Hospitals battle new trauma care proposal

UF Health among 5 hospitals challenging proposal by state health department

TALLAHASSEE, Fla. – Five major hospitals are challenging a proposal by the Florida Department of Health that would revamp the approval of new trauma centers --- the latest chapter in years of legal wrangling about the state's trauma system.

UF Health Jacksonville, Tampa General Hospital, St. Joseph's Hospital in Tampa, Bayfront Health in St. Petersburg and Lee Memorial Hospital in Fort Myers filed the challenges last week in the state Division of Administrative Hearings.

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They contend that the Department of Health is overstepping its legal authority in the proposal, which would change criteria that have limited the numbers of trauma centers allowed in each of 19 areas of the state. The Department of Health began moving forward last month with the process of approving what are technically known as proposed rules.

The five hospitals have long operated trauma centers and argue that the proposal could lead to the opening of multiple new trauma centers. Florida has regulated the number of trauma centers, at least in part, because the facilities are expensive to operate and require specialized staff.

"The department's proposed rules mock the trauma planning requirements of Florida law by simply declaring that any applicant in any area of the state may be approved to operate a new trauma center, regardless of whether the center is needed in a particular service area," identical language in four of the challenges said.

But supporters of making changes in the system have argued that additional trauma centers can shorten the distance and time for patients to receive care after getting injured in traffic accidents or other types of incidents. Perhaps the biggest supporter of adding trauma centers has been the HCA hospital company, which has successfully pushed in recent years to open new trauma facilities in some parts of the state.

The department had not filed a response as of Wednesday afternoon to the hospitals' legal challenges. But in a notice published Sept. 1, the department indicated it was proposing the changes "to develop an inclusive, sustainable trauma system that allocates trauma center need necessary to establish reasonable access to high quality trauma services."

Legal and regulatory fights about the trauma system have regularly flared during the past five years, including in a protracted battle about HCA's successful efforts to open 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.

UF Health Jacksonville is currently battling in a separate case at the Division of Administrative Hearings about a state decision to give what is known as "provisional" approval for Orange Park Medical Center to open a trauma center. Orange Park Medical Center, which is just outside Jacksonville in Clay County, is part of the HCA chain.

In their filings last week, the five hospitals raised a series of arguments in challenging the new proposal by the Department of Health.

For example, they contended that the proposal would improperly allow trauma centers to be approved in areas of the state without determination that the facilities are needed. Also, they argued that the proposal improperly adds wording about "minimum" numbers of trauma centers needed in the areas --- a change that the opponents say could open the door to more trauma facilities than would have been allowed in the past.