Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
CHAMBER ACTION
Senate House
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05/03/2006 04:12 PM .
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11 Senator Saunders moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 38, lines 17 and 18, delete those lines
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16 and insert:
17 Section 16. Section 395.4001, Florida Statutes, is
18 amended to read:
19 395.4001 Definitions.--As used in this part, the term:
20 (1) "Agency" means the Agency for Health Care
21 Administration.
22 (2) "Charity care" or "uncompensated trauma care"
23 means that portion of hospital charges reported to the agency
24 for which there is no compensation, other than restricted or
25 unrestricted revenues provided to a hospital by local
26 governments or tax districts regardless of method of payment,
27 for care provided to a patient whose family income for the 12
28 months preceding the determination is less than or equal to
29 200 percent of the federal poverty level, unless the amount of
30 hospital charges due from the patient exceeds 25 percent of
31 the annual family income. However, in no case shall the
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 hospital charges for a patient whose family income exceeds
2 four times the federal poverty level for a family of four be
3 considered charity.
4 (3) "Department" means the Department of Health.
5 (4) "Interfacility trauma transfer" means the transfer
6 of a trauma victim between two facilities licensed under this
7 chapter, pursuant to this part.
8 (5) "International Classification Injury Severity
9 Score" means the statistical method for computing the severity
10 of injuries sustained by trauma patients. The International
11 Classification Injury Severity Score shall be the methodology
12 used by the department and trauma centers to report the
13 severity of an injury.
14 (6)(5) "Level I trauma center" means a trauma center
15 that:
16 (a) Has formal research and education programs for the
17 enhancement of trauma care; is verified by the department to
18 be in substantial compliance with Level I trauma center and
19 pediatric trauma center standards; and has been approved by
20 the department to operate as a Level I trauma center.
21 (b) Serves as a resource facility to Level II trauma
22 centers, pediatric trauma centers, and general hospitals
23 through shared outreach, education, and quality improvement
24 activities.
25 (c) Participates in an inclusive system of trauma
26 care, including providing leadership, system evaluation, and
27 quality improvement activities.
28 (7)(6) "Level II trauma center" means a trauma center
29 that:
30 (a) Is verified by the department to be in substantial
31 compliance with Level II trauma center standards and has been
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 approved by the department to operate as a Level II trauma
2 center.
3 (b) Serves as a resource facility to general hospitals
4 through shared outreach, education, and quality improvement
5 activities.
6 (c) Participates in an inclusive system of trauma
7 care.
8 (8) "Local funding contribution" means local
9 municipal, county, or tax district funding exclusive of any
10 patient-specific funds received pursuant to ss.
11 154.301-154.316, private foundation funding, or public or
12 private grant funding of at least $150,000 received by a
13 hospital or health care system that operates a trauma center.
14 (9)(7) "Pediatric trauma center" means a hospital that
15 is verified by the department to be in substantial compliance
16 with pediatric trauma center standards as established by rule
17 of the department and has been approved by the department to
18 operate as a pediatric trauma center.
19 (10)(8) "Provisional trauma center" means a hospital
20 that has 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 provisional Level I
23 trauma center, Level II trauma center, or pediatric trauma
24 center.
25 (11)(9) "Trauma agency" means a department-approved
26 agency established and operated by one or more counties, or a
27 department-approved entity with which one or more counties
28 contract, for the purpose of administering an inclusive
29 regional trauma system.
30 (12)(10) "Trauma alert victim" means a person who has
31 incurred a single or multisystem injury due to blunt or
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 penetrating means or burns, who requires immediate medical
2 intervention or treatment, and who meets one or more of the
3 adult or pediatric scorecard criteria established by the
4 department by rule.
5 (13) "Trauma caseload volume" means the number of
6 trauma patients reported by individual trauma centers to the
7 Trauma Registry and validated by the department.
8 (14)(11) "Trauma center" means a hospital that has
9 been verified by the department to be in substantial
10 compliance with the requirements in s. 395.4025 and has been
11 approved by the department to operate as a Level I trauma
12 center, Level II trauma center, or pediatric trauma center.
13 (15) "Trauma patient" means a person who has incurred
14 a physical injury or wound caused by trauma and has accessed a
15 trauma center.
16 (16)(12) "Trauma scorecard" means a statewide
17 methodology adopted by the department by rule under which a
18 person who has incurred a traumatic injury is graded as to the
19 severity of his or her injuries or illness and which
20 methodology is used as the basis for making destination
21 decisions.
22 (17)(13) "Trauma transport protocol" means a document
23 which describes the policies, processes, and procedures
24 governing the dispatch of vehicles, the triage, prehospital
25 transport, and interfacility trauma transfer of trauma
26 victims.
27 (18)(14) "Trauma victim" means any person who has
28 incurred a single or multisystem injury due to blunt or
29 penetrating means or burns and who requires immediate medical
30 intervention or treatment.
31 Section 17. Section 395.4035, Florida Statutes, is
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
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1 repealed.
2 Section 18. Subsection (1) of section 395.4036,
3 Florida Statutes, is amended to read:
4 395.4036 Trauma payments.--
5 (1) Recognizing the Legislature's stated intent to
6 provide financial support to the current verified trauma
7 centers and to provide incentives for the establishment of
8 additional trauma centers as part of a system of
9 state-sponsored trauma centers, the department shall utilize
10 funds collected under s. 318.18(15)(14) and deposited into the
11 Administrative Trust Fund of the department to ensure the
12 availability and accessibility of trauma services throughout
13 the state as provided in this subsection.
