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A01691
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
786
Session of
2019
INTRODUCED BY CUTLER, SCHLOSSBERG, RYAN, MILLARD, KAUFER,
ZIMMERMAN, MADDEN, HILL-EVANS, WHEELAND AND SCHMITT,
MARCH 12, 2019
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, JUNE 4, 2019
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, in emergency medical services system,
further providing for definitions and for Pennsylvania Trauma
Systems Foundation, providing for accreditation of trauma
centers, for submission of list, for funding, for
notification of trauma center closure, for reporting and for
certification and financial report; and making a related
repeal.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 8103 of Title 35 of the Pennsylvania
Consolidated Statutes is amended by adding definitions to read:
§ 8103. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
* * *
"Comprehensive emergency services." The capacity of a
hospital emergency department to maintain staff and provide
immediate and advanced care for Pennsylvania patients who
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require trauma care treatment 24 hours per day and seven days
per week based on the availability of the following services:
(1) At least two qualified physicians to staff the
emergency department during periods of peak utilization.
(2) At least one registered nurse with specialized
training in advanced life support techniques AT ALL TIMES .
(3) Anesthesia services at all times.
(4) Physician specialists who can immediately consult by
telephone or radio and can report immediately to the hospital
emergency department as needed.
(5) Ancillary services, such as laboratory, radiology,
pharmacy and respiratory therapy, at all times, with
appropriate personnel who can report immediately to the
hospital emergency department as needed.
* * *
"Trauma care." Medical services provided to an individual
with a severe, life-threatening injury that is likely to result
in mortality or permanent disability.
* * *
"Travel distance." The distance traveled by a motor vehicle
on paved public roads having at least two driving lanes of width
and on which a motor vehicle would reasonably travel in the
transport of patients. Travel distance is calculated by rounding
up to the next whole mile for a portion of a mile over a whole
mile for the distance traveled.
Section 2. Section 8107(a)(1) of Title 35 is amended to
read:
§ 8107. Pennsylvania Trauma Systems Foundation.
(a) Trauma center accreditation.--The foundation shall
develop a private voluntary accreditation program to:
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(1) Establish standards for the operation of trauma
centers that receive or seek to receive Commonwealth funds,
adopting, at a minimum, current guidelines for trauma centers
defined by the American College of Surgeons. Additionally,
Level III trauma centers shall meet accreditation criteria
for Level III trauma centers imposed by the act of March 24,
2004, (P.L.148, No.15), known as the Pennsylvania Trauma
Systems Stabilization Act. For the purpose of
reaccreditation, the standards shall require, at a minimum,
that each adult Level I and Level II trauma center [establish
that] treat at least 600 severe and urgent injury cases [have
been treated] per year [and each Level II trauma center
establish that 350 severe and urgent injury cases have been
treated per year].
* * *
Section 3. Title 35 is amended by adding sections to read:
§ 8107.1. Accreditation of trauma centers.
(a) Standards.--The foundation shall accredit Level III
trauma centers by adopting, at a minimum, current guidelines
defined by the American College of Surgeons for Level III trauma
centers. The accreditation process shall be conducted in
compliance with section 8107 (relating to Pennsylvania Trauma
Systems Foundation).
(b) Additional requirements.--In addition to the Level III
standards established by the foundation under subsection (a), a
hospital must meet all of the following criteria to qualify for
Level III accreditation:
(1) Provide comprehensive emergency services.
(2) Total on an annual basis at least 4,000 inpatient
admissions from its emergency department.
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(3) Be located in a third, fourth, fifth, sixth, seventh
or eighth class county.
(4) Be located more than 25 miles of travel distance
established by roadways from a Level I, Level II or Level III
trauma center.
(c) Submission of application required.--To be eligible for
accreditation as a Level III trauma center and to qualify for
funds under section 8107.3 (relating to funding), a hospital
must comply with subsection (b) to submit an application to the
foundation.
(d) Review of application.--Within 120 days of the receipt
of an application, the foundation shall complete its review of
the application to determine compliance with the criteria under
subsection (b). No later than 240 days from the completion of a
site survey, the foundation shall grant or deny a certificate to
a hospital seeking to be accredited as a Level III trauma center
under subsections (a) and (b).
(e) Additional accreditation criteria.-- For a hospital that
submits an application for Level I, Level II or Level III
accreditation after the effective date of this subsection, the
hospital shall be located more than 25 miles of travel distance
established by roadways from a Level I, Level II or Level III
trauma center. If a trauma center is accredited before the
effective date of this subsection, and the accreditation is
denied or voluntarily withdrawn, notwithstanding the reason, the
trauma center shall be subject to the travel distance
requirement under this section in the same manner as a trauma
center that has never been accredited if the hospital reapplies
for accreditation.
§ 8107.2. Submission of list.
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The foundation shall annually submit to the department its
list of accredited Level I, II, III and IV trauma centers with
updates as necessary. The list shall include all Level I and
Level II trauma centers as specified under this chapter.
§ 8107.3. Funding.
(a) Distribution.--Beginning fiscal year 2008-2009 and each
year thereafter, the department shall distribute annually, from
available funds appropriated for this purpose, a supplemental
payment to each accredited Level I or Level II trauma center or
each Level III trauma center or hospital seeking Level III
accreditation as provided in section 8107.1(b) (relating to
a ccreditation of trauma centers) for the purpose of improving
access to readily available and coordinated trauma care for the
citizens of this Commonwealth.
(b) Funding.--The department shall seek to maximize any
Federal funds, including funds obtained pursuant to Title XIX of
the Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.)
available for trauma care stabilization.
(c) Payment calculation.--
(1) Payment shall be allocated as follows:
(i) Ninety percent of available funds shall be
allocated to accredited Level I and Level II trauma
centers.
