HB 715

1	A bill to be entitled
2	An act relating to trauma services; amending s. 395.4001,
3	F.S.; providing definitions; repealing s. 395.4035, F.S.,
4	to terminate the Trauma Services Trust Fund; amending s.
5	395.4036, F.S.; revising provisions relating to
6	distribution of funds to trauma centers and use thereof;
7	amending s. 395.404, F.S.; requiring an annual audit of
8	Trauma Registry data; providing an effective date.
9
10	Be It Enacted by the Legislature of the State of Florida:
11
12	Section 1.  Section 395.4001, Florida Statutes, is amended
13	to read:
14	395.4001  Definitions.--As used in this part, the term:
15	(1)  "Agency" means the Agency for Health Care
16	Administration.
17	(2)  "Charity care" or "uncompensated trauma care" means
18	that portion of hospital charges reported to the agency for
19	which there is no compensation, other than restricted or
20	unrestricted revenues provided to a hospital by local
21	governments or tax districts regardless of method of payment,
22	for care provided to a patient whose family income for the 12
23	months preceding the determination is less than or equal to 200
24	percent of the federal poverty level, unless the amount of
25	hospital charges due from the patient exceeds 25 percent of the
26	annual family income. However, in no case shall the hospital
27	charges for a patient whose family income exceeds four times the
28	federal poverty level for a family of four be considered
29	charity.
30	(3)  "Department" means the Department of Health.
31	(4)  "Interfacility trauma transfer" means the transfer of
32	a trauma victim between two facilities licensed under this
33	chapter, pursuant to this part.
34	(5)  "International Classification Injury Severity Score"
35	means the statistical method for computing the severity of
36	injury sustained by trauma patients. The International
37	Classification Injury Severity Score shall be the methodology
38	used by the department and trauma centers to report the severity
39	of an injury.
40	(6)(5)  "Level I trauma center" means a trauma center that:
41	(a)  Has formal research and education programs for the
42	enhancement of trauma care; is verified by the department to be
43	in substantial compliance with Level I trauma center and
44	pediatric trauma center standards; and has been approved by the
45	department to operate as a Level I trauma center.
46	(b)  Serves as a resource facility to Level II trauma
47	centers, pediatric trauma centers, and general hospitals through
48	shared outreach, education, and quality improvement activities.
49	(c)  Participates in an inclusive system of trauma care,
50	including providing leadership, system evaluation, and quality
51	improvement activities.
52	(7)(6)  "Level II trauma center" means a trauma center
53	that:
54	(a)  Is verified by the department to be in substantial
55	compliance with Level II trauma center standards and has been
56	approved by the department to operate as a Level II trauma
57	center.
58	(b)  Serves as a resource facility to general hospitals
59	through shared outreach, education, and quality improvement
60	activities.
61	(c)  Participates in an inclusive system of trauma care.
62	(8)(7)  "Pediatric trauma center" means a hospital that is
63	verified by the department to be in substantial compliance with
64	pediatric trauma center standards as established by rule of the
65	department and has been approved by the department to operate as
66	a pediatric trauma center.
67	(9)(8)  "Provisional trauma center" means a hospital that
68	has been verified by the department to be in substantial
69	compliance with the requirements in s. 395.4025 and has been
70	approved by the department to operate as a provisional Level I
71	trauma center, Level II trauma center, or pediatric trauma
72	center.
73	(10)(9)  "Trauma agency" means a department-approved agency
74	established and operated by one or more counties, or a
75	department-approved entity with which one or more counties
76	contract, for the purpose of administering an inclusive regional
77	trauma system.
78	(11)(10)  "Trauma alert victim" means a person who has
79	incurred a single or multisystem injury due to blunt or
80	penetrating means or burns, who requires immediate medical
81	intervention or treatment, and who meets one or more of the
82	adult or pediatric scorecard criteria established by the
83	department by rule.
84	(12)  "Trauma caseload volume" means the number of trauma
85	patients reported by individual trauma centers to the Trauma
86	Registry and validated by the department.
87	(13)(11)  "Trauma center" means a hospital that has been
88	verified by the department to be in substantial compliance with
89	the requirements in s. 395.4025 and has been approved by the
90	department to operate as a Level I trauma center, Level II
91	trauma center, or pediatric trauma center.
