After years of legal wrangling, Florida’s trauma center debate reached the negotiation table Thursday with a former Florida Supreme Court justice leading the talks.
Parties in the dispute are trying to make headway in a long-standing dispute about how Florida approves new trauma centers throughout the state, reports Jim Saunders for the News Service of Florida.
In a daylong negotiation, the Florida Department of Health’s top attorney met with trauma surgeons and hospital lawyers to hammer out rules to determine how and where trauma centers will open in the future.
It was an unprecedented summit capping more than two years of legal and political clashes about how the FDOH allowed HCA-affiliated health-care centers to open trauma centers, as well as how they should handle subsequent requests.
Last year, the FDOH proposed a draft rule that could lead to more trauma centers in Florida. A scoring system would be used that takes into account several factors, including population, transportation times and community support to determine the number of trauma centers in each of 19 regions of the state.
Instead of clarifying the process, the draft rule divided the industry, culminating in Thursday’s session headed by former Florida Supreme Court Justice Kenneth Bell.
Discussed were possible changes to the proposed rule. Both sides said they made progress on issues like using population as a determining factor for authorizing trauma centers. But there continued to be disagreement, such as the FDOH attitude that community support be an influential factor in approving trauma centers.
Giving significant weight to community support, critics say, would politicize the process instead of basing it solely on need. They believe it is not appropriate, giving the expense of operating the centers with specialized physicians and staff.
“I don’t know how community support equates to the need for a trauma center,” said University of Florida trauma surgeon Fred Moore.
HCA and other supporters of additional trauma centers disagree, saying that communities require increased access to emergency care. Department of Health general counsel Jennifer Tschetter was clear that the department is not backing away from exercising community support as a factor.
“The department feels very strongly that that needs to be part of this analysis,” Tschetter told the News Service.
Thursday’s negotiations will help the department in revising the proposed rule, which they intend to accomplish by April 1. They will also call on the public for input, with the possibility of further legal challenges if the opposing parties are not satisfied.
Overshadowing the talks were legal battles going back to 2011 when Tampa General, St. Joseph’s in Tampa, Bayfront Medical Center in St. Petersburg and the former Shands Jacksonville Medical Center challenged the rule FDOH used in reviewing trauma applications.
Tampa Bay and Jacksonville hospitals both have long-standing trauma centers, and they moved to block approval of three new trauma facilities: Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County and Orange Park Medical Center in Clay County.
After an administrative law judge invalidated the old rule, the department then allowed trauma facilities to start at all three affiliates of the HCA health-care chain.
Trauma centers have continued at Blake and Regional Medical Center Bayonet Point, while the state closed the Orange Park facility for unrelated reasons.
Adding to the controversy is an FDOH decision in late 2012 to allow another trauma center at Ocala Regional Medical Center, which drew opposition from Gainesville’s UF Health Shands Hospital.
Saunders reports that the department informed a House panel in January that there are 19 pending legal cases related to the decisions on approving trauma centers, including several that threaten the operations of trauma centers at HCA trauma.
