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California 58 counties Population: 36.5M Size: 158,706 sq miles. Florida 67 counties Population: 18m Size: 58,664 sq miles. Florida Trauma / EMS System. Florida Trauma / EMS System. 266 licensed EMS providers 3800 permitted BLS/ALS ground units 21 rotor wing providers, 61 helicopters
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California 58 counties Population: 36.5M Size: 158,706 sq miles Florida 67 counties Population: 18m Size: 58,664 sq miles Florida Trauma / EMS System
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 Trauma / EMS System • Active: • EMT 28,131 • Paramedics 21,238 • Inactive: • EMT 7,694 • Paramedic 1,605
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.
Florida Adult and Pediatric Trauma Center Locations Level I: 7 Level II: 6 Level II & Pediatric: 5 Pediatric: 2 Total: 20 Trauma Centers
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
Secretary of Health/ Surgeon General Director, Emergency Medical Operations Bureau of Emergency Medical Services Office of Trauma Public Health Preparedness
Trauma Center Verification • ACS versus State DOH • New trauma center
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 Costs of Trauma CenterReadiness 2002
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
Data and Outcomes • EMS Tracking and Recording System (EMSTARS) (CEMSIS) • State trauma registry
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
Out-of-County Indigent Patients • County resident • Funded • Trauma Center – Outside County agreements • HCRA funding – millage tax • Repatriation