Florida Trauma

1. Florida Trauma / EMS System California 58 counties Population: 36.5M Size: 158,706 sq miles Florida 67 counties Population: 18m Size: 58,664 sq miles Population density: FL 312/sq mile � CA 231/sq mile Population rank: FL #4 � CA #1Population density: FL 312/sq mile � CA 231/sq mile Population rank: FL #4 � CA #1

2. Florida Trauma / EMS System 266 licensed EMS providers 3800 permitted BLS/ALS ground units 21 rotor wing providers, 61 helicopters 19 fixed wing providers, 59 airplanes Boats? 3,200,000 EMS calls per year Florida has 1,197 miles of coastline/tidal coastline 2,276 miles - >11,000 miles of rivers, streams and waterways California coastline 840 miles/ tidal coastline 1340Florida has 1,197 miles of coastline/tidal coastline 2,276 miles - >11,000 miles of rivers, streams and waterways California coastline 840 miles/ tidal coastline 1340

3. Florida Trauma / EMS System Active: EMT 28,131 Paramedics 21,238 Inactive: EMT 7,694 Paramedic 1,605

4. Florida Trauma Center History 1982 Certification of trauma centers began. During the 1980�s, as many as 48 approved trauma centers existed. 26 trauma centers closed during the 1980�s. 2 trauma centers closed during the 1990�s. There are currently 20 approved trauma centers.

5. Florida Adult and Pediatric Trauma Center Locations

6. Trauma Care Regulation Chapter 395, Hospital Licensing and Regulation, Part II: Trauma 64E-2, Florida Administrative Code DOH Pamphlet 150-9, Trauma Center and Pediatric Trauma Center Approval Standards

8. Trauma Center Verification ACS versus State DOH New trauma center

9. Costs of Trauma CenterReadiness 2002 Focused on four areas: Physician on-call coverage Periodic recertification Outreach and prevention programs Other extraordinary and non-chargeable costs (Average median annual cost) * The study omitted several significant types of costs: start-up, cost of uninsured/underinsured patients, and many indirect facility costs associated with being prepared to treat trauma patients $2,080,102 $124,120 $56,543 $811,274 $2,706,510

10. 2003-2008Funding Examples $4 Million 2003 HRSA Burn Care Grant $11 Million 2004 HRSA Burn Care Grant $16 Million 2005 HRSA Burn Care Grant $5 Million 2006 HRSA Burn Care Grant $6.5 Million 2007 HRSA Burn Care Grant $4.5 Million 2008 HRSA Burn Care Grant 2003-2007 Total: $42.5 Million HB 497, HB 1697 � Red light running � $12.4m over 21 months distributed to trauma centers

11. Data and Outcomes EMS Tracking and Recording System (EMSTARS) (CEMSIS) State trauma registry

12. Adult Trauma Criteria

13. Adult Trauma Criteria

14. Pediatric Trauma Criteria

15. Pediatric Trauma Criteria

17. Miami-Dade County Uniform Trauma Transport Protocols System participants: City of Coral Gables Fire-Rescue Department City of Hialeah Fire-Rescue Department Miami-Dade County Fire-Rescue Department City of Miami Fire-Rescue Department City of Miami Beach Fire-Rescue Department Village of Key Biscayne Fire-Rescue Department American Ambulance Service American Medical Response Florida Medi-Van Ambulance Medics Ambulance Service Miami-Dade Ambulance Lifeflight (Miami Children�s Hospital) LifeNet Air Medical Services

18. Out-of-County Indigent Patients County resident Funded Trauma Center � Outside County agreements HCRA funding � millage tax Repatriation Health Care Responsibility Act (HCRA) In 1977, the Legislature declared that it is inequitable for hospitals and taxpayers of one county to be expected to subsidize the care of out-of-county indigent persons. In order to assure that adequate and affordable health care is available to all Floridians, the Health Care Responsibility Act (HCRA) was enacted. The Act places the ultimate financial obligation for an indigent patient�s out-of-county emergency care on the county in which the indigent patient resides. The Health Care responsibility act can be found in Chapter 154, Sections .301 - .331, Florida Statutes, and Rule Chapter 59H-1.001-.015, Florida Administrative Code. In 1998, the Legislature revised the Act to allow counties to use up to � of the HCRA funds to reimburse eligible in-county hospitals for indigent care. �Currently there are nine (9) counties that elected to reimburse their in county hospital(s) for resident indigents under the HCRA. �These counties are: Bradford, Calhoun, Hamilton, Holmes, Levy, Madison, Suwannee, Taylor, and Volusia. Health Care Responsibility Act (HCRA) In 1977, the Legislature declared that it is inequitable for hospitals and taxpayers of one county to be expected to subsidize the care of out-of-county indigent persons. In order to assure that adequate and affordable health care is available to all Floridians, the Health Care Responsibility Act (HCRA) was enacted. The Act places the ultimate financial obligation for an indigent patient�s out-of-county emergency care on the county in which the indigent patient resides. The Health Care responsibility act can be found in Chapter 154, Sections .301 - .331, Florida Statutes, and Rule Chapter 59H-1.001-.015, Florida Administrative Code. In 1998, the Legislature revised the Act to allow counties to use up to � of the HCRA funds to reimburse eligible in-county hospitals for indigent care. �Currently there are nine (9) counties that elected to reimburse their in county hospital(s) for resident indigents under the HCRA. �These counties are: Bradford, Calhoun, Hamilton, Holmes, Levy, Madison, Suwannee, Taylor, and Volusia.