Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1354
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 6/AD/2R         .                                
             04/28/2014 07:10 PM       .                                

       Senator Grimsley moved the following:
    1         Senate Amendment (with title amendment)
    3         Delete line 365
    4  and insert:
    5         Section 10. Effective upon this act becoming a law,
    6  paragraph (a) of subsection (7) and subsection (14) of section
    7  395.4001, Florida Statutes, are amended to read:
    8         395.4001 Definitions.—As used in this part, the term:
    9         (7) “Level II trauma center” means a trauma center 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 or is designated pursuant to s. 395.4025(13) s.
   14  395.4025(14).
   15         (14) “Trauma center” means a hospital that has been
   16  verified by the department to be in substantial compliance with
   17  the requirements in s. 395.4025 and has been approved by the
   18  department to operate as a Level I trauma center, Level II
   19  trauma center, or pediatric trauma center, or is designated by
   20  the department as a Level II trauma center pursuant to s.
   21  395.4025(13) s. 395.4025(14).
   22         Section 11. Effective upon this act becoming a law, present
   23  paragraphs (k) through (o) of subsection (1) of section 395.401,
   24  Florida Statutes, are redesignated as paragraphs (l) through
   25  (p), respectively, a new paragraph (k) is added to that
   26  subsection, and present paragraph (k) of that subsection is
   27  amended, to read:
   28         395.401 Trauma services system plans; approval of trauma
   29  centers and pediatric trauma centers; procedures; renewal.—
   30         (1)
   31         (k) A hospital operating a trauma center may not charge a
   32  trauma activation fee greater than $15,000. This paragraph
   33  expires on July 1, 2015.
   34         (l)(k)A It is unlawful for any hospital or other facility
   35  may not to hold itself out as a trauma center unless it has been
   36  so verified or designated pursuant to s. 395.4025(13) s.
   37  395.4025(14).
   38         Section 12. Effective upon this act becoming a law,
   39  subsection (5) is added to section 395.402, Florida Statutes, to
   40  read:
   41         395.402 Trauma service areas; number and location of trauma
   42  centers.—
   43         (5)By October 1, 2014, the department must convene the
   44  Florida Trauma System Plan Advisory Council in order to review
   45  the Trauma System Consultation Report issued by the American
   46  College of Surgeons Committee on Trauma dated February 2-5,
   47  2013. Based on this review, the advisory council must submit
   48  recommendations, including recommended statutory changes, to the
   49  President of the Senate and the Speaker of the House of
   50  Representatives by February 1, 2015. The advisory council may
   51  make recommendations to the State Surgeon General regarding the
   52  continuing development of the state trauma system. The advisory
   53  council shall consist of nine representatives of an inclusive
   54  trauma system appointed by the State Surgeon General as follows:
   55         (a)A trauma patient, or a family member of a trauma
   56  patient, who has sustained and recovered from severe injuries;
   57         (b)A member of the Florida Committee on Trauma;
   58         (c)A member of the Association of Florida Trauma
   59  Coordinators;
   60         (d)A chief executive officer of a nontrauma acute care
   61  hospital who is a member of the Florida Hospital Association;
   62         (e)A member of the Florida Emergency Medical Services
   63  Advisory Council;
   64         (f)A member of the Florida Injury Prevention Advisory
   65  Council;
   66         (g)A member of the Brain and Spinal Cord Injury Program
   67  Advisory Council;
   68         (h)A member of the Florida Chamber of Commerce; and
   69         (i)A member of the Florida Health Insurance Advisory
   70  Board.
   71         Section 13. Effective upon this act becoming a law, present
   72  subsections (8) through (12) of section 395.4025, Florida
   73  Statutes, are redesignated as subsections (7) through (11),
   74  respectively, paragraph (d) of subsection (2) and present
   75  subsection (7) of that section are amended, present subsections
   76  (13) and (14) of that section are redesignated as subsections
   77  (12) and (13), respectively, and amended, and a new subsection
   78  (14) and subsection (15) are added to that section, to read:
   79         395.4025 Trauma centers; selection; quality assurance;
   80  records.—
   81         (2)
   82         (d)1. Notwithstanding other provisions in this section, the
   83  department may grant up to an additional 18 months to a hospital
   84  applicant that is unable to meet all requirements as provided in
   85  paragraph (c) at the time of application if the number of
   86  applicants in the service area in which the applicant is located
   87  is equal to or less than the service area allocation, as
   88  provided by rule of the department. An applicant that is granted
   89  additional time under pursuant to this paragraph shall submit a
   90  plan for departmental approval which includes timelines and
   91  activities that the applicant proposes to complete in order to
   92  meet application requirements. An Any applicant that
   93  demonstrates an ongoing effort to complete the activities within
   94  the timelines outlined in the plan shall be included in the
   95  number of trauma centers at such time that the department has
   96  conducted a provisional review of the application and has
   97  determined that the application is complete and that the
   98  hospital has the critical elements required for a trauma center.
