Revises the method of determining funding allocations for distribution to the Florida trauma centers.

DEPARTMENT OF HEALTH
Division of Environmental Health

RULE NO: RULE TITLE
64E-2.040: Funding for Verified Trauma Centers
PURPOSE AND EFFECT: Revises the method of determining funding allocations for distribution to the Florida trauma centers.
SUMMARY: This proposed rulemaking revises the definitions applicable to this section of the rule and amends the timeframe and funding allocation formulas for distribution of funds collected under subsections 318.14(5) and 318.18(15), F.S. to Florida's trauma centers in accordance with statutory changes included in House Bill 7141.
SUMMARY OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
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.
SPECIFIC AUTHORITY: 395.4036 FS.
LAW IMPLEMENTED: HB 7141
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
TIME AND DATE: December 1, 2006, 10:00 a.m. EDT
PLACE: Department of Health, Division of Emergency Medical Operations, Capital Circle Office Complex, 4025 Esplanade Way, Conference Room 301, Tallahassee, FL 32399-1738
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 2 days before the workshop/meeting by contacting: Susan McDevitt, Office of Trauma, Department of Health, 4052 Bald Cypress Way, Bin C-18, Tallahassee, FL 32399-1738, [phone], ext. 2760; Email: [e-mail]; Fax: [phone]. 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: Susan McDevitt, Office of Trauma, Department of Health, 4052 Bald Cypress Way, Bin C-18, Tallahassee, FL 32399-1738, [phone], ext. 2760; Email: [e-mail]; Fax: [phone]

THE FULL TEXT OF THE PROPOSED RULE IS:

64E-2.040 Funding for Verified Trauma Centers.

(1) For purposes of Sections 318.14 and 395.4036, F.S., and this rule, in addition to those terms defined in the Florida Trauma Registry Manual, December 2005, (see Rule 64E-2.018, F.A.C.) and elsewhere in these rules, the following definitions also apply:

(a) “Attestation” – means a letter on hospital letterhead, signed under oath consistent with Section 92.50, F.S., by the person with direct or delegated authority to make such a statement, stating that the proceeds received by the hospital under Section 395.4036, F.S., were used in compliance with law.

(b) “Certified trauma center”, “verified trauma center” and “trauma center” – all mean a Level I, Level II or Pediatric Trauma Center.

(c) “Caseload volume”, “trauma caseload volume”, and “volume of trauma cases” – all mean the number of verified trauma patients served by a trauma center during a calendar year, after 2004, on whom data timely supplied by the trauma center to the trauma registry satisfies the Florida Trauma Registry Manual, December 2005, reporting requirements for determining trauma caseload volume (see page 5 of the manual). Solely for calendar years 2004 and 2005, this definition shall be the number of patients served by a trauma center during the respective calendar year on which data was supplied timely by the trauma center consistent with the Florida Trauma Registry Manual, December 2004.

(d) “International Classification Injury Severity Score” (ICISS) means a mathematical system of risk stratification based on anatomic diagnosis of trauma patients as initially defined and validated in the following reference: “Osler T, Rutledge R, Deis J, Bedrick E., ICISS: an international classification of disease-9 based injury severity score, Journal of Trauma. 1996 Sep:41(3):380-6; discussion 386-8.” “Local funding contribution” – means local municipal, county or tax district funding public or private and public foundation funding and service district organization funding received by a hospital or healthcare system that operates a trauma center.

(e) “Severe Injury Patient” – Through December 31, 2007, means a verified trauma patient with a computed ICISS Ps<.90 and, after December 31, 2007, means a verified trauma patient with computed ICISS Ps<.85. “Weighted ISS volume” – means (The number of patients in the caseload volume for the previous calendar year with an ISS score of 14 and below) + (3 x the number of patients in the caseload volume for the previous calendar year with an ISS score of 15 and above).

(f) “Verified Trauma Patient” means a patient treated at a state certified trauma center with at least one ICD-9-CM discharge diagnosis between 800 and 959.9 with a Survival Risk Ratio (SRR)<1 whose data is used by the trauma registry to determine caseload volume. SRR’s for each diagnosis code will be determined from analysis of data in the trauma registry by the Department consistent with ICISS and shall be published by the Department.

(g) “Year” means the most recent complete calendar year for which caseload volume is available from the trauma registry.

(2) Funds collected under Section 318.14(5), F.S., and Section 318.18(15)(14), F.S., and deposited into the department’s administrative trust fund shall be distributed quarterly to the certified trauma centers. during the subsequent first calendar quarter and during the subsequent third calendar quarter as follows:

(a) First quarter distribution shall be calculated, consistent with paragraphs (d) and (e) below, using timely submitted caseload volume data from the year preceding the previous calendar year.

(b) Third quarter distribution shall be calculated, consistent with paragraphs (d) and (e) below, using timely submitted caseload volume data for the previous calendar year.

(a)(c) All distribution shall be consistent with (2) or upon resolution of all relevant administrative and judicial challenges, whichever is later.

(b)(d) Funds collected under Section 318.14(5), F.S. and deposited into the department’s administrative trust fund shall be distributed to the trauma center as follows: [(.5 x funds)/Current total number of trauma centers)] + [(.5 x funds) x (Caseload volume for the trauma center for the previous calendar year/The sum of caseload volume for all trauma centers during the previous calendar year)].

(c)(e) Funds collected under Section 318.18(15)(14), F.S. and deposited into the department’s administrative trust fund under Section 395.4095(1), F.S., shall be distributed as follows:

1. To each trauma center in a region receiving a local funding contribution as of December 31 of the previous year: (.2 x funds) x (Caseload volume for the trauma center for the previous calendar year/The sum of caseload volume for the previous calendar year for all trauma centers receiving funding under subparagraph (2)(c)(e)1. of this rule).

2. To each trauma center: [(.4 x funds) x (Caseload volume of the trauma center during the previous calendar year/The sum of caseload volume for all trauma centers during the previous calendar year)].

3. To each trauma center ([.4 x funds) x (The total number of severe injury patients served by the trauma center for the year trauma center’s weighted ISS volume/The total number of all severe injury patients served by all trauma centers for the year sum of all trauma centers’ weighted ISS volume)].

Specific Authority 395.4036 FS. Law Implemented 395.4036 FS. History–New 4-25-06, Amended _______.

NAME OF PERSON ORIGINATING PROPOSED RULE: Susan McDevitt, Director, Office of Trauma
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Jennifer Bencie-Fairburn, M.D., M.S.A., Director, Division of Emergency Medical Opperations
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 31, 2006
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: September 15, 2006