What is a trauma center?
A trauma center is a type of hospital that provides trauma surgeons, neurosurgeons and other surgical and non-surgical specialists and medical personnel, equipment and facilities for immediate or follow-up treatment for severely injured patients, 24 hours-a-day, seven-days-a-week. If you've experienced a mild or moderate injury, the emergency departments of acute care hospitals licensed by the Agency for Health Care Administration are ready with basic emergency services to treat you. However, if you have severe traumatic injuries, having fast access to a hospital that has been verified by the Department of Health as a Level I, Level II or Pediatric trauma center is critical to your survival. Each year, Florida's trauma system helps to ensure that emergency medical services providers provide pre-hospital care and transport of injured residents and visitors to the nearest trauma center. Timely and quality emergency medical services, trauma care and medical rehabilitation can help individuals continue to live to their full potential, despite having experienced a severe injury.
How are Florida’s trauma centers verified?
Florida's trauma centers are verified by the Bureau of Emergency Medical Oversight’s Trauma Program in accordance with sections 395.402and 395.4025, Florida Statutes and Rules 64J-2.011 - 2.017, F.A.C.
Section 395.402, Florida Statutes (F.S.) allows for 44 trauma center positions disbursed throughout 19 trauma service areas (TSA). The TSAs were originally designated by geographic population and each is allotted a specified number of trauma center slots or positions in Rule 64J-2.010, F.A.C. Each TSA is to have at least one Level I or Level II trauma center. Currently, one of the 19 TSAs is not directly covered by a verified or provisional trauma center (TSA 17, Collier County).
To date, there are 25 verified trauma centers (eight Level I, twelve Level II, three Level II/Pediatric, one joint Pediatric verification (Bayfront/All Children’s), and one stand alone Pediatric) and two provisional Level II trauma centers) for a total of 27 trauma centers. Only Level I or Level II trauma centers are designated to occupy the 44 trauma center positions pursuant to section 395.402, F.S. Below is a list of Florida’s Trauma Centers and maps that provide the location of these centers throughout the state.
Florida Trauma Centers List as of 3-29-13
What are the Trauma Center verification levels and the standards for each level that must be met by hospitals seeking trauma center verification in Florida?
Florida verifies Level I, Level II and Pediatric trauma centers. Each hospital seeking verification must meet the trauma center standards included in the department’s Pamphlet 150-9, which is incorporated by reference in Rule 64J-2.011, Florida Administrative Code pursuant to s. 395.401(2), Florida Statutes.
All levels of trauma centers are critical components of Florida's trauma system. The following provides the major differences between a Provisional, Level I, Level II and Pediatric trauma centers:
Provisional Trauma Center
A provisional trauma center is an acute care hospital that has applied to become a Level I, Level II or Pediatric verified trauma center and the hospital that has been verified by the department to be in substantial compliance with the requirements in s. 395.4025, Florida Statutes and the Trauma Center Standards, DH Pamphlet 150-9. The hospital has been approved by the department to operate as a provisional Level I, Level II or pediatric trauma center based on the department's provisional review of the application package. These hospitals must operate as a provisional trauma center for a period of up to a year, while the department conducts an in-depth review and a provisional onsite survey prior to the department’s determination to approve verification or deny verification. Currently, there are two provisional Level II trauma centers: Bay Medical Center, Panama City, Trauma Service Area 2 and Ocala Regional Medical Center, Ocala, Trauma Service Area 6.
Level I Trauma Center
Level I trauma centers are verified by the department to be in substantial compliance with Level I trauma center and Pediatric trauma referral-center standards. Level I trauma centers serve as resource facilities to Level II trauma centers, Pediatric trauma referral-centers, and general hospitals through shared outreach, education, and quality-improvement activities. Currently, there are eight Level I Trauma Centers. Specific differences in the Level I standards and other verifications are:
Level II Trauma Center
Level II trauma centers are verified by the department to be in substantial compliance with Level II trauma center standards, as established by Department of Health rule. Level II trauma centers serve as resource facilities to general hospitals through shared outreach, education, and quality improvement activities. Currently, there are twelve trauma centers that hold only Level II verification and three verified Level II trauma centers that also hold a pediatric verification – for a total of fifteen Level II verified trauma centers. Specific differences in the Level II standards and other verifications are:
Pursuant to 2013 legislative revisions to s. 395.4025 in Enrolled HB 1159, hospitals outside of Trauma Service Areas 1 and 11 seeking verification to operate as a Level II trauma center in Florida will continue to be required to meet the Florida Department of Health standards, whereas potential trauma centers in Trauma Service Areas (TSAs) 1 and 11 can seek a Level II verification certificate from the American College of Surgeons. The department when presented with a certificate of verification from the American College of Surgeons for hospitals in TSA 1 and II, the department must designate these hospitals to operate as a verified Level II trauma center to serve those areas of the state. Escambia, Santa Rosa, Okaloosa and Walton counties make up TSA-1; Polk, Highlands and Hardee counties comprise TSA-11.
