Senate Bill sb1532c1
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Florida Senate - 2006 CS for SB 1532
By the Committee on Health Care; and Senator Lynn
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1 A bill to be entitled
2 An act relating to trauma services; amending s.
3 395.4001, F.S.; providing definitions;
4 repealing s. 395.4035, F.S., to terminate the
5 Trauma Services Trust Fund; amending s.
6 395.4036, F.S.; revising provisions relating to
7 distribution of funds to trauma centers and use
8 thereof; requiring the Department of Health to
9 adopt rules for purposes of calculating
10 payments to trauma centers; requiring that the
11 most recent calendar year data be used for
12 purposes of distributing funds to trauma
13 centers; creating s. 395.6062, F.S.; creating
14 the trauma center startup grant program;
15 providing for certain acute care general
16 hospitals to apply to the Department of Health
17 for a startup grant; providing requirements for
18 eligibility to receive a grant; requiring that
19 a hospital forfeit its grant funds if it does
20 not become a provisional trauma center within a
21 specified period after receiving a grant;
22 providing an appropriation; providing an
23 effective date.
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25 Be It Enacted by the Legislature of the State of Florida:
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27 Section 1. Section 395.4001, Florida Statutes, is
28 amended to read:
29 395.4001 Definitions.--As used in this part, the term:
30 (1) "Agency" means the Agency for Health Care
31 Administration.
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Florida Senate - 2006 CS for SB 1532
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1 (2) "Charity care" or "uncompensated trauma care"
2 means that portion of hospital charges reported to the agency
3 for which there is no compensation, other than restricted or
4 unrestricted revenues provided to a hospital by local
5 governments or tax districts regardless of method of payment,
6 for care provided to a patient whose family income for the 12
7 months preceding the determination is less than or equal to
8 200 percent of the federal poverty level, unless the amount of
9 hospital charges due from the patient exceeds 25 percent of
10 the annual family income. However, in no case shall the
11 hospital charges for a patient whose family income exceeds
12 four times the federal poverty level for a family of four be
13 considered charity.
14 (3) "Department" means the Department of Health.
15 (4) "Interfacility trauma transfer" means the transfer
16 of a trauma victim between two facilities licensed under this
17 chapter, pursuant to this part.
18 (5) "International Classification Injury Severity
19 Score" means the statistical method for computing the severity
20 of injury sustained by trauma patients. The International
21 Classification Injury Severity Score shall be the methodology
22 used by the department and trauma centers to report the
23 severity of an injury.
24 (6)(5) "Level I trauma center" means a trauma center
25 that:
26 (a) Has formal research and education programs for the
27 enhancement of trauma care; is verified by the department to
28 be in substantial compliance with Level I trauma center and
29 pediatric trauma center standards; and has been approved by
30 the department to operate as a Level I trauma center.
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Florida Senate - 2006 CS for SB 1532
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1 (b) Serves as a resource facility to Level II trauma
2 centers, pediatric trauma centers, and general hospitals
3 through shared outreach, education, and quality improvement
4 activities.
5 (c) Participates in an inclusive system of trauma
6 care, including providing leadership, system evaluation, and
7 quality improvement activities.
8 (7)(6) "Level II trauma center" means a trauma center
9 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.
14 (b) Serves as a resource facility to general hospitals
15 through shared outreach, education, and quality improvement
16 activities.
17 (c) Participates in an inclusive system of trauma
18 care.
19 (8) "Local funding contribution" means funds from a
20 municipality, county, or tax district, exclusive of any
21 patient-specific funds received under ss. 154.301-154.316;
22 funds from a private foundation; or public or private grant
23 funds of at least $150,000 which are received by a hospital or
24 health care system that operates a trauma center.
25 (9)(7) "Pediatric trauma center" means a hospital that
26 is verified by the department to be in substantial compliance
27 with pediatric trauma center standards as established by rule
28 of the department and has been approved by the department to
29 operate as a pediatric trauma center.
