Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
CHAMBER ACTION
Senate House
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11 The Committee on Health and Human Services Appropriations
12 (Saunders) recommended the following amendment:
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14 Senate Amendment (with title amendment)
15 Delete everything after the enacting clause
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17 and insert:
18 Section 1. Section 395.4001, Florida Statutes, is
19 amended to read:
20 395.4001 Definitions.--As used in this part, the term:
21 (1) "Agency" means the Agency for Health Care
22 Administration.
23 (2) "Charity care" or "uncompensated trauma care"
24 means that portion of hospital charges reported to the agency
25 for which there is no compensation, other than restricted or
26 unrestricted revenues provided to a hospital by local
27 governments or tax districts regardless of method of payment,
28 for care provided to a patient whose family income for the 12
29 months preceding the determination is less than or equal to
30 200 percent of the federal poverty level, unless the amount of
31 hospital charges due from the patient exceeds 25 percent of
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 the annual family income. However, in no case shall the
2 hospital charges for a patient whose family income exceeds
3 four times the federal poverty level for a family of four be
4 considered charity.
5 (3) "Department" means the Department of Health.
6 (4) "Interfacility trauma transfer" means the transfer
7 of a trauma victim between two facilities licensed under this
8 chapter, pursuant to this part.
9 (5) "International Classification Injury Severity
10 Score" means the statistical method for computing the severity
11 of injuries sustained by trauma patients. The International
12 Classification Injury Severity Score shall be the methodology
13 used by the department and trauma centers to report the
14 severity of an injury.
15 (6)(5) "Level I trauma center" means a trauma center
16 that:
17 (a) Has formal research and education programs for the
18 enhancement of trauma care; is verified by the department to
19 be in substantial compliance with Level I trauma center and
20 pediatric trauma center standards; and has been approved by
21 the department to operate as a Level I trauma center.
22 (b) Serves as a resource facility to Level II trauma
23 centers, pediatric trauma centers, and general hospitals
24 through shared outreach, education, and quality improvement
25 activities.
26 (c) Participates in an inclusive system of trauma
27 care, including providing leadership, system evaluation, and
28 quality improvement activities.
29 (7)(6) "Level II trauma center" means a trauma center
30 that:
31 (a) Is verified by the department to be in substantial
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 compliance with Level II trauma center standards and has been
2 approved by the department to operate as a Level II trauma
3 center.
4 (b) Serves as a resource facility to general hospitals
5 through shared outreach, education, and quality improvement
6 activities.
7 (c) Participates in an inclusive system of trauma
8 care.
9 (8) "Local funding contribution" means local
10 municipal, county, or tax district funding exclusive of any
11 patient-specific funds received pursuant to ss.
12 154.301-154.316, private foundation funding, or public or
13 private grant funding of at least $150,000 received by a
14 hospital or health care system that operates a trauma center.
15 (9)(7) "Pediatric trauma center" means a hospital that
16 is verified by the department to be in substantial compliance
17 with pediatric trauma center standards as established by rule
18 of the department and has been approved by the department to
19 operate as a pediatric trauma center.
20 (10)(8) "Provisional trauma center" means a hospital
21 that has been verified by the department to be in substantial
22 compliance with the requirements in s. 395.4025 and has been
23 approved by the department to operate as a provisional Level I
24 trauma center, Level II trauma center, or pediatric trauma
25 center.
26 (11)(9) "Trauma agency" means a department-approved
27 agency established and operated by one or more counties, or a
28 department-approved entity with which one or more counties
29 contract, for the purpose of administering an inclusive
30 regional trauma system.
31 (12)(10) "Trauma alert victim" means a person who has
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 incurred a single or multisystem injury due to blunt or
2 penetrating means or burns, who requires immediate medical
3 intervention or treatment, and who meets one or more of the
4 adult or pediatric scorecard criteria established by the
5 department by rule.
6 (13) "Trauma caseload volume" means the number of
7 trauma patients reported by individual trauma centers to the
8 Trauma Registry and validated by the department.
9 (14)(11) "Trauma center" means a hospital that has
10 been verified by the department to be in substantial
11 compliance with the requirements in s. 395.4025 and has been
12 approved by the department to operate as a Level I trauma
13 center, Level II trauma center, or pediatric trauma center.
14 (15) "Trauma patient" means a person who has incurred
15 a physical injury or wound caused by trauma and has accessed a
16 trauma center.
17 (16)(12) "Trauma scorecard" means a statewide
18 methodology adopted by the department by rule under which a
19 person who has incurred a traumatic injury is graded as to the
20 severity of his or her injuries or illness and which
21 methodology is used as the basis for making destination
22 decisions.
23 (17)(13) "Trauma transport protocol" means a document
24 which describes the policies, processes, and procedures
25 governing the dispatch of vehicles, the triage, prehospital
26 transport, and interfacility trauma transfer of trauma
27 victims.
28 (18)(14) "Trauma victim" means any person who has
29 incurred a single or multisystem injury due to blunt or
30 penetrating means or burns and who requires immediate medical
31 intervention or treatment.
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 Section 2. Section 395.4035, Florida Statutes, is
2 repealed.
3 Section 3. Subsection (1) of section 395.4036, Florida
4 Statutes, is amended to read:
5 395.4036 Trauma payments.--
6 (1) Recognizing the Legislature's stated intent to
7 provide financial support to the current verified trauma
8 centers and to provide incentives for the establishment of
9 additional trauma centers as part of a system of
10 state-sponsored trauma centers, the department shall utilize
11 funds collected under s. 318.18(15)(14) and deposited into the
12 Administrative Trust Fund of the department to ensure the
13 availability and accessibility of trauma services throughout
14 the state as provided in this subsection.
15 (a) Twenty percent of the total funds collected under
16 this subsection during the state fiscal year shall be
17 distributed to verified trauma centers located in a region
18 that have has a local funding contribution as of December 31.
19 Distribution of funds under this paragraph shall be based on
20 trauma caseload volume for the most recent calendar year
21 available.
22 (b) Forty percent of the total funds collected under
23 this subsection shall be distributed to verified trauma
24 centers based on trauma caseload volume for of the most recent
25 previous calendar year available. The determination of
26 caseload volume for distribution of funds under this paragraph
27 shall be based on the department's Trauma Registry data.
28 (c) Forty percent of the total funds collected under
29 this subsection shall be distributed to verified trauma
30 centers based on severity of trauma patients for the most
31 recent calendar year available. The determination of severity
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 for distribution of funds under this paragraph shall be based
2 on the department's International Classification Injury
3 Severity Scores or another statistically valid and
4 scientifically accepted method of stratifying a trauma
5 patient's severity of injury, risk of mortality, and resource
6 consumption as adopted by the department by rule, weighted
7 based on the costs associated with and incurred by the trauma
8 center in treating trauma patients. The weighting of scores
9 shall be established by the department by rule scores of 1-14
10 and 15 plus.
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12 Funds deposited in the department's Administrative Trust Fund
13 for verified trauma centers may be used to maximize the
14 receipt of federal funds that may be available for such trauma
15 centers. Notwithstanding this section and s. 318.14,
16 distributions to trauma centers may be adjusted in a manner to
17 ensure that total payments to trauma centers represent the
18 same proportional allocation as set forth in this section and
19 s. 318.14. For purposes of this section and s. 318.14, total
20 funds distributed to trauma centers may include revenue from
21 the Administrative Trust Fund and federal funds for which
22 revenue from the Administrative Trust Fund is used to meet
23 state or local matching requirements. Funds collected under
24 ss. 318.14 and 318.18(15) and deposited in the Administrative
25 Trust Fund of the department shall be distributed to trauma
26 centers on a quarterly basis using the most recent calendar
27 year data available. Such data shall not be used for more than
28 four quarterly distributions unless there are extenuating
29 circumstances as determined by the department, in which case
30 the most recent calendar year data available shall continue to
31 be used and appropriate adjustments shall be made as soon as
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 the more recent data becomes available. Trauma centers may
2 request that their distributions from the Administrative Trust
3 Fund be used as intergovernmental transfer funds in the
4 Medicaid program.
5 Section 4. Section 395.41, Florida Statutes, is
6 created to read:
7 395.41 Trauma center startup grant program.--There is
8 established a trauma center startup grant program.
9 (1) The Legislature recognizes the need for a
10 statewide, cohesive, uniform, and integrated trauma system,
11 and the Legislature acknowledges that the state has been
12 divided into trauma service areas. Each of the trauma service
13 areas should have at least one trauma center; however, some
14 trauma service areas do not have a trauma center because of
15 the significant up-front investment of capital required for
16 hospitals to develop the physical space, equipment, and
17 qualified personnel necessary to provide quality trauma
18 services.
19 (2) An acute care general hospital that has submitted
20 a letter of intent and an application to become a trauma
21 center pursuant to s. 395.4025 may apply to the department for
22 a startup grant. The grant applicant must demonstrate that:
23 (a) There are currently no other trauma centers in the
24 hospital's trauma service area as established under s.
25 395.402.
26 (b) There is not a trauma center within a 100-mile
27 radius of the proposed trauma center.
28 (c) The hospital has received a local funding
29 contribution as defined under s. 395.4001.
30 (d) The hospital has incurred startup costs in excess
31 of the amount of grant funding requested.
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 (e) The hospital is pursuing the establishment of a
2 residency program in internal medicine or emergency medicine.
3 (3) A hospital receiving startup grant funding that
4 does not become a provisional trauma center within 24 months
5 after submitting an application to become a trauma center must
6 forfeit any state grant funds received pursuant to this
7 section.
8 (4) A hospital that receives startup grant funding may
9 not receive more than $500,000, must ensure that the startup
10 grant funding is matched on a dollar-for-dollar basis with a
11 local funding contribution, and shall receive startup grant
12 funding only one time.
13 Section 5. This act shall take effect July 1, 2006,
14 except that section 395.41, Florida Statutes, as created by
15 this act, shall take effect subject to an appropriation for
16 the trauma center startup grant program in the 2006-2007
17 General Appropriations Act.
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20 ================ T I T L E A M E N D M E N T ===============
21 And the title is amended as follows:
22 Delete everything before the enacting clause
23
24 and insert:
25 A bill to be entitled
26 An act relating to trauma services; amending s.
27 395.4001, F.S.; providing definitions;
28 repealing s. 395.4035, F.S., to terminate the
29 Trauma Services Trust Fund; amending s.
30 395.4036, F.S.; revising provisions relating to
31 distribution of funds to trauma centers and use
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Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1532
Barcode 495172
1 thereof; creating s. 395.41, F.S.; establishing
2 a trauma center startup grant program;
3 providing conditions for the receipt of a
4 startup grant; providing limitations; making
5 the trauma center startup grant program subject
6 to an appropriation in the General
7 Appropriations Act; providing a contingent
8 effective date.
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