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Judge Affirms DOH on Trauma Rule

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

Florida’s Department of Health was within its legal right to revamp the state’s system for establishing new hospital trauma centers, an administrative judge ruled late Friday.

The state’s year-long process to create a new formula to approve trauma centers was done carefully and within responsibilities assigned to the DOH, reads the 71-page order by Judge R. Bruce McKibben of the state’s Division of Administrative Hearings.

“The rulemaking process also refutes any claim that the Proposed Rule was arbitrary or capricious. There was ample testimony as to the facts and logic supporting each of the criteria in the Proposed Rule--negating any claim of arbitrariness,” he wrote.

Friday’s decision addresses the DOH rule divvying Florida into 19 zones, and opening up the chance for a number of new trauma centers across the state. Specifically, it answers the question whether the Department overstepped its authority in creating the rule.

And it is just the latest in a long list of lawsuits, administrative complaints and legislative policy battles over trauma centers – hospitals that have additional staff to handle serious medical emergencies and that can charge additional fees for the higher level of care.

This decision is a blow to large, mostly urban non-profit trauma centers that have spent several years challenging DOH’s rule that opened up the opportunity for more trauma centers in the state. It's an enormous boost to newer, suburban trauma centers in Pasco, Manatee and Marion Counties that have been threatened with closure.

Plaintiffs including Tampa General Hospital, Miami’s Jackson Health and UF Shands Health in Gainesville maintain that more centers dilutes the talent pool and quality of care needed at trauma centers, and financially cripples hospitals already invested in the costly care.

McKibben didn’t buy that argument. “The fact that the Proposed Rule may cause Petitioners economic harm is not a basis to invalidate it,” he wrote.

HCA Healthcare owns most of the newer trauma centers, and argues that residents who don’t live close to existing centers deserve better access to trauma care. The for-profit chain has come under scrutiny for how its trauma center fees are disproportionately higher than those from other hospitals.

Friday’s decision comes after multiple hearings were held in March, April and May. It wasn’t clear late Friday how this administrative ruling affects other pending complaints.

For example, the same court this month announced it planned to delay final hearings until September in other cases involving Blake Medical Center in Bradenton and Regional Medical Center Bayonet Point.

Mary Shedden is news director at WUSF.