Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1354
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 5/F/2R          .                                
             04/28/2014 06:55 PM       .                                

       Senator Diaz de la Portilla moved the following:
    1         Senate Amendment (with title amendment)
    3         Before line 52
    4  insert:
    5         Section 1. Section 395.4027, Florida Statutes, is created
    6  to read:
    7         395.4027 Florida Teletrauma Pilot Project.—
    8         (1) DEFINITION.—As used in this section, the term
    9  “teletrauma health care” means the remote management or
   10  assistance in management of the care of a trauma patient using
   11  telemedicine technology to allow the remote presence of a health
   12  care provider from a Level I trauma center in geographic areas
   13  in 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 which
   17  is 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  this section expire December 31, 2021.
   29         Section 2. Section 395.4045, Florida Statutes, is amended
   30  to read:
   31         395.4045 Emergency medical service providers; trauma
   32  transport protocols; transport of trauma alert victims to trauma
   33  centers or teletrauma hospitals; interfacility transfer.—
   34         (1) Each emergency medical services provider licensed under
   35  chapter 401 shall transport trauma alert victims to hospitals
   36  approved as trauma centers or participating in the teletrauma
   37  pilot project pursuant to s. 395.4027, except as may be provided
   38  for either in the department-approved trauma transport protocol
   39  of the trauma agency for the geographical area in which the
   40  emergency medical services licensee provides services or, if no
   41  such department-approved trauma transport protocol is in effect,
   42  as provided for in a department-approved provider’s trauma
   43  transport protocol.
   44         (2) A trauma agency may develop a uniform trauma transport
   45  protocol that is applicable to the emergency medical services
   46  licensees providing services within the geographical boundaries
   47  of the trauma agency, including hospitals participating in the
   48  teletrauma pilot project under s. 395.4027. Development of a
   49  uniform trauma protocol by a trauma agency shall be through
   50  consultation with interested parties, including, but not limited
   51  to, each approved trauma center; physicians specializing in
   52  trauma care, emergency care, and surgery in the region; each
   53  trauma system administrator in the region; each emergency
   54  medical service provider in the region licensed under chapter
   55  401, and such providers’ respective medical directors.
   56         (3) Trauma alert victims shall be identified through the
   57  use of a trauma scoring system, including adult and pediatric
   58  assessment as specified in rule of the department. The rule
   59  shall also include the requirements of licensed emergency
   60  medical services providers for performing and documenting these
   61  assessments.
   62         (4) The department shall specify by rule the subjects and
   63  the minimum criteria related to prehospital trauma transport;,
   64  trauma center, teletrauma center, or hospital destination
   65  determinations;, and interfacility trauma transfer transport by
   66  an emergency medical services provider to be included in a
   67  trauma agency’s or emergency medical service provider’s trauma
   68  transport protocol and shall approve or disapprove each such
   69  protocol. Trauma transport protocol rules pertaining to the air
   70  transportation of trauma victims shall be consistent with, but
   71  not limited to, applicable Federal Aviation Administration
   72  regulation. Emergency medical services licensees and trauma
   73  agencies shall be subject to monitoring by the department, under
   74  ss. 395.401(3) and 401.31(1) for compliance with requirements,
   75  as applicable, regarding trauma transport protocols and the
   76  transport of trauma victims.
   77         (5) If there is no department-approved trauma agency trauma
   78  transport protocol for the geographical area in which the
   79  emergency medical services license applicant intends to provide
   80  services, as provided for in subsection (1), each applicant for
   81  licensure as an emergency medical services provider, under
   82  chapter 401, must submit and obtain department approval of a
   83  trauma transport protocol prior to the department granting a
   84  license. The department shall prescribe by rule the submission
   85  and approval process for an applicant’s trauma transport
   86  protocols whether the applicant will be using a trauma agency’s
   87  or its own trauma transport protocol.
   88         (6) If an air ambulance service is available in the trauma
   89  service area in which an emergency medical service provider is
   90  located, trauma transport protocols shall not provide for
   91  transport outside of the trauma service area unless otherwise
   92  provided for by written mutual agreement. If air ambulance
   93  service is not available and there is no agreement for
   94  interagency transport of trauma patients between two adjacent
   95  local or regional trauma agencies, both of which include at
   96  least one approved trauma center, then the transport of a trauma
   97  patient with an immediately life-threatening condition shall be
   98  to the most appropriate trauma center as defined pursuant to
   99  trauma transport protocols approved by the department. The
  100  provisions of this subsection shall apply only to those counties
  101  with a population in excess of 1 million residents.
  102         (7) Prior to an interfacility trauma transfer, the
  103  emergency medical services provider’s medical director or his or
  104  her designee must agree, pursuant to protocols and procedures in
  105  the emergency medical services provider’s trauma transport
  106  protocol, that the staff of the transport vehicle has the
  107  medical skills, equipment, and resources to provide anticipated
  108  patient care as proposed by the transferring physician. The
  109  emergency medical services provider’s medical director or his or
  110  her designee may require appropriate staffing, equipment, and
  111  resources to ensure proper patient care and safety during
  112  transfer.
  113         (8) The department shall adopt and enforce all rules
  114  necessary to administer this section. The department shall adopt
  115  and enforce rules to specify the submission and approval process
  116  for trauma transport protocols or modifications to trauma
  117  transport protocols by trauma agencies and licensed emergency
  118  medical services providers.
  120  ================= T I T L E  A M E N D M E N T ================
  121  And the title is amended as follows:
  122         Delete line 2
  123  and insert:
  124         An act relating to health care; creating s. 395.4027,
  125         F.S.; establishing the Florida Teletrauma Pilot
  126         Project; defining the term “teletrauma health care”;
  127         authorizing certain hospitals to provide remote care
  128         to trauma patients at satellite hospitals under
  129         certain circumstances; prohibiting the application or
  130         verification of additional trauma centers in the
  131         impacted trauma service area for the duration of the
  132         pilot project; providing for future expiration of the
  133         pilot project; amending s. 395.4045, F.S.; requiring
  134         emergency medical service providers to transport
  135         trauma alert victims to hospitals participating in the
  136         teletrauma pilot project; revising the authorized
  137         uniform trauma transport protocol; requiring the
  138         Department of Health to specify by rule certain
  139         subjects and criteria related to the transport of
  140         trauma victims to and from a teletrauma center;
  141         amending s. 409.967,