After years of legal and legislative conflicts, the breach in the hospital industry is a step closer to resolution as the Florida House passed a bill Friday to keep three disputed trauma centers open.
With the session inching closer to its May 2 deadline, the issue is still not settled. The Senate has yet to reach an agreement over the continued operation of trauma centers at Blake Medical Center in Manatee County, Ocala Regional Medical Center in Marion County and the Regional Medical Center Bayonet Point in Pasco County.
On trauma centers, both chambers seem to agree. It is the other matters used by the House to create a legislative “train” of controversial health-care related topics — such as expanded powers for nurse practitioners and the use of telemedicine — that prove to be true roadblocks.
Although the House may have voted 74-42 to pass the massive “cobbled together” healthcare bill, reports Jim Saunders of the News Service of Florida, the Senate is addressing trauma centers as a separate issue, as in SB 1276.
A resolution seems to be coming after almost three years of litigation focusing mainly determining if the Florida Department of Health used an invalid rule in allowing the trauma centers to open in Manatee County, Pasco County and Marion County, and if the facilities should remain open.
The facilities are part of the HCA health-care chain, and face challenges from longstanding trauma centers at Tampa General Hospital, St. Joseph’s Hospital in Tampa, Bayfront Medical Center in St. Petersburg, and UF Health Shands Hospital in Gainesville.
Language in both the House and Senate bill are somewhat different, but they are close enough to allow the three trauma centers to stay open. To help matters further, the bills place a hold on the Department of Health approving any new trauma centers, perhaps until July 1, 2015. The DOH is trying craft new administrative rules for the approval of trauma centers, a proposal that is currently under legal challenge.
Saunders notes that throughout the legislative session the strongest opposition to the trauma bills was from Safety Net Hospital Alliance of Florida, a group including public and teaching hospitals with existing trauma facilities.
However, the House bill does try to address two of Safety Net Alliance’s chief concerns, especially when it comes to the possible reopening of a closed trauma center at Clay County’s Orange Park Medical Center.
In 2011, Orange Park Medical, also an HCA hospital, opened a trauma center but later shut down for reasons unconnected to the current legal battle.
Another argument by Safety Net is that Ocala Regional’s trauma center had been operating under a “provisional” status, not permanent. The House bill would require Ocala Regional to become permanent — as a “verified” trauma center — by the end of the year or risk closure.
Ron Bartlett, a spokesperson for Safety Net, said the group is “cautiously optimistic” that the legislation would bring about new negotiations with the Department of Health over the rules on trauma-facility approvals.
Supporters of the House bill contend that all three issues — trauma centers, telemedicine and expended powers of nurse practitioners — all have one single goal, improved access to primary care.
“This is access to good primary care,” said Rep. Cary Pigman, while discussing nurse-practitioners. “We need good primary care.”
Critics argue issues like expanded powers for nurse practitioners actually threaten overall quality of care.
“The basic tenet is, do no harm,” Rep. Gayle Harrell told the News Service. “This is the massive bill of harm.”