30 (10)(8) "Provisional trauma center" means a hospital
31 that has been verified by the department to be in substantial
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Florida Senate - 2006 CS for SB 1532
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1 compliance with the requirements in s. 395.4025 and has been
2 approved by the department to operate as a provisional Level I
3 trauma center, Level II trauma center, or pediatric trauma
4 center.
5 (11)(9) "Trauma agency" means a department-approved
6 agency established and operated by one or more counties, or a
7 department-approved entity with which one or more counties
8 contract, for the purpose of administering an inclusive
9 regional trauma system.
10 (12)(10) "Trauma alert victim" means a person who has
11 incurred a single or multisystem injury due to blunt or
12 penetrating means or burns, who requires immediate medical
13 intervention or treatment, and who meets one or more of the
14 adult or pediatric scorecard criteria established by the
15 department by rule.
16 (13) "Trauma caseload volume" means the number of
17 trauma patients reported by individual trauma centers to the
18 Trauma Registry and validated by the department.
19 (14)(11) "Trauma center" means a hospital that has
20 been verified by the department to be in substantial
21 compliance with the requirements in s. 395.4025 and has been
22 approved by the department to operate as a Level I trauma
23 center, Level II trauma center, or pediatric trauma center.
24 (15) "Trauma patient" means a person who has incurred
25 a physical injury or wound caused by trauma and has accessed a
26 trauma center.
27 (16)(12) "Trauma scorecard" means a statewide
28 methodology adopted by the department by rule under which a
29 person who has incurred a traumatic injury is graded as to the
30 severity of his or her injuries or illness and which
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1 methodology is used as the basis for making destination
2 decisions.
3 (17)(13) "Trauma transport protocol" means a document
4 which describes the policies, processes, and procedures
5 governing the dispatch of vehicles, the triage, prehospital
6 transport, and interfacility trauma transfer of trauma
7 victims.
8 (18)(14) "Trauma victim" means any person who has
9 incurred a single or multisystem injury due to blunt or
10 penetrating means or burns and who requires immediate medical
11 intervention or treatment.
12 Section 2. Section 395.4035, Florida Statutes, is
13 repealed.
14 Section 3. Subsection (1) of section 395.4036, Florida
15 Statutes, is amended to read:
16 395.4036 Trauma payments.--
17 (1) Recognizing the Legislature's stated intent to
18 provide financial support to the current verified trauma
19 centers and to provide incentives for the establishment of
20 additional trauma centers as part of a system of
21 state-sponsored trauma centers, the department shall utilize
22 funds collected under s. 318.18(15) s. 318.18(14) and
23 deposited into the Administrative Trust Fund of the department
24 to ensure the availability and accessibility of trauma
25 services throughout the state as provided in this subsection.
26 (a) Twenty percent of the total funds collected under
27 this subsection during the state fiscal year shall be
28 distributed to verified trauma centers located in a region
29 that have has a local funding contribution as of December 31.
30 Distribution of funds under this paragraph shall be based on
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1 the department's Trauma Registry trauma caseload volume for
2 the most recent calendar year available.
3 (b) Forty percent of the total funds collected under
4 this subsection shall be distributed to verified trauma
5 centers based on trauma caseload volume of the most recent
6 previous calendar year available. The determination of
7 caseload volume for distribution of funds under this paragraph
8 shall be based on the department's Trauma Registry data.
9 (c) Forty percent of the total funds collected under
10 this subsection shall be distributed to verified trauma
11 centers based on severity of trauma patients for the most
12 recent calendar year available. The determination of severity
13 for distribution of funds under this paragraph shall be based
14 on the department's Trauma Registry International
15 Classification Injury Severity Scores or other statistically
16 valid and scientifically accepted methods of stratifying a
17 trauma patient's severity of injury, risk of mortality, and
18 resource consumption as adopted by the department by rule,
19 weighted based on the costs associated with and incurred by
20 the trauma center in treating trauma patients. The weighting
21 of scores shall be established by the department by rule
22 scores of 1-14 and 15 plus.
