business on April 1. The department shall conduct an
  371  initial a provisional review of each application for the purpose
  372  of determining that the hospital’s application is complete and
  373  that the hospital is capable of constructing and operating a
  374  trauma center that includes has the critical elements required
  375  for a trauma center. This critical review must will be based on
  376  trauma center standards and must shall include, but need not be
  377  limited to, a review as to of whether the hospital is prepared
  378  to attain and operate with all of the following components
  379  before April 30 of the following year has:
  380         1. Equipment and physical facilities necessary to provide
  381  trauma services.
  382         2. Personnel in sufficient numbers and with proper
  383  qualifications to provide trauma services.
  384         3. An effective quality assurance process.
  385         4. A submitted written confirmation by the local or
  386  regional trauma agency that the hospital applying to become a
  387  trauma center is consistent with the plan of the local or
  388  regional trauma agency, as approved by the department, if such
  389  agency exists.
  390         (d)1.If the department determines that the hospital is
  391  capable of attaining and operating with the components required
  392  in paragraph (c), the applicant must be ready to operate no
  393  later than April 30 of the following year. A hospital that fails
  394  to comply with this subsection may not be designated as a trauma
  395  center Notwithstanding other provisions in this section, the
  396  department may grant up to an additional 18 months to a hospital
  397  applicant that is unable to meet all requirements as provided in
  398  paragraph (c) at the time of application if the number of
  399  applicants in the service area in which the applicant is located
  400  is equal to or less than the service area allocation, as
  401  provided by rule of the department. An applicant that is granted
  402  additional time pursuant to this paragraph shall submit a plan
  403  for departmental approval which includes timelines and
  404  activities that the applicant proposes to complete in order to
  405  meet application requirements. Any applicant that demonstrates
  406  an ongoing effort to complete the activities within the
  407  timelines outlined in the plan shall be included in the number
  408  of trauma centers at such time that the department has conducted
  409  a provisional review of the application and has determined that
  410  the application is complete and that the hospital has the
  411  critical elements required for a trauma center.
  412         2. Timeframes provided in subsections (1)-(8) shall be
  413  stayed until the department determines that the application is
  414  complete and that the hospital has the critical elements
  415  required for a trauma center.
  416         (3) After April 30, the department shall select one or more
  417  hospitals any hospital that submitted an application found
  418  acceptable by the department based on initial provisional review
  419  for approval to prepare shall be eligible to operate with the
  420  components required in paragraph (2)(c). The number of
  421  applicants selected is limited to available statutory capacity
  422  in the specified trauma service area, as designated in s.
  423  395.402(1). If the department receives more applications than
  424  may be approved under the statutory capacity in the specified
  425  trauma service area, the department must select the best
  426  applicant or applicants from the available pool based on the
  427  department’s determination of the capability of an applicant to
  428  provide the highest quality patient care using the most recent
  429  technological, medical, and staffing resources available, as
  430  well as any other criteria as determined by the department by
  431  rule. The applicant may not operate as a provisional trauma
  432  center until the final evaluation has been completed by the
  433  department.
  434         (4) Between May 1 and April 30 October 1 of the following
  435  each year, the department shall conduct an in-depth evaluation
  436  of all applications found acceptable in the initial provisional
  437  review. The applications shall be evaluated against criteria
  438  enumerated in the application packages as provided to the
  439  hospitals by the department.
  440         (5) Between May 1 and April 30 Beginning October 1 of each
  441  year and ending no later than June 1 of the following year, a
  442  review team of out-of-state experts assembled by the department
  443  shall make onsite visits to all existing provisional trauma
  444  centers. The department shall develop a survey instrument to be
  445  used by the expert team of reviewers. The instrument must shall
  446  include objective criteria and guidelines for reviewers based on
  447  existing trauma center standards such that all trauma centers
  448  are assessed equally. The survey instrument must shall also
  449  include a uniform rating system that will be used by reviewers
  450  must use to indicate the degree of compliance of each trauma
  451  center with specific standards, and to indicate the quality of
  452  care provided by each trauma center as determined through an
  453  audit of patient charts. In addition, hospitals being considered
  454  as proposed provisional trauma centers must shall meet all the
  455  requirements of a trauma center and must shall be located in a
  456  trauma service area that has a need for such a trauma center.
  457         (6) Based on recommendations from the review team, the
  458  department may designate a trauma center that is in compliance
  459  with trauma center standards and with this section shall select
  460  trauma centers by July 1. An applicant may not operate as a
  461  trauma center unless it has been designated as a trauma center
  462  and maintains compliance with the operating requirements listed
  463  in paragraph (2)(c) An applicant for designation as a trauma
  464  center may request an extension of its provisional status if it
  465  submits a corrective action plan to the department. The
  466  corrective action plan must demonstrate the ability of the
  467  applicant to correct deficiencies noted during the applicant’s
  468  onsite review conducted by the department between the previous
  469  October 1 and June 1. The department may extend the provisional
  470  status of an applicant for designation as a trauma center
  471  through December 31 if the applicant provides a corrective
  472  action plan acceptable to the department. The department or a
  473  team of out-of-state experts assembled by the department shall
  474  conduct an onsite visit on or before November 1 to confirm that
  475  the deficiencies have been corrected. The provisional trauma
  476  center is responsible for all costs associated with the onsite
  477  visit in a manner prescribed by rule of the department. By
  478  January 1, the department must approve or deny the application
  479  of any provisional applicant granted an extension. Each trauma
  480  center shall be granted a 7-year approval period during which
  481  time it must continue to maintain trauma center standards and
  482  acceptable patient outcomes as determined by department rule. An
  483  approval, unless sooner suspended or revoked, automatically
  484  expires 7 years after the date of issuance and is renewable upon
  485  application for renewal as prescribed by rule of the department.
