House, Senate poised for battle on controversial health-care issues

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The House and Senate are setting the stage for a fight this legislative session over a number of health-care issues, including the disputed operation of three trauma centers.

A significant House committee approved an omnibus bill Thursday that bundled several controversial topics, including the call to close HCA-run trauma centers, a measure expanding the responsibilities of nurse practitioners, and a framework for the use of telemedicine.

Meanwhile, a Senate committee passed a stand-alone bill on the trauma issue, reports Jim Saunders of the News Service of Florida.

Both chambers are attempting to ensure the continued operation of trauma centers at Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County, and Ocala Regional Medical Center in Marion County

The HCA facilities face strong opposition from hospitals with long-standing trauma centers in Tampa Bay and Gainesville.

The House strategy is to merge the trauma issue together with other controversial issues, a process known as a legislative “train,” a risky move that could lead to complicated negotiations through the end of the session on May 2.

As for the nurse practitioner and telemedicine issues, the House and Senate have significant differences, and prominent physician groups have been busy fighting the House version.

Once the House Health & Human Services Committee approved the omnibus HB 7113, Rep. Mia Jones, leading Democrat on the committee, told the News Service of Florida that creating a legislative train could raise doubts that the Senate will pass the bill.

She admitted she was not sure what would happen next.

“I’m trying to figure that out as well,” Jones said.

The bill follows nearly three years of legal wrangling, centered on whether the Florida Department of Health was correct in allowing the trauma centers in Manatee, Pasco and Marion Counties to open — and if they should continue to operate. Tampa General Hospital, Bayfront Medical Center in St. Petersburg, St. Joseph’s Hospital in Tampa and UF Health Shands Hospital in Gainesville — each with existing trauma facilities – have disputed the newer centers.

Although the bills are different, both the House and Senate versions allow the three HCA trauma centers to remain open. For its part, HCA health-care is lobbying for the bills, with opposition from the Safety Net Hospital Alliance of Florida, which represents the older trauma centers.  

Republican Sen. Denise Grimsley, who sponsored the Senate bill (SB 1276), told the News Service she was irritated at the industry battle. Both sides had made hospitals the issue, not patients, which she called “disgusting.”

“As a nurse, I see myself first as a patient advocate,” Grimsley told the Senate Appropriations Committee prior to the 15-3 approval vote.

Mark Delegal, lobbyist for the Safety Net Hospital Alliance of Florida, said the main concern was more trauma centers would lead to a weakening in quality of care. Trauma centers need proper flows of patients for the specialized staff, Delegal said.

“The quality is best if you ensure there are the appropriate number of trauma centers seeing the appropriate number of trauma patients in Florida,” he added..

However, supporters of the HCA-affiliated trauma centers claim that they provide quicker access for critically injured patients.

Sen. Alan Hays agreed that more trauma centers in Florida would reduce transportation times.

“I think we need to focus on the benefit to the patient and not worry so much about the hospital,” he said.

Originally, the omnibus bill approved by the House Health & Human Services Committee addressed only the trauma issue. But it was amended to include allowing nurse practitioners to provide care without the supervision of a physician, which is opposed by some physician groups, including the Florida Medical Association.

In addition, the bill sets up a legal framework to promote the use of telemedicine, where physicians and other health providers can treat patients remotely by means of telecommunications and Internet technology.

One part of the House bill spurred controversy, since it would allow out-of-state doctors to provide care Floridians without them being licensed in Florida. Supporters the omnibus legislation will address the shortage of primary-care physicians. The House committee approved the “trained” bill 15-2.

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Phil Ammann is a St. Petersburg-based journalist and blogger. With more than three decades of writing, editing and management experience, Phil produced material for both print and online, in addition to founding HRNewsDaily.com. His broad range includes covering news, local government and culture reviews for Patch.com, technical articles and profiles for BetterRVing Magazine and advice columns for a metaphysical website, among others. Phil has served as a contributor and production manager for SaintPetersBlog since 2013. He lives in St. Pete with his wife, visual artist Margaret Juul and can be reached at phil@floridapolitics.com and on Twitter @PhilAmmann.