14 (a) Twenty percent of the total funds collected under
15 this subsection during the state fiscal year shall be
16 distributed to verified trauma centers located in a region
17 that have has a local funding contribution as of December 31.
18 Distribution of funds under this paragraph shall be based on
19 trauma caseload volume for the most recent calendar year
20 available.
21 (b) Forty percent of the total funds collected under
22 this subsection shall be distributed to verified trauma
23 centers based on trauma caseload volume for of the most recent
24 previous calendar year available. The determination of
25 caseload volume for distribution of funds under this paragraph
26 shall be based on the department's Trauma Registry data.
27 (c) Forty percent of the total funds collected under
28 this subsection shall be distributed to verified trauma
29 centers based on severity of trauma patients for the most
30 recent calendar year available. The determination of severity
31 for distribution of funds under this paragraph shall be based
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
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1 on the department's International Classification Injury
2 Severity Scores or another statistically valid and
3 scientifically accepted method of stratifying a trauma
4 patient's severity of injury, risk of mortality, and resource
5 consumption as adopted by the department by rule, weighted
6 based on the costs associated with and incurred by the trauma
7 center in treating trauma patients. The weighting of scores
8 shall be established by the department by rule scores of 1-14
9 and 15 plus.
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11 Funds deposited in the department's Administrative Trust Fund
12 for verified trauma centers may be used to maximize the
13 receipt of federal funds that may be available for such trauma
14 centers. Notwithstanding this section and s. 318.14,
15 distributions to trauma centers may be adjusted in a manner to
16 ensure that total payments to trauma centers represent the
17 same proportional allocation as set forth in this section and
18 s. 318.14. For purposes of this section and s. 318.14, total
19 funds distributed to trauma centers may include revenue from
20 the Administrative Trust Fund and federal funds for which
21 revenue from the Administrative Trust Fund is used to meet
22 state or local matching requirements. Funds collected under
23 ss. 318.14 and 318.18(15) and deposited in the Administrative
24 Trust Fund of the department shall be distributed to trauma
25 centers on a quarterly basis using the most recent calendar
26 year data available. Such data shall not be used for more than
27 four quarterly distributions unless there are extenuating
28 circumstances as determined by the department, in which case
29 the most recent calendar year data available shall continue to
30 be used and appropriate adjustments shall be made as soon as
31 the more recent data becomes available. Trauma centers may
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 request that their distributions from the Administrative Trust
2 Fund be used as intergovernmental transfer funds in the
3 Medicaid program.
4 Section 19. Section 395.41, Florida Statutes, is
5 created to read:
6 395.41 Trauma center startup grant program.--There is
7 established a trauma center startup grant program.
8 (1) The Legislature recognizes the need for a
9 statewide, cohesive, uniform, and integrated trauma system,
10 and the Legislature acknowledges that the state has been
11 divided into trauma service areas. Each of the trauma service
12 areas should have at least one trauma center; however, some
13 trauma service areas do not have a trauma center because of
14 the significant up-front investment of capital required for
15 hospitals to develop the physical space, equipment, and
16 qualified personnel necessary to provide quality trauma
17 services.
18 (2) An acute care general hospital that has submitted
19 a letter of intent and an application to become a trauma
20 center pursuant to s. 395.4025 may apply to the department for
21 a startup grant. The grant applicant must demonstrate that:
22 (a) There are currently no other trauma centers in the
23 hospital's trauma service area as established under s.
24 395.402.
25 (b) There is not a trauma center within a 100-mile
26 radius of the proposed trauma center.
27 (c) The hospital has received a local funding
28 contribution as defined under s. 395.4001.
29 (d) The hospital has incurred startup costs in excess
30 of the amount of grant funding requested.
31 (e) The hospital is pursuing the establishment of a
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 residency program in internal medicine or emergency medicine.
2 (3) A hospital receiving startup grant funding that
3 does not become a provisional trauma center within 24 months
4 after submitting an application to become a trauma center must
5 forfeit any state grant funds received pursuant to this
6 section.
7 (4) A hospital that receives startup grant funding may
8 not receive more than $500,000, must ensure that the startup
9 grant funding is matched on a dollar-for-dollar basis with a
10 local funding contribution, and shall receive startup grant
11 funding only one time.
12 Section 20. This act shall take effect July 1, 2006,
13 except that sections 1-15 of this act shall take effect
14 October 1, 2006, and section 395.41, Florida Statutes, as
15 created by this act, shall take effect subject to an
16 appropriation for the trauma center startup grant program in
17 the 2006-2007 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 On page 5, line 16, delete that line
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24 and insert:
25 amending s. 395.4001, F.S.; providing
26 definitions; repealing s. 395.4035, F.S., to
27 terminate the Trauma Services Trust Fund;
28 amending s. 395.4036, F.S.; revising provisions
29 relating to distribution of funds to trauma
30 centers and use thereof; creating s. 395.41,
31 F.S.; establishing a trauma center startup
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Florida Senate - 2006 SENATOR AMENDMENT
Bill No. CS for SB 2214
Barcode 333142
1 grant program; providing conditions for the
2 receipt of a startup grant; providing
3 limitations; making the trauma center startup
4 grant program subject to an appropriation in
5 the General Appropriations Act; providing
6 effective dates.
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