(ii) Ten percent shall be allocated to hospitals
accredited as Level III trauma centers and hospitals
seeking Level III accreditation for up to four years with
documented evidence of progression toward accreditation
and achievement of benchmarks as verified and established
by the foundation in collaboration with the department.
Funds not distributed under this subsection by the end of
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a fiscal year may be used for the funding of Level IV
trauma centers in rural counties, as defined by the
Center for Rural Pennsylvania, in the next fiscal year
utilizing the same formula as for the Level III trauma
centers.
(2) Payment to each qualifying Level I or Level II
trauma center shall be calculated using data provided by the
foundation as follows:
(i) Fifty percent of the total amount available for
Level I and Level II trauma centers shall be allocated
equally among Level I and Level II trauma centers.
(ii) Fifty percent of the total amount available for
Level I and Level II trauma centers shall be allocated on
the basis of each trauma center's percentage of medical
assistance and uninsured trauma cases and patient days
compared to the Statewide total number of medical
assistance and uninsured trauma cases and patient days
for all Level I and Level II trauma centers.
(3) Subject to paragraph (4), payment to each qualifying
hospital accredited or seeking accreditation as a Level III
trauma center shall be calculated using the information and
data provided by the foundation as follows:
(i) Fifty percent of the total amount available for
Level III trauma centers shall be allocated equally among
all Level III trauma centers.
(ii) Fifty percent of the total amount available for
Level III trauma centers shall be allocated on the basis
of each trauma center's percentage of medical assistance
and uninsured trauma cases and patient days compared to
the Statewide total number of medical assistance and
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uninsured trauma cases and patient days for all Level III
trauma centers.
(4) Payment to each qualifying hospital accredited as a
Level III may not be greater than 50% of the average
Statewide annual payment to a Level I or Level II trauma
center as determined in the methodology described in
paragraph (2).
(d) Out-of-State trauma centers.--Any hospital with a Level
I or Level II trauma center not licensed in this Commonwealth
shall be eligible for payment under this section if it meets the
definition of "trauma center" in section 8103 (relating to
definitions).
§ 8107.4. Notification of trauma center closure.
A hospital that receives funds under section 8107.3 (relating
to funding) shall notify the department, the foundation and the
Department of Health of its intent to cease operation of its
trauma center no later than 60 days prior to closure of that
trauma center.
§ 8107.5. Reporting.
(a) General rule.--On March 1, 2011, and annually
thereafter, the department shall report to the Health and Human
Services Committee of the Senate and the Health Committee of the
House of Representatives on the trauma centers funded under
section 8107.3 (relating to funding) .
(b) Contents of report.--The report shall do all of the
following:
(1) Identify the trauma centers receiving funds.
(2) State the amount received and the number of
individuals served.
(3) Make any recommendations for improvements in this
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chapter which further promote the availability of trauma care
services to the citizens of this Commonwealth.
§ 8107.6. Certification and financial report.
(a) Certification.--Before funds are provided, a trauma
center qualifying for funds under section 8107.3 (relating to
funding) shall certify that the funds are intended to be used
for developing and providing for the availability of and access
to trauma care for patients.
(b) Report.--Each trauma center that receives funds under
section 8107.3 shall report to the department the following:
(1) An expenditure report six months after the end of
the fiscal year accounting for how the funds were spent.
(2) The amount received and the number of individuals
served.
(3) How funds received through section 8107.3 improved
access to trauma care for patients.
Section 4. Repeals are as follows:
(1) The General Assembly declares that the repeal under
paragraph (2) is necessary to effectuate the amendment or
addition of 35 Pa.C.S. §§ 8103, 8107.1, 8107.2, 8107.3,
8107.4, 8107.5 and 8107.6.
(2) Article VIII-H of the act of June 13, 1967 (P.L.31,
No.21), known as the Human Services Code, is repealed.
Section 5. The amendment or addition of 35 Pa.C.S. §§ 8103,
8107.1, 8107.2, 8107.3, 8107.4, 8107.5 and 8107.6 is a
continuation of Article VIII-H of the act of June 13, 1967
(P.L.31, No.21), known as the Human Services Code. The following
apply:
(1) Except as otherwise provided in 35 Pa.C.S. §§ 8103,
8107.1, 8107.2, 8107.3, 8107.4, 8107.5 and 8107.6, all
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activities initiated under Article VIII-H of the Human
Services Code shall continue and remain in full force and
effect and may be completed under 35 Pa.C.S. §§ 8103, 8107.1,
8107.2, 8107.3, 8107.4, 8107.5 and 8107.6. Orders,
regulations, rules and decisions which were made under
Article VIII-H of the Human Services Code and which are in
effect on the effective date of section 6 of this act shall
remain in full force and effect until revoked, vacated or
modified under 35 Pa.C.S. §§ 8103, 8107.1, 8107.2, 8107.3,
8107.4, 8107.5 and 8107.6. Contracts, obligations and
collective bargaining agreements entered into under Article
VIII-H of the Human Services Code are not affected nor
impaired by the repeal of Article VIII-H of the Human
Services Code.
(2) Except as set forth in paragraph (3), any difference
in language between 35 Pa.C.S. §§ 8103, 8107.1, 8107.2,
8107.3, 8107.4, 8107.5 and 8107.6 and Article VIII-H of the
Human Services Code is intended only to conform to the style
of the Pennsylvania Consolidated Statutes and is not intended
to change or affect the legislative intent, judicial
construction or administration and implementation of Article
VIII-H of the Human Services Code.
(3) Paragraph (2) does not apply to the addition of 35
Pa.C.S. § 8107.1(e).
Section 6. This act shall take effect immediately.
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