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Dr. Kelly Gray-Eurom, MD, MMM, FACEP
President, Florida College of Emergency Physicians
March 15, 2013
The Florida College of Emergency Physicians exists to promote high quality emergency medical care.
FCEP supports and promotes the health and safety of the public by ensuring patient access to quality emergency care.
1,400 members statewide.
Treat/See Over 7,000,000 Patients Each Year in Florida
Working in Academic Setting, Community Hospitals, Urban-Tertiary Care
Diverse ED Environment
Diverse Specialty
FCEP values a working relationship with AHCA as well as with hospitals to ensure patients have access to quality care
FCEP supports the AHCA initiative to create transparency and further defining the Hospital Emergency Services Inventory
LEGISLATIVE INTENT◦ The Legislature finds and declares it to be of vital
importance that emergency services and care be provided by hospitals and physicians to every person in need of such care.
It is further the intent of the Legislature that hospitals, emergency medical services providers, and other health care providers work together in their local communities to enter into agreements or arrangements to ensure access to emergency services and care.
The agency shall establish and maintain an inventory of hospitals with emergency services - ◦ All services within the service capability of the
hospital◦ Each hospital having emergency services shall
notify the agency of its service capability ◦ Assist emergency medical services providers and
others in locating appropriate emergency medical care.
◦ Available to the general public.
If the hospital provides the service (i.e. neurosurgery),then the hospital must provide that service to its Emergency Department patients
If the hospital is unable to provide that
service◦ Have a transfer arrangement relating to service◦ Obtain a waiver/exemption from AHCA
enforce the ability of persons to receive all necessary and appropriate emergency services and care;
and that the agency act in a thorough and timely manner against hospitals and physicians which deny persons emergency services and care
Where are the gaps? What needs to change to make this access
more available to our patients? What needs to change to make the system
more transparent to our providers? How can this information be more readily
available to the public? What resources does AHCA need?
Inventory of hospitals with emergency services ◦ All services within the service capability of the
hospital◦ Each hospital having emergency services shall
notify the agency of its service capability ◦ Assist emergency medical services providers and
others in locating appropriate emergency medical care
◦ Available to the general public
Trauma
Anesthesia Burn Cardiology Cardiovascular Surgery Colon/Rectal Surgery Emergency Medicine Endocrinology Gastroenterology General Surgery Hematology Hyperbaric Medicine Internal Medicine Nephrology Neurology
Neurosurgery Obstetrics Ophthalmology Oral/ Max Facial Surgery Orthopedics Otolaryngology Plastic Surgery Podiatry Psychiatry Pulmonary Medicine Radiology Thoracic Surgery Urology Vascular Surgery
Trauma
Anesthesia Burn Cardiology Cardiovascular Surgery Colon/Rectal Surgery Emergency Medicine Endocrinology Gastroenterology General Surgery Hematology Hyperbaric Medicine Internal Medicine Nephrology Neurology
Neurosurgery Obstetrics Ophthalmology Oral/ Max Facial Surgery Orthopedics Otolaryngology Plastic Surgery Podiatry Psychiatry Pulmonary Medicine Radiology Thoracic Surgery Urology Vascular Surgery
Trauma PEDIATRICS
Anesthesia Burn Cardiology Cardiovascular Surgery Colon/Rectal Surgery Emergency Medicine Endocrinology Gastroenterology General Surgery Hematology Hyperbaric Medicine Internal Medicine Nephrology Neurology
Neurosurgery Obstetrics Ophthalmology Oral/ Max Facial Surgery Orthopedics Otolaryngology Plastic Surgery Podiatry Psychiatry Pulmonary Medicine Radiology Thoracic Surgery Urology Vascular Surgery
Emergency Medicine evaluates and treats all age groups
Most adult providers will only see patients >17 years old◦ Consultations◦ Admissions◦ Procedures
Pediatrics must be required on the emergency services inventory
Pediatric surgical subspecialties should be added◦ General surgery◦ Gastroenterology◦ Neurosurgery
Critical Care / Pulmonary Medicine
Inventory of hospitals with emergency services ◦ All services within the service capability of the
hospital◦ Each hospital having emergency services shall
notify the agency of its service capability ◦ Assist emergency medical services providers and
others in locating appropriate emergency medical care
◦ Available to the general public
ACHA needs to do an assessment of the statewide inventory of emergency services.
Provide medical oversight to assist with approval of exemptions – formerly State EMS Medical Director/DOH provided.
Currently the AHCA website has 16 hospitals listed that are approved for exemptions◦ PDF◦ Static◦ Hospital Licensure
Do not provide Provide on a limited basis by exemption Provide through a transfer agreement with
another hospital Provide through a combination of in-house
and transfer agreement Provide in-house 24 hours, 7 days a week
Interactive list of services denoting changes◦ Updated regularly by designated personnel
Removes any doubt of services provided by Hospitals
Inventory of hospitals with emergency services ◦ All services within the service capability of the
hospital◦ Each hospital having emergency services shall
notify the agency of its service capability ◦ Assist emergency medical services providers and
others in locating appropriate emergency medical care
◦ Available to the general public