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Document Citation: 64J-2.007, F.A.C.
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FLORIDA ADMINISTRATIVE CODE
TITLE 64 DEPARTMENT OF HEALTH
64J DIVISION OF EMERGENCY MEDICAL OPERATIONS
CHAPTER 64J-2 TRAUMA SERVICES
Date:
08/31/2009
Document:
64J-2.007 Trauma Agency Formation, Continuation, and Plan Requirements.
(1) To form a trauma agency, a county or counties (if regional), or an entity with which the county or counties contract for the purpose of trauma service administration shall:
(a) Obtain formal authority to create the agency from the county commission of each of the counties in which the agency plans to operate.
(b) Establish interlocal agreements between county governments if the proposed agency shall provide service to more than one county.
(2) For the formation and for continuation of a trauma agency, a county or counties, or an entity with which the county or counties contract for the purpose of trauma agency service administration, shall submit a trauma agency plan initially and an update at five-year intervals thereafter to the department for approval. Prior to the submission of the trauma agency plan or five-year plan update to the department, the county or counties, an entity with which the county or counties contract or the existing trauma agency shall:
(a) Hold a public hearing at least 60 days prior to the submission of the plan to the department, and give adequate notice of the hearing to the public in the defined geographic area to be served by the trauma agency. Adequate notice shall consist of publishing the notice, at least 30 days prior to the public hearing, in at least one newspaper of general circulation in each affected county. If a newspaper is not published in a county in which the trauma agency shall operate, adequate notice may be given by publishing the notice in at least one newspaper of general circulation in adjoining affected counties.
(b) Develop and submit an electronic copy of the trauma agency plan or five-year plan update to the department for review and approval.
(3) The trauma agency initial plan or five-year plan update shall contain the following information in the following order:
(a) Table of Contents;
(b) Population and Geographic Area to be Served.
1. Describe the population and defined geographic area to be served by the trauma agency;
2. Include a map showing the defined geographic area of the trauma agency, each major geographical barrier, all medical facilities, all prehospital ground and air facilities, and all other significant factors that affect the determination of the geographic area boundaries; and
3. Describe the historical patient flow, patient referral, and transfer patterns used to define the geographic areas of the trauma agency.
(c) Organizational Structure:
1. Provide a detailed description of the managerial and administrative structure of the proposed agency;
2. Include a table of organization, the names of the board of directors and each member's affiliation, and identify the individuals who will administer or operate the trauma agency, if known;
3. Provide the names, job descriptions and responsibilities of officials who shall be directly responsible for trauma agency personnel, and the names, job descriptions and responsibilities of individuals who shall be responsible for managing and operating the trauma agency on a daily basis; and
4. Describe in detail the Specific Authority that trauma agency personnel shall have in directing the operation of prehospital and hospital entities within the purview of the trauma agency, if approved, be it a single or multi-county trauma agency.
(d) Trauma System Structure:
1. Describe the operational functions of the system; the components of the system; the integration of the components and operational functions; and the coordination and integration of the activities and responsibilities of trauma centers, hospitals, and prehospital EMS providers; and
2. Include a list of all participating and non-participating trauma care resources within the defined geographical area of the trauma agency and documentation showing that these entities have been given the opportunity to participate in the system. Trauma care resources shall include, but are not limited to, hospitals, trauma centers, EMS providers, training centers, emergency medical dispatch, and planning entities; and
3. Include the trauma agency's recommendation and justification for the number and location of trauma centers required to serve its defined geographical area.
(e) Objectives, Proposed Actions, and Implementation Schedule. Provide a description of the objectives of the plan, a detailed list of the proposed actions necessary to accomplish each objective, and a timetable for the implementation of the objectives and action.
(f) Describe the source of income and anticipated expenses by category for the trauma agency;
(g) Describe the trauma agency's fiscal impact on the trauma system which includes a description of any increased costs related to providing trauma care.
(h) Transportation System Design:
1. Describe the EMS ground, water, and air transportation system design of the trauma system; and
2. Include trauma patient flow patterns, emergency inter-hospital transfer agreements and procedures, and the number, type, and level of service of the EMS providers within the trauma system.
(i) TTPs:
1. Provide confirmation that existing department-approved TTPs for each EMS provider, within the defined geographical area of the trauma agency, are accurate and shall be adopted by the trauma agency, pending department approval of the plan;
2. A trauma agency may develop uniform TTPs for department approval that shall be adhered to by all EMS providers that serve the geographical area of the trauma agency. If uniform TTPs are submitted to the department for approval, the TTPs shall include the name of each EMS provider that shall operate according to the uniform TTPs, and proof of consultation with each EMS provider's medical director. TTPs developed and submitted by a trauma agency shall be processed in accordance with Rule 64J-2.003, F.A.C.; and
3. The trauma agency shall provide a copy of any county ordinance governing the transport of trauma patients within the defined geographic area of the trauma agency.
(j) Medical Control and Accountability. Identify and describe the qualifications, responsibilities and authority of individuals and institutions providing off-line (system) medical direction and on-line (direct) medical control of all hospitals and EMS providers operating under the purview of the trauma agency.
(k) Emergency Medical Communications:
1. Describe the EMS communication system within the trauma agency's trauma service area; and
2. Verify that the existing communications within the trauma agency's trauma service area meet all the requirements for compliance with the Florida Emergency Medical Services Communications Plan, Volume I - March 2004 and Volume II - July 2008, to include all hospitals with emergency departments. The Florida Emergency Medical Services Communications Plan (Volumes I and II) is incorporated by reference and a copy of the document can be obtained by mail from the Department of Management Services, Division of Telecommunications, 4030 Esplanade Way, Suite 180, Tallahassee, Florida 32399; or electronically through the following web link:http://dms.myflorida.com/suncom/public_safety/radio_communications/radio_communication_plans.
(l) Data Collection. Describe the trauma data management system developed for the purpose of documenting and evaluating the trauma systems operation.
(m) Trauma System Evaluation. Describe the methodology by which the trauma agency shall evaluate the trauma system.
(n) Mass Casualty and Disaster Plan Coordination. Describe the trauma agency's role with local and/or regional emergency management entities in the coordination of the prehospital and hospital component's mass casualty and disaster plan for the defined geographic area it represents.
(o) Public Information and Education. Describe the trauma agency's programs designed to increase public awareness of the trauma system and public education programs designed to prevent, reduce the incidence of, and care for traumatic injuries within the defined geographic area it represents.
(p) Attachments. Include the following:
1. A sample of each type of contract and agreement entered into by the trauma agency for the benefit and operation of the trauma system. A description of these agreements may be substituted.
2. Documentation showing that the county commission of the county or counties in the geographic area to be served by the trauma agency have endorsed the initial plan or five-year plan update, pending department approval of the same; and
3. A copy of the public hearing notice and minutes of the hearing for the initial plan or five-year plan update.
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