92	(14)  "Trauma patient" means a person who has incurred a
93	physical injury or wound caused by trauma and has accessed a
94	trauma center.
95	(15)(12)  "Trauma scorecard" means a statewide methodology
96	adopted by the department by rule under which a person who has
97	incurred a traumatic injury is graded as to the severity of his
98	or her injuries or illness and which methodology is used as the
99	basis for making destination decisions.
100	(16)(13)  "Trauma transport protocol" means a document
101	which describes the policies, processes, and procedures
102	governing the dispatch of vehicles, the triage, prehospital
103	transport, and interfacility trauma transfer of trauma victims.
104	(17)(14)  "Trauma victim" means any person who has incurred
105	a single or multisystem injury due to blunt or penetrating means
106	or burns and who requires immediate medical intervention or
107	treatment.
108	Section 2.  Section 395.4035, Florida Statutes, is
109	repealed.
110	Section 3.  Subsection (1) of section 395.4036, Florida
111	Statutes, is amended to read:
112	395.4036  Trauma payments.--
113	(1)  Recognizing the Legislature's stated intent to provide
114	financial support to the current verified trauma centers and to
115	provide incentives for the establishment of additional trauma
116	centers as part of a system of state-sponsored trauma centers,
117	the department shall utilize funds collected under s.
118	318.18(15)(14) and deposited into the Administrative Trust Fund
119	of the department to ensure the availability and accessibility
120	of trauma services throughout the state as provided in this
121	subsection.
122	(a)  Twenty percent of the total funds collected under this
123	subsection during the state fiscal year shall be distributed to
124	verified trauma centers located in a region that have has a
125	local funding contribution as of December 31. Distribution of
126	funds under this paragraph shall be based on the department's
127	audited Trauma Registry trauma caseload volume for the previous
128	calendar year.
129	(b)  Forty percent of the total funds collected under this
130	subsection shall be distributed to verified trauma centers based
131	on trauma caseload volume of the previous calendar year. The
132	determination of caseload volume for distribution of funds under
133	this paragraph shall be based on the department's audited Trauma
134	Registry data.
135	(c)  Forty percent of the total funds collected under this
136	subsection shall be distributed to verified trauma centers based
137	on severity of trauma patients. The determination of severity
138	for distribution of funds under this paragraph shall be based on
139	the department's audited Trauma Registry International
140	Classification Injury Severity Scores and other statistically
141	valid and scientifically accepted methods of stratifying a
142	trauma patient's severity of injury, risk of mortality, and
143	resource consumption as adopted by the department by rule,
144	weighted based on the costs associated with and incurred by the
145	trauma center in treating trauma patients. The weighting of
146	scores shall be established by the department by rule scores of
147	1-14 and 15 plus.
148
149	Funds deposited in the department's Administrative Trust Fund
150	for verified trauma centers may be used to maximize the receipt
151	of federal funds that may be available for such trauma centers.
152	Notwithstanding this section and s. 318.14, distributions to
153	trauma centers may be adjusted in a manner to ensure that total
154	payments to trauma centers represent the same proportional
155	allocation as set forth in this section and s. 318.14. For
156	purposes of this section and s. 318.14, total funds distributed
157	to trauma centers may include revenue from the Administrative
158	Trust Fund and federal funds for which revenue from the
159	Administrative Trust Fund is used to meet state or local
160	matching requirements. Trauma centers may request that their
161	distributions from the Administrative Trust Fund be used as
162	intergovernmental transfer funds in the Medicaid program.
163	Section 4.  Paragraph (c) is added to subsection (1) of
164	section 395.404, Florida Statutes, to read:
165	395.404  Review of trauma registry data; report to central
166	registry; confidentiality and limited release.--
167	(1)
168	(c)  An independent entity shall annually audit Trauma
169	Registry data and submit the audit report to the department.
170	Section 5.  This act shall take effect July 1, 2006.

CODING: Words stricken are deletions; words underlined are additions.