Pediatric Trauma Center
Pediatric trauma centers are verified by the Trauma Program to be in substantial compliance with the pediatric trauma center standards, as established by Department of Health rule. These centers serve as resource facilities to general hospitals through shared outreach, education, and quality improvement activities. Currently, there is one stand-alone pediatric trauma centers (Miami Children’s Hospital), one joint pediatric trauma center (Bayfront and All Children’s Hospital) and three Level II trauma centers (Sacred Heart Hospital, St. Joseph’s Hospital and St. Mary’s Hospital) that also have a Pediatric verification - for a total of five Pediatric verified trauma centers. Pediatric trauma centers are not included in the 44 trauma center positions apportioned within trauma service areas in accordance with s. 395.402, Florida Statutes. Specific differences in the standards of a Pediatric trauma center and other verifications are:
What are Florida’s trauma center application and verification processes?
Trauma Center Letter of Intent Process
Pursuant to s. 395.4025, Florida Statutes., acute care hospitals, that submit a Letter of Intent to the department by October 1 each year are eligible to submit a trauma center application by April 1 of the subsequent year. Hospitals located in Trauma Service Areas 1 and 11 are exempt from the Letter of Intent process.
Letter of Intent Form
DH Form 1840 - January 2010
Trauma Center Application Process
Pursuant to s. 395.4025, Florida Statutes, no later than October 15, 2012 the department will send a letter acknowledging receipt of each hospital's Letter of Intent with the directions on how to complete the application process.
Trauma Center Applications
Level One Trauma Center Application Manual - January 2010
Level Two Trauma Center Application Manual - January 2010
Pediatric Trauma Center Application Manual - January 2010
Trauma Center Application Timeline
Trauma Center Application Timeline
In order to be considered by the department, applications from those hospitals seeking selection as trauma centers, including those current verified trauma centers that seek a change or re-designation in approval status as a trauma center, must be received by the department no later than the close of business on April 1, 64J-2.012. Process for the Approval of Trauma Centers, F.A.C. The department will conduct a provisional review of each application for the purpose of determining that the hospital's application is complete and that the hospital has the critical elements required for a trauma center.
The department may grant an extension of up to an additional 18 months to a hospital applicant that is unable to meet all requirements of the critical elements by April 1, (Rule 64J-2.013, Extension of Application Period.)
After April 30, any hospital that submitted an application found acceptable by the department based on the provisional review will be eligible to operate as a provisional trauma center. Between May 1 and October 1 of each year, the department will conduct an in-depth evaluation of all applications found acceptable in the provisional review. The applications will be evaluated against criteria enumerated in the application packages as provided to the hospitals by the department. Beginning October 1 of each year and ending no later than June 1 of the following year, a review team of out-of-state reviewers assembled by the department, will make onsite visits to all provisional trauma centers. Based on recommendations from the review team, the department will select trauma centers by July 1. Each hospital approved as a trauma center will be issued a "DH Form 2032, Certificate of Approval", (Rule 64J-2.014, Certificate of Approval. F.A.C.)
What is Florida’s Trauma Center Verification Renewal Process?
At least 14 months prior to the expiration of the trauma center's certificate, the Department of Health, Trauma Program, will send a blank DH Form 2032R, January 2010 to each trauma center that is eligible for verification renewal. Within 15 calendar days after receipt, the trauma center choosing to renew its certification will submit the completed DH Form 2032R to the department. (64J-2.015, Process for Renewal of Trauma Centers.)
Trauma Center Renewal Form
DH Form 2032R Application to Renew, January 2010
Trauma Center Survey Process
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
For more information:
Email: Trauma Program
Florida Department of Health
Division of Emergency Preparedness and Community Support
4052 Bald Cypress Way, Bin A-22
Tallahassee, FL 32399-1738
Phone: (850) 245-4440
Fax: (850) 488-2512
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