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24 Funds deposited in the department's Administrative Trust Fund
25 for verified trauma centers may be used to maximize the
26 receipt of federal funds that may be available for such trauma
27 centers. Notwithstanding this section and s. 318.14,
28 distributions to trauma centers may be adjusted in a manner to
29 ensure that total payments to trauma centers represent the
30 same proportional allocation as set forth in this section and
31 s. 318.14. For purposes of this section and s. 318.14, total
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1 funds distributed to trauma centers may include revenue from
2 the Administrative Trust Fund and federal funds for which
3 revenue from the Administrative Trust Fund is used to meet
4 state or local matching requirements. Funds collected under
5 ss. 318.14 and 318.18(15) and deposited into the
6 Administrative Trust Fund of the department shall be
7 distributed to trauma centers each quarter using the most
8 recent calendar year data that is available. Such data may not
9 be used for more than four quarterly distributions unless
10 there are extenuating circumstances, as determined by the
11 department, in which case the most recent calendar year data
12 available shall continue to be used and, as soon as the more
13 recent data becomes available, adjustments shall be made
14 accordingly. Trauma centers may request that their
15 distributions from the Administrative Trust Fund be used as
16 intergovernmental transfer funds in the Medicaid program.
17 Section 4. Section 395.6062, Florida Statutes, is
18 created to read:
19 395.6062 Trauma center startup grant program.--There
20 is established a trauma center startup grant program.
21 (1) The Legislature recognizes the need for a
22 statewide, cohesive, uniform, and integrated trauma system,
23 and the Legislature acknowledges that the state has been
24 divided into trauma service areas. Each of the trauma service
25 areas should have at least one trauma center; however, some
26 trauma service areas do not have a trauma center because of
27 the significant up-front investment of capital which is needed
28 by hospitals to develop the physical space, equipment, and
29 qualified personnel necessary to provide quality trauma
30 services.
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Florida Senate - 2006 CS for SB 1532
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1 (2) An acute care general hospital that has submitted
2 a letter of intent and an application to become a trauma
3 center pursuant to s. 395.4025 may apply to the department for
4 a startup grant. The grant applicant must demonstrate that:
5 (a) There are currently no other trauma centers in the
6 hospital's trauma service area as established under s.
7 395.402.
8 (b) There is not a trauma center within a 100-mile
9 radius of the proposed trauma center.
10 (c) The hospital has received a local funding
11 contribution as defined under s. 395.4001.
12 (d) The hospital has incurred startup costs in excess
13 of the amount of grant funding requested.
14 (e) The hospital is pursuing the establishment of a
15 residency program in emergency medicine.
16 (3) Any hospital receiving startup grant funding which
17 does not become a provisional trauma center within 24 months
18 after submitting an application to become a trauma center must
19 forfeit any state grant funds received pursuant to this
20 section.
21 Section 5. For the 2006-2007 fiscal year only, the sum
22 of $500,000 is appropriated from the General Revenue Fund for
23 deposit into the Administrative Trust Fund in the Department
24 of Health for the purpose of providing trauma center startup
25 grants under s. 395.6062, Florida Statutes. A single hospital
26 may not receive more than $500,000, startup grant funds must
27 be matched dollar-for-dollar with a local funding
28 contribution, and startup grant funds shall be provided to a
29 hospital only once.
30 Section 6. This act shall take effect July 1, 2006.
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1 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
2 Senate Bill 1532
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4 The committee substitute adds a definition for local funding
contribution. Instead of using data from the previous calendar
5 year, data will be used from the most recent calendar year
available. The committee substitute no longer requires an
6 independent entity to conduct an audit of the trauma registry.
The committee substitute specifies that funds will be
7 distributed to trauma centers on a quarterly basis using the
most recent calendar year data available. The data will not be
8 used for more than four quarters unless there are extenuating
circumstances as determined by the Department of Health (DOH)
9 and then adjustments will be made when new data is available.
The committee substitute creates the trauma center startup
10 grant program, outlining the requirements for eligibility. The
committee substitute provides for a one time appropriation of
11 $500,000 to be deposited in the DOH Administrative Trust Fund
for the grant program.
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