Florida Nonprofits Win Fight Over Trauma Centers

BILL KACZOR, Associated Press

TALLAHASSEE, Fla. (AP) — Four not-for-profit hospitals that operate urban trauma centers won a victory Friday when a Florida appellate court struck down a state administrative rule that had authorized competing trauma centers at for-profit hospitals in outlying communities.

A three-judge panel of the 1st District Court of Appeal said in a 2-1 decision that the rule is outdated and, therefore, invalid.

The not-for-profits oppose the centers at for-profit hospitals. They contend the competition would siphon off patients, compete for staff and worsen the already strained financial conditions of the not-for-profits and reduce their ability to provide life-saving care. The argument for the additional facilities is that they could save lives by providing quicker care to trauma patients in those communities.

“This is a substantial step in our ongoing effort to overturn the designation of the trauma centers” in the nearby communities, said Kanika Tomalin, a spokeswoman for Bayfront Medical Center in St. Petersburg.

The other not-for-profits in the case are Tampa Medical Center, St. Joseph’s Hospital of Tampa and Shands Jacksonville Medical Center.

They oppose trauma centers in Pasco and Manatee counties in the Tampa Bay area and Clay County near Jacksonville that are being opened by HCA, a company once headed by Gov. Rick Scott. The Florida Department of Health, which is under Scott, approved the additional trauma centers under the now-stricken rule.

The state will not appeal the decision and will revise the rule to meet the court’s objections, said Surgeon General Dr. John Armstrong, who heads the Department of Health.

“Workshops will begin in December to develop an inclusive, sustainable trauma system that distributes trauma centers throughout Florida,” Armstrong said in a written statement. “The department intends to work with the American College of Surgeons Committee on Trauma to conduct a system consultation that will inform the rule development process.”

While the rule challenge was pending, the department granted authority for trauma centers in the outlying communities. The not-for-profits are challenging that decision in a separate case that’s also now before the 1st District Court in Tallahassee.

Judges Philip Padovano and Nikki Ann Clark said the rule was out of date because it failed to reflect changes in state law made in 2005.

They noted it still divides the state into 19 trauma service areas although the law reduced the number to seven to match Florida’s seven domestic security task force regions. They also noted the rule never was amended to reflect a requirement in the law to conduct annual trauma region reviews.

Judge Bradford Thomas dissented, contending another statute supported the rule. He also pointed out the Legislature never disapproved of it.

“This eight-year silence within the legislative branch constitutes evidence of its approval of the department’s decision to retain the rule,” Thomas wrote.

All three judges, though, rejected an argument by the not-for-profit hospitals that the rule also is arbitrary and capricious.

Copyright 2012 The Associated Press.

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