House panel backs revamping trauma system

By Jim Saunders, News Service of Florida
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TALLAHASSEE, Fla. - After years of hospital-industry legal battles about opening new trauma centers, a House panel Monday approved a bill that would repeal limits on the numbers of trauma facilities across the state.

The vote by the House Health Innovation Subcommittee would eliminate a system that allows a maximum of 44 trauma centers statewide and also caps the numbers in 19 different regions.

Gov. Rick Scott has backed the repeal idea, as has the HCA health-care company, which in recent years has sought to open trauma centers in several regions. But the House bill (HB 1077) is opposed by other major players in the hospital industry, including the Florida Hospital Association, the Safety Net Hospital Alliance of Florida and Tenet Healthcare.

Bill sponsor Jay Trumbull, R-Panama City, pointed to the state's population growth since the 44-facility limit was set in 1990 and said more trauma facilities would improve access to care in the so-called "golden hour" after patients suffer injuries. He also pointed to high litigation costs for the Florida Department of Health and hospitals because of the legal battles.

"This bill will allow the market to determine the need for trauma centers while ending a system that has been so costly for the state and hospitals seeking to operate a trauma center," Trumbull said.

But the bill's critics argue, in part, that trauma centers need trained surgeons and staff members and adequate numbers of patients. They contend that allowing more trauma facilities would dilute the quality of care.

Mark Delegal, general counsel for the Safety Net Hospital Alliance of Florida, said "volume equals quality."

"You want your team to be highly trained and to be ready to go at a moment's notice," said Delegal, whose organization includes teaching, public and children's hospitals. "With more trauma centers, where I would argue they are not needed, they may economically be able to survive and to compete but they are not needed, you are going to dilute your workforce."

Legal battles have flared repeatedly since 2011 about plans to open new trauma centers, with the Department of Health often defending decisions to let new trauma facilities move forward.

In January, for example, an administrative law judge ruled that the department improperly allowed Orange Park Medical Center in Clay County to open a trauma center. That case, filed by UF Health Jacksonville hospital, is awaiting final action by the department. The judge found that the state's Northeast region, which includes Orange Park Medical Center and UF Health Jacksonville, is only allotted one trauma center under the current system --- a slot long filled by UF Health Jacksonville.

Department of Health official Paul Runk told the House panel Monday that the department has spent almost $1 million during the past 18 months litigating trauma-center cases.

"The current statute no longer works," Runk said.

House Republican leaders this year are backing a series of bills aimed at creating more of a free market in health care. While the trauma bill was approved 10-5 on Monday, it remains unclear whether it will ultimately pass. A Senate version (SB 746) has not received a committee vote.

Rep. Nicholas Duran, D-Miami, voted for the bill Monday but appeared to question whether it was going too far.

"It seems to me we're taking a bulldozer approach to something we need to be using a scalpel," he said.

News Service of Florida