Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1276
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       Senator Diaz de la Portilla moved the following:
    1         Senate Amendment (with title amendment)
    3         Between lines 146 and 147
    4  insert:
    5         Section 4. Section 395.4027, Florida Statutes, is created
    6  to read:
    7         395.4027 Florida Tele-trauma Pilot Project.—
    8         (1) DEFINITION.—As used in this section, the term “tele
    9  trauma health care” means the remote management or assistance in
   10  management of the care of a trauma patient using telemedicine
   11  technology to allow the remote presence of a health care
   12  provider from a Level I trauma center in geographic areas in
   13  which such trauma centers are not available.
   15         (a) A pilot project is created to allow a teaching hospital
   16  with multiple hospitals operating under a single license that is
   17  in a county with a population of more than two million people
   18  and also serves as the surgical training facility for branches
   19  of the United States military to provide trauma services at any
   20  of its hospitals through the use of telemedicine from its
   21  existing level I trauma center, provided that the hospitals that
   22  provide these services meet the requirements for staffing and
   23  infrastructure of a level II trauma center.
   24         (b) Additional trauma centers may not apply or be verified
   25  in the impacted trauma service area for the duration of the
   26  pilot project.
   27         (3) EXPIRATION.—The authorization for the pilot project and
   28  the provisions of this section shall expire on December 31,
   29  2021.
   30         Section 5. Section 395.4045, Florida Statutes, is amended
   31  to read:
   32         395.4045 Emergency medical service providers; trauma
   33  transport protocols; transport of trauma alert victims to trauma
   34  centers or tele-trauma hospitals; interfacility transfer.—
   35         (1) Each emergency medical services provider licensed under
   36  chapter 401 shall transport trauma alert victims to hospitals
   37  approved as trauma centers or participating in the tele-trauma
   38  pilot project pursuant to s. 395.4027, except as may be provided
   39  for either in the department-approved trauma transport protocol
   40  of the trauma agency for the geographical area in which the
   41  emergency medical services licensee provides services or, if no
   42  such department-approved trauma transport protocol is in effect,
   43  as provided for in a department-approved provider’s trauma
   44  transport protocol.
   45         (2) A trauma agency may develop a uniform trauma transport
   46  protocol that is applicable to the emergency medical services
   47  licensees providing services within the geographical boundaries
   48  of the trauma agency, including hospitals participating in the
   49  tele-trauma pilot project under s. 395.4027. Development of a
   50  uniform trauma protocol by a trauma agency shall be through
   51  consultation with interested parties, including, but not limited
   52  to, each approved trauma center; physicians specializing in
   53  trauma care, emergency care, and surgery in the region; each
   54  trauma system administrator in the region; each emergency
   55  medical service provider in the region licensed under chapter
   56  401, and such providers’ respective medical directors.
   57         (3) Trauma alert victims shall be identified through the
   58  use of a trauma scoring system, including adult and pediatric
   59  assessment as specified in rule of the department. The rule
   60  shall also include the requirements of licensed emergency
   61  medical services providers for performing and documenting these
   62  assessments.
   63         (4) The department shall specify by rule the subjects and
   64  the minimum criteria related to prehospital trauma transport;,
   65  trauma center, tele-trauma center, or hospital destination
   66  determinations;, and interfacility trauma transfer transport by
   67  an emergency medical services provider to be included in a
   68  trauma agency’s or emergency medical service provider’s trauma
   69  transport protocol and shall approve or disapprove each such
   70  protocol. Trauma transport protocol rules pertaining to the air
   71  transportation of trauma victims shall be consistent with, but
   72  not limited to, applicable Federal Aviation Administration
   73  regulation. Emergency medical services licensees and trauma
   74  agencies shall be subject to monitoring by the department, under
   75  ss. 395.401(3) and 401.31(1) for compliance with requirements,
   76  as applicable, regarding trauma transport protocols and the
   77  transport of trauma victims.
   78         (5) If there is no department-approved trauma agency trauma
   79  transport protocol for the geographical area in which the
   80  emergency medical services license applicant intends to provide
   81  services, as provided for in subsection (1), each applicant for
   82  licensure as an emergency medical services provider, under
   83  chapter 401, must submit and obtain department approval of a
   84  trauma transport protocol prior to the department granting a
   85  license. The department shall prescribe by rule the submission
   86  and approval process for an applicant’s trauma transport
   87  protocols whether the applicant will be using a trauma agency’s
   88  or its own trauma transport protocol.
   89         (6) If an air ambulance service is available in the trauma
   90  service area in which an emergency medical service provider is
   91  located, trauma transport protocols shall not provide for
   92  transport outside of the trauma service area unless otherwise
   93  provided for by written mutual agreement. If air ambulance
   94  service is not available and there is no agreement for
   95  interagency transport of trauma patients between two adjacent
   96  local or regional trauma agencies, both of which include at
   97  least one approved trauma center, then the transport of a trauma
   98  patient with an immediately life-threatening condition shall be
   99  to the most appropriate trauma center as defined pursuant to
  100  trauma transport protocols approved by the department. The
  101  provisions of this subsection shall apply only to those counties
  102  with a population in excess of 1 million residents.
  103         (7) Prior to an interfacility trauma transfer, the
  104  emergency medical services provider’s medical director or his or
  105  her designee must agree, pursuant to protocols and procedures in
  106  the emergency medical services provider’s trauma transport
  107  protocol, that the staff of the transport vehicle has the
  108  medical skills, equipment, and resources to provide anticipated
  109  patient care as proposed by the transferring physician. The
  110  emergency medical services provider’s medical director or his or
  111  her designee may require appropriate staffing, equipment, and
  112  resources to ensure proper patient care and safety during
  113  transfer.
  114         (8) The department shall adopt and enforce all rules
  115  necessary to administer this section. The department shall adopt
  116  and enforce rules to specify the submission and approval process
  117  for trauma transport protocols or modifications to trauma
  118  transport protocols by trauma agencies and licensed emergency
  119  medical services providers.
  121  ================= T I T L E  A M E N D M E N T ================
  122  And the title is amended as follows:
  123         Delete line 22
  124  and insert:
  125         expiration; creating s. 395.4027, F.S.; establishing
  126         the Florida Tele-Trauma Pilot Project; defining the
  127         term “tele-trauma health care”; authorizing certain
  128         hospitals to provide remote care to trauma patients at
  129         satellite hospitals under certain circumstances;
  130         prohibiting the application or verification of
  131         additional trauma centers in the impacted trauma
  132         service area for the duration of the pilot project;
  133         providing for future expiration of the pilot project;
  134         amending s. 395.4045, F.S.; requiring emergency
  135         medical service providers to transport trauma alert
  136         victims to hospitals participating in the tele-trauma
  137         pilot project; revising the authorized uniform trauma
  138         transport protocol; requiring the Department of Health
  139         to specify by rule certain subjects and criteria
  140         related to the transport of trauma victims to and from
  141         a tele-trauma center; providing an effective date.