To develop an inclusive, sustainable trauma system that allocates trauma centers throughout the state.

 

DEPARTMENT OF HEALTH

Division of Emergency Medical Operations

RULE NO.:RULE TITLE:

64J-2.010Apportionment of Trauma Centers within a Trauma Service Area (TSA)

PURPOSE AND EFFECT: To develop an inclusive, sustainable trauma system that allocates trauma centers throughout the state.

SUMMARY: This proposed rule will allocate the number of trauma centers needed for each trauma service area based on an assessment of the trauma service areas and a review of the assignment of Florida's 67 counties to trauma service areas.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: : Through its analysis of regulatory costs required as a part of the SERC analysis, the Department has determined this rule will not require legislative ratification pursuant to Section 120.541(3), F.S. No other statute requires legislative ratification for this rule

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 395.402, 395.405 FS.

LAW IMPLEMENTED: 395.402 FS.

A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Tuesday, February 25, 2014, 9:00 a.m.

PLACE: Florida Department of Health, 4052 Bald Cypress Way, Room 301, Tallahassee, Florida

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 7 days before the workshop/meeting by contacting: Sophia Flowers, 4052 Bald Cypress Way, Bin #A-02, Tallahassee, Florida 32399, telephone: [phone], [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Sophia Flowers, 4052 Bald Cypress Way, Bin #A-02, Tallahassee, Florida 32399, telephone: [phone], [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

(Substantial rewording of Rule 64J-2.010 follows. See Florida Administrative Code for present text.)

 

64J-2.010 Allocation Apportionment of Trauma Centers among the within a Trauma Service Areas (TSAs).

(1) Level I and Level II trauma centers shall be allocated among the trauma service areas (TSAs) based upon the following:

(a) The following criteria shall be used to determine a total score for each TSA. Points shall be determined based upon data in the Trauma Service Area Assessment.

1. Population

a. A total population of 0 to 600,000 receives 2 points.

b. A total population of 600,001 to 1,200,000 receives 4 points.

c. A total population of 1,200,001 to 1,700,000 receives 6 points.

d. A total population of 1,700,001 to 2,300,000 receives 8 points.

e. A total population greater than 2,300,000 receives 10 points.

2. Median Transport Times

a. Median transport time of 0 to 10 minutes receives 0 points.

b. Median transport time of 11 to 20 minutes receives 1 point.

c. Median transport time of 21 to 30 minutes receives 2 points.

d. Median transport time of 31 to 40 minutes receives 3 points.

e. Median transport time of greater than 41 minutes receives 4 points.

3. Community Support

a. Letters of support for an additional trauma center from 0 to 50 percent of the city and county commissions located within the TSA receive 1 point. Letters of support must be received by the Department on or before April 1 annually.

b. Letters of support for an additional trauma center from more than 50 percent of the city or county commissions located within the TSA receive 2 points. Letters of support must be received by the Department on or before April 1 annually.

4. Severely injured Patients Not Treated In Trauma Centers

a. Discharge of 0 to 200 patients with an International Classification Injury Severity Score (“ICISS”) score of less than 0.85 (“severely injured patients”) from hospitals other than trauma centers receives 0 points.

b. Discharge of 201 to 400 severely injured patients from hospitals other than trauma centers receives 1 point.

c. Discharge of 401 to 600 severely injured patients from hospitals other than trauma centers receives 2 points.

d. Discharge of 601 to 800 severely injured patients from hospitals other than trauma centers receives 3 points.

e. Discharge of more than 800 severely injured patients from hospitals other than trauma centers receives 4 points.

5. Level I Trauma Centers

a. The existence of a verified Level I trauma center receives one negative point.

b. The existence of two verified Level I trauma centers receives two negative points.

c. The existence of three verified Level I trauma centers receives three negative points.

6. Number of Severely Injured Patients

a. If the annual number of severely injured patients exceeds the statutory trauma center patient volumes, by more than 500 patients, the TSA receives 2 points.

b. If the annual number of severely injured patients exceeds the statutory trauma center patient volumes, by 0 to 500 patients, the TSA receives 1 point.

c. If the annual number of severely injured patients is less than the statutory trauma center patient volumes by 0 to 500 patients, the TSA receives one negative point.

d. If the annual number of severely injured patients is less than the statutory trauma center patient volumes by more than 500 patients, the TSA receives two negative points.

(b) The following scoring system shall be used to allocate trauma centers within the TSAs:

1. TSAs with a score of 5 points or less shall be allocated 1 trauma center.

2. TSAs with a score of 6 to 10 points shall be allocated 2 trauma centers.

3. TSAs with a score of 11 to 15 points shall be allocated 3 trauma centers.

4. TSAs with a score of more than 15 points shall be allocated 4 trauma centers.

(2) An assessment and scoring shall be conducted by the Department annually on or before August 30th, beginning August 30, 2015.

(3) The number of trauma centers allocated for each TSA based upon the Trauma Service Area Assessment, dated January 31, 2014, which can be found at www.FLHealth.gov/, is as follows:

 

TSA	Counties	Trauma Centers
1	Escambia, Okaloosa, Santa Rosa, Walton	1
2	Bay, Gulf, Holmes, Washington	1
3	Calhoun, Franklin, Gadsden, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla	1
4	Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, Union	1
5	Baker, Clay, Duval, Nassau, St. Johns	2
6	Citrus, Hernando, Marion	2
7	Flagler, Volusia	1
8	Lake, Orange, Osceola, Seminole, Sumter	3
9	Pasco, Pinellas	3
10	Hillsborough	1
11	Hardee, Highlands, Polk	1
12	Brevard, Indian River	1
13	DeSoto, Manatee, Sarasota	2
14	Martin, Okeechobee, St. Lucie	1
15	Charlotte, Glades, Hendry, Lee	2
16	Palm Beach	1
17	Collier	1
18	Broward	2
19	Dade, Monroe	3

 

Rulemaking Specific Authority 395.405 FS. Law Implemented 395.401, 395.4015, 395.402, 395.405 FS. History–New 12-10-92, Formerly 10D-66.1075, Amended 6-9-05, 12-18-06,Formerly 64E-2.022, Amended_________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jennifer A. Tschetter, General Counsel

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: John H. Armstrong, MD, FACS, Surgeon General and Secretary of Health

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: January 31, 2014

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: December 4, 2012 and December 23, 2013