  486         (7) Only a Any hospital in the same trauma service area or
  487  in a trauma service area contiguous that wishes to the trauma
  488  service area where the applicant has applied to locate a trauma
  489  center may protest a decision made by the department based on
  490  the department’s preliminary or in-depth review of applications
  491  or on the recommendations of the site visit review team pursuant
  492  to this section shall proceed as provided in chapter 120.
  493  Hearings held under this subsection shall be conducted in the
  494  same manner as provided in ss. 120.569 and 120.57. Cases filed
  495  under chapter 120 may combine all disputes between parties.
  496         (15)(a) A trauma center that was verified by the department
  497  before December 15, 2017, is deemed to have met the trauma
  498  center application and operational requirements of this section.
  499         (b) A trauma center that was not verified by the department
  500  before December 15, 2017, but that was provisionally approved by
  501  the department to be in substantial compliance with Level II
  502  trauma standards before January 1, 2017, and is operating as a
  503  Level II trauma center is deemed to have met the application and
  504  operational requirements of this section for a trauma center.
  505         (c) A trauma center that was not verified by the department
  506  before December 15, 2017, as a Level I trauma center but that
  507  was provisionally approved by the department as a Level I trauma
  508  center in calendar year 2016 is deemed to have met the
  509  application and operational requirements for a Level I trauma
  510  center, if the trauma center complies with the American College
  511  of Surgeons Committee on Trauma standards for adult Level I
  512  trauma centers and does not treat pediatric trauma patients.
  513         (d) A trauma center that was not verified by the department
  514  before December 15, 2017, as a pediatric trauma center but that
  515  was provisionally approved by the department to be in
  516  substantial compliance with the pediatric trauma standards
  517  established by rule before January 1, 2018, and is operating as
  518  a pediatric trauma center is deemed to have met the application
  519  and operational requirements of this section for a pediatric
  520  trauma center.
  521         (e) Notwithstanding the statutory capacity limits
  522  established in s. 395.402(1), any hospital operating as a Level
  523  II trauma center after January 1, 2017, must be designated by
  524  the department as a Level II trauma center if all of the
  525  following apply:
  526         1. The hospital was provisionally approved after January 1,
  527  2017, to operate as a Level II trauma center.
  528         2. The department’s decision to approve the hospital to
  529  operate a provisional Level II trauma center was pending in
  530  litigation on or before January 1, 2018;
  531         3. The hospital has received a final recommended order from
  532  the Division of Administrative Hearings, a final determination
  533  from the department, or an order from a court of competent
  534  jurisdiction that it was entitled to be designated as a Level II
  535  trauma center; and
  536         4. The department determines that the hospital is in
  537  substantial compliance with the Level II trauma center
  538  standards.
  539         Section 3. Section 395.404, Florida Statutes, is amended to
  540  read:
  541         395.404 Review of trauma registry data; report to central
  542  registry; confidentiality and limited release.—
  543         (1)(a) Each trauma center shall participate in the National
  544  Trauma Data Bank.
  545         (2) Each trauma center and acute care hospital shall report
  546  to the department all transfers of trauma patients and the
  547  outcomes of such patients furnish, and, upon request of the
  548  department, all acute care hospitals shall furnish for
  549  department review trauma registry data as prescribed by rule of
  550  the department for the purpose of monitoring patient outcome and
  551  ensuring compliance with the standards of approval.
  552         (b) Trauma registry data obtained pursuant to this
  553  subsection are confidential and exempt from the provisions of s.
  554  119.07(1) and s. 24(a), Art. I of the State Constitution.
  555  However, the department may provide such trauma registry data to
  556  the person, trauma center, hospital, emergency medical service
  557  provider, local or regional trauma agency, medical examiner, or
  558  other entity from which the data were obtained. The department
  559  may also use or provide trauma registry data for purposes of
  560  research in accordance with the provisions of chapter 405.
  561         (3)(2) Each trauma center, pediatric trauma center, and
  562  acute care hospital shall report to the department’s brain and
  563  spinal cord injury central registry, consistent with the
  564  procedures and timeframes of s. 381.74, any person who has a
  565  moderate-to-severe brain or spinal cord injury, and shall
  566  include in the report the name, age, residence, and type of
  567  disability of the individual and any additional information that
  568  the department finds necessary.
  569         Section 4. This act shall take effect upon becoming a law.