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Proposed Deal Could End Trauma Battles

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
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The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Legal wrangling over new trauma centers and which hospitals should be allowed to operate them could come to an end under a proposal moving through the Legislature.

Senate Health Policy Chairwoman Dana Young, R-Tampa, said Wednesday the Senate, House and major players in the hospital industry have reached agreement on how to revamp the state’s 26-year old trauma rules.

“We have a deal,” Young told members of the Senate Health and Human Services Appropriations Subcommittee.

The deal would settle disputes across the state and would establish a new methodology to prevent future disputes from occurring, Young said. 

The disputes have largely come as the for-profit HCA Healthcare has moved in recent years to open trauma centers at many of its hospitals. Other hospitals that have long provided trauma services have challenged the HCA plans in a series of legal battles.

The agreement would seek to clear up the statuses of trauma centers in various parts of the state.

For example, it would recognize trauma centers at Bayfront and John Hopkins All Children’s Hospital in Pinellas county; Orange Park Medical Center in Clay County; and Aventura Hospital and Medical Center in Miami-Dade County.

Jackson South Medical Center, part of the Jackson Health System in Miami, and Kendall Regional Medical Center would be recognized trauma centers as would Wolfson Children’s Hospital in Jacksonville, which is a pediatric trauma center.

Northside Hospital in St. Petersburg would not get a trauma department under the negotiated plan. Young said that whether Memorial Hospital in Jacksonville would have a trauma center would hinge on the outcome of litigation currently underway.

‘This is something of a jump ball, and I think that resolves some of the conflict there,” she said of the bill’s wait-and-see approach for that facility.

Young called the agreement a comprehensive approach to “legal and regulatory issues that literally have taken over our trauma system.”

The Legislature for the last several years has wrangled with the state’s trauma system and whether to continue with current regulations or to allow a more competitive environment that would increase the number of trauma facilities. The regulation of trauma centers is governed by laws and Department of Health rules.

Under current law, the state is divided into 19 “trauma service areas,” with limits on the number of trauma facilities in each area. A hospital can receive a designation as a Level I, Level II, pediatric, or provisional trauma center.

Under the agreement, no trauma service area would have more than a total of five Level I, Level II, Level II/pediatric, and stand-alone pediatric trauma centers. A trauma service area could not have more than one stand-alone pediatric trauma center.

The bill would change the number of trauma service areas in the state from 19 to 18, and it would move Collier County from the same trauma service area as Broward County. Instead, Collier County would be included in the trauma service area with Charlotte, Glades, Hendry and Lee counties.

The Department of Health would be required by Oct. 1 to establish an 11-member Florida Trauma System Advisory Council. The group would be required to meet no later than Jan. 5, 2019 and quarterly thereafter.

Senate Health and Human Services Appropriations Chairwoman Anitere Flores R-Miami, told panel members that there would be “a couple” more changes before the bill went to the floor.

Mark Delegal, general counsel for the Safety Net Hospital Alliance of Florida, which includes public, teaching and children’s hospitals, told senators his association had been working with Young.

“We are comfortable with where we are,” he said, adding that the group’s main goal was to ensure quality at existing trauma centers.

HCA attorney Steve Ecenia thanked Young for what he called a “Herculean effort” and called the product “a very fine balancing act with a lot of interests.”