Latest news on the Florida trauma system

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Florida continues to be the epicenter of trauma system controversies in the U.S. This page provides the latest news from the Sunshine State, as lawmakers, regulators and trauma center leaders attempt to create a fair system that balances the needs of hospitals, caregivers and injured patients.

May 1, 2017: Judge blocks new St. Pete trauma center

A circuit court judge in Florida has blocked Northside Hospital in St. Petersburg from operating as a Level II trauma center, according to the Tampa Bay Times. (Read Judge blocks new trauma center at St. Petersburg’s Northside Hospital.)

The hospital had received a provisional license from the state health department to open its trauma center on May 1, according to the report. The Friday court order blocked the planned opening, upholding current regulations that limit the number of trauma centers allowed in each of the state’s trauma service areas.

Judge Karen Gievers wrote that the health department’s action “ignores the plain language of the law,” according to the Tampa Bay Times. The order also stated that department’s move “seemed unconnected to existing statutes that control Florida’s trauma system…and more reflective of hoped for legislation.”

April 28, 2017: Florida house approves bill repealing regional trauma center caps

On Friday, the Florida House of Representatives approved proposed legislation that would repeal the state’s system of regional trauma center caps, according to a News4Jax report. (Read House approves trauma system changes.) The measure passed by a vote of 93 to 24 with little debate.

If it becomes law, the bill would set a minimum requirement of two trauma centers for service areas with more than 1.25 million people and four trauma centers for areas with a population greater than 2.5 million, according to the report.

April 25, 2017: Florida senate trauma bill dies in committee

A trauma system reform bill introduced in the Florida state senate has died in committee. (Read Legislation Adding More Trauma Centers Moves In Florida House, Stalls In Senate.)

Senate bill SB 746 was introduced by Sen. Travis Hutson in February. The proposed law was reportedly similar to the house trauma center bill sponsored by Rep. Jay Trumbull. The failure of this measure casts doubt on the entire push to re-do the Florida trauma system.

April 17, 2017: Trauma cap repeal bill clears Florida budget committee

A bill that would eliminate regional caps on trauma center numbers has cleared Florida’s House Appropriations Subcommittee on Health Care.

The Republican-backed bill was passed on a 10-5 vote that broke along party lines, according to the SaintPetersBlog. (Read Bill to remove limit on number of trauma centers moves in House.)

Jay Trumbull (R-Panama City), sponsor of the proposed legislation, has said the bill would reduce the burden of litigation on the state’s Department of Health. “Records show 31 cases have been filed since 2014, most at the administrative hearing level, and the state has spent over $900,000 on outside attorneys in the last year and a half,” according to the SaintPetersBlog report.

The lawmaker argues that Florida does not currently have enough trauma centers, according to a Tampa Bay Times report: “As a contrast, Trumbull points to New York City, which at a third of the population has nine Level One trauma centers to Florida’s 10.” (Read Trauma care ideas clash.)

April 5, 2017: Surgeons speak out against proposed law

Trauma surgeons representing three Florida trauma centers held a press conference in Tallahassee on Tuesday to express their opposition to proposed changes in the state’s trauma system regulations.

Michael L. Cheatham, MD, of Orlando Regional Medical Center, expressed his concern that new entrants into the trauma system are not prepared to make the financial investment required by top-level trauma care.

“You can bill for trauma care and so many hospitals think that there’s money in it,” Dr. Cheatham said, according to a report from WFSU. “But if you truly want to be a quality trauma center, it takes a tremendous amount of money that would exceed what many hospitals are able to do. They just can’t invest that kind of money.”

Other participants in the press briefing represented Lee Memorial Hospital and Broward Health Medical Center.

According to the WFSU report, the proposed legislation would allow trauma centers to operate for 5 years without a quality evaluation.

March 31, 2017: Editorial argues “don’t repeal, repair” Florida system

An editorial published in the Fort Lauderdale Sun Sentinel argued against a