   99         2. Timeframes provided in subsections (1)-(7) (1)-(8) shall
  100  be stayed until the department determines that the application
  101  is complete and that the hospital has the critical elements
  102  required for a trauma center.
  103         (7) Any hospital that wishes to protest a decision made by
  104  the department based on the department’s preliminary or in-depth
  105  review of applications or on the recommendations of the site
  106  visit review team pursuant to this section shall proceed as
  107  provided in chapter 120. Hearings held under this subsection
  108  shall be conducted in the same manner as provided in ss. 120.569
  109  and 120.57. Cases filed under chapter 120 may combine all
  110  disputes between parties.
  111         (12)(13) The department may adopt, by rule, the procedures
  112  and process by which it will select trauma centers. Such
  113  procedures and process must be used in annually selecting trauma
  114  centers and must be consistent with subsections (1)-(7) (1)-(8)
  115  except in those situations in which it is in the best interest
  116  of, and mutually agreed to by, all applicants within a service
  117  area and the department to reduce the timeframes.
  118         (13)(14) Notwithstanding the procedures established
  119  pursuant to subsections (1)-(12) (1) through (13), hospitals
  120  located in areas with limited access to trauma center services
  121  shall be designated by the department as Level II trauma centers
  122  based on documentation of a valid certificate of trauma center
  123  verification from the American College of Surgeons. Areas with
  124  limited access to trauma center services are defined by the
  125  following criteria:
  126         (a) The hospital is located in a trauma service area with a
  127  population greater than 600,000 persons but a population density
  128  of less than 225 persons per square mile;
  129         (b) The hospital is located in a county with no verified
  130  trauma center; and
  131         (c) The hospital is located at least 15 miles or 20 minutes
  132  travel time by ground transport from the nearest verified trauma
  133  center.
  134         (14)Notwithstanding any other law, a hospital designated
  135  as a provisional or verified as a Level I, Level II, or
  136  pediatric trauma center after the enactment of chapter 2004-259,
  137  Laws of Florida, whose approval has not been revoked may
  138  continue to operate at the same trauma center level as a Level
  139  I, Level II, or pediatric trauma center until the approval
  140  period in subsection (6) expires, as long as the hospital
  141  continues to meet the other requirements of part II of this
  142  chapter related to trauma center standards and patient outcomes.
  143  Any hospital that meets the requirements of this section is
  144  eligible for renewal of its 7-year approval period pursuant to
  145  subsection (6).
  146         (15) The department may not verify, designate, or
  147  provisionally approve any hospital to operate as a trauma center
  148  through the procedures established in subsections (1)-(13). This
  149  subsection expires July 1, 2015.
  150         Section 14. Except as otherwise expressly provided in this
  151  act and except for this section, which shall take effect upon
  152  becoming a law, this act shall take effect July 1, 2014.
  154  ================= T I T L E  A M E N D M E N T ================
  155  And the title is amended as follows:
  156         Delete line 48
  157  and insert:
  158         amending s. 395.4001, F.S.; conforming cross
  159         references; amending s. 395.401, F.S.; limiting trauma
  160         service fees to a certain amount; providing for future
  161         expiration; conforming a cross-reference; amending s.
  162         395.402, F.S.; requiring the Department of Health to
  163         convene the Florida Trauma System Plan Advisory
  164         Council by a specified date; requiring the advisory
  165         council to review the Trauma System Consultation
  166         Report and make recommendations to the Legislature by
  167         a specified date; authorizing the advisory council to
  168         make recommendations to the State Surgeon General;
  169         designating the membership of the advisory council;
  170         amending s. 395.4025, F.S.; deleting a provision
  171         relating to the procedure for protesting an
  172         application decision by the department; conforming
  173         cross-references; authorizing certain provisional and
  174         verified trauma centers to continue operating and to
  175         apply for renewal; restricting the department from
  176         verifying, designating, or provisionally approving
  177         hospitals as trauma centers; providing for future
  178         expiration; providing effective dates.