Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS/CS/CS/HB 573, 2nd Eng.
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 4/AD/2R         .                                
             05/01/2014 02:25 PM       .                                

       Senator Grimsley moved the following:
    1         Senate Amendment (with title amendment)
    3         Between lines 2694 and 2695
    4  insert:
    5         Section 48. Present paragraphs (k) through (o) of
    6  subsection (1) of section 395.401, Florida Statutes, are
    7  redesignated as paragraphs (l) through (p), respectively, and a
    8  new paragraph (k) is added to that subsection, to read:
    9         395.401 Trauma services system plans; approval of trauma
   10  centers and pediatric trauma centers; procedures; renewal.—
   11         (1)
   12         (k) A hospital operating a trauma center may not charge a
   13  trauma activation fee greater than $15,000. This paragraph
   14  expires on July 1, 2015.
   15         Section 49. Subsections (2) and (4) of section 395.402,
   16  Florida Statutes, are amended, and subsection (5) is added to
   17  that section, to read:
   18         395.402 Trauma service areas; number and location of trauma
   19  centers.—
   20         (2) Trauma service areas as defined in this section are to
   21  be utilized until the Department of Health completes an
   22  assessment of the trauma system and reports its finding to the
   23  Governor, the President of the Senate, the Speaker of the House
   24  of Representatives, and the substantive legislative committees.
   25  The report shall be submitted by February 1, 2005. The
   26  department shall review the existing trauma system and determine
   27  whether it is effective in providing trauma care uniformly
   28  throughout the state. The assessment shall:
   29         (a)Consider aligning trauma service areas within the
   30  trauma region boundaries as established in July 2004.
   31         (a)(b) Review the number and level of trauma centers needed
   32  for each trauma service area to provide a statewide integrated
   33  trauma system.
   34         (b)(c) Establish criteria for determining the number and
   35  level of trauma centers needed to serve the population in a
   36  defined trauma service area or region.
   37         (c)(d) Consider including criteria within trauma center
   38  approval standards based upon the number of trauma victims
   39  served within a service area.
   40         (e)Review the Regional Domestic Security Task Force
   41  structure and determine whether integrating the trauma system
   42  planning with interagency regional emergency and disaster
   43  planning efforts is feasible and identify any duplication of
   44  efforts between the two entities.
   45         (d)(f) Make recommendations regarding a continued revenue
   46  source which shall include a local participation requirement.
   47         (e)(g) Make recommendations regarding a formula for the
   48  distribution of funds identified for trauma centers which shall
   49  address incentives for new centers where needed and the need to
   50  maintain effective trauma care in areas served by existing
   51  centers, with consideration for the volume of trauma patients
   52  served, and the amount of charity care provided.
   53         (4) Annually thereafter, the department shall review the
   54  assignment of the 67 counties to trauma service areas, in
   55  addition to the requirements of subsections (2) paragraphs
   56  (2)(b)-(g) and subsection (3). County assignments are made for
   57  the purpose of developing a system of trauma centers. Revisions
   58  made by the department shall consider take into consideration
   59  the recommendations made as part of the regional trauma system
   60  plans approved by the department and the recommendations made as
   61  part of the state trauma system plan. If In cases where a trauma
   62  service area is located within the boundaries of more than one
   63  trauma region, the trauma service area’s needs, response
   64  capability, and system requirements shall be considered by each
   65  trauma region served by that trauma service area in its regional
   66  system plan. Until the department completes the February 2005
   67  assessment, the assignment of counties shall remain as
   68  established in this section.
   69         (a) The following trauma service areas are hereby
   70  established:
   71         1. Trauma service area 1 shall consist of Escambia,
   72  Okaloosa, Santa Rosa, and Walton Counties.
   73         2. Trauma service area 2 shall consist of Bay, Gulf,
   74  Holmes, and Washington Counties.
   75         3. Trauma service area 3 shall consist of Calhoun,
   76  Franklin, Gadsden, Jackson, Jefferson, Leon, Liberty, Madison,
   77  Taylor, and Wakulla Counties.
   78         4. Trauma service area 4 shall consist of Alachua,
   79  Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy,
   80  Putnam, Suwannee, and Union Counties.
   81         5. Trauma service area 5 shall consist of Baker, Clay,
   82  Duval, Nassau, and St. Johns Counties.
   83         6. Trauma service area 6 shall consist of Citrus, Hernando,
   84  and Marion Counties.
   85         7. Trauma service area 7 shall consist of Flagler and
   86  Volusia Counties.
   87         8. Trauma service area 8 shall consist of Lake, Orange,
   88  Osceola, Seminole, and Sumter Counties.
   89         9. Trauma service area 9 shall consist of Pasco and
   90  Pinellas Counties.
   91         10. Trauma service area 10 shall consist of Hillsborough
   92  County.
   93         11. Trauma service area 11 shall consist of Hardee,
   94  Highlands, and Polk Counties.
   95         12. Trauma service area 12 shall consist of Brevard and
   96  Indian River Counties.
   97         13. Trauma service area 13 shall consist of DeSoto,
   98  Manatee, and Sarasota Counties.
   99         14. Trauma service area 14 shall consist of Martin,
  100  Okeechobee, and St. Lucie Counties.
  101         15. Trauma service area 15 shall consist of Charlotte,
  102  Glades, Hendry, and Lee Counties.
  103         16. Trauma service area 16 shall consist of Palm Beach
  104  County.
  105         17. Trauma service area 17 shall consist of Collier County.
  106         18. Trauma service area 18 shall consist of Broward County.
  107         19. Trauma service area 19 shall consist of Miami-Dade and
  108  Monroe Counties.
  109         (b) Each trauma service area should have at least one Level
  110  I or Level II trauma center. The department shall allocate, by
  111  rule, the number of trauma centers needed for each trauma
  112  service area.
  113         (c) There may shall be no more than a total of 44 trauma
  114  centers in the state.
  115         (5)By October 1, 2014, the department shall convene the
  116  Florida Trauma System Plan Advisory Committee in order to review
  117  the Trauma System Consultation Report issued by the American
  118  College of Surgeons Committee on Trauma dated February 2-5,
  119  2013. Based on this review, the advisory council shall submit
  120  recommendations, including recommended statutory changes, to the
  121  President of the Senate and the Speaker of the House of
  122  Representatives by February 1, 2015. The advisory council may
  123  make recommendations to the State Surgeon General regarding the
  124  continuing development of the state trauma system. The advisory
  125  council shall consist of the following nine representatives of
  126  an inclusive trauma system appointed by the State Surgeon
  127  General:
  128         (a)A trauma patient, or a family member of a trauma
  129  patient, who has sustained and recovered from severe injuries;
  130         (b)A member of the Florida Committee on Trauma;
  131         (c)A member of the Association of Florida Trauma
  132  Coordinators;
  133         (d)A chief executive officer of a nontrauma acute care
  134  hospital who is a member of the Florida Hospital Association;
  135         (e)A member of the Florida Emergency Medical Services
  136  Advisory Council;
  137         (f)A member of the Florida Injury Prevention Advisory
  138  Council;
  139         (g)A member of the Brain and Spinal Cord Injury Program
  140  Advisory Council;
  141         (h)A member of the Florida Chamber of Commerce; and
  142         (i)A member of the Florida Health Insurance Advisory
  143  Board.
  144         Section 50. Subsection (7) of section 395.4025, Florida
  145  Statutes, is amended, and subsections (15) and (16) are added to
  146  that section, to read:
  147         395.4025 Trauma centers; selection; quality assurance;
  148  records.—
  149         (7) A Any hospital that has submitted an application for
  150  selection as a trauma center may wishes to protest an adverse a
  151  decision made by the department based on the department’s
  152  preliminary, provisional, or in-depth review of its application,
  153  applications or on the recommendations of the site visit review
  154  team pursuant to this section, and shall proceed as provided
  155  under in chapter 120. Hearings held under this subsection shall
  156  be conducted in the same manner as provided in ss. 120.569 and
  157  120.57. Cases filed under chapter 120 may combine all disputes
  158  between parties.
  159         (15)Notwithstanding any other law, a hospital designated
  160  as a provisional or verified as a Level I, Level II, or
  161  pediatric trauma center after the enactment of chapter 2004-259,
  162  Laws of Florida, whose approval has not been revoked may
  163  continue to operate at the same trauma center level until the
  164  approval period in subsection (6) expires if the hospital
  165  continues to meet the other requirements of part II of this
  166  chapter related to trauma center standards and patient outcomes.
  167  A hospital that meets the requirements of this section is
  168  eligible for renewal of its 7-year approval period pursuant to
  169  subsection (6).
  170         (16) Except as otherwise provided in this act, the
  171  department may not verify, designate, or provisionally approve
  172  any hospital to operate as a trauma center through the
  173  procedures established in subsections (1)-(14), unless the
  174  hospital is designated as a provisional Level I trauma center
  175  and is seeking to be verified as a Level I trauma center as of
  176  July 1, 2014. This subsection expires on the earlier of July 1,
  177  2015, or upon the entry of a final order affirming the validity
  178  of a proposed rule of the department allocating the number of
  179  trauma centers needed for each trauma service area as provided
  180  in s. 395.402(4).
  183  ================= T I T L E  A M E N D M E N T ================
  184  And the title is amended as follows:
  185         Delete line 292
  186  and insert:
  187         home health agencies; amending s. 395.401, F.S.;
  188         limiting trauma service fees to a certain amount;
  189         providing for future expiration; conforming a cross
  190         reference; amending s. 395.402, F.S.; revising
  191         provisions relating to the contents of the Department
  192         of Health trauma system assessment; requiring the
  193         Department of Health to convene the Florida Trauma
  194         System Plan Advisory Committee by a specified date;
  195         requiring the advisory council to review the Trauma
  196         System Consultation Report and make recommendations to
  197         the Legislature by a specified date; authorizing the
  198         advisory council to make recommendations to the State
  199         Surgeon General; designating the membership of the
  200         advisory council; amending s. 395.4025, F.S.;
  201         specifying that only applicants for trauma centers may
  202         protest an adverse decision made by the department;
  203         authorizing certain provisional and verified trauma
  204         centers to continue operating and to apply for
  205         renewal; restricting the department from verifying,
  206         designating, or provisionally approving certain
  207         hospitals as trauma centers; providing for future
  208         expiration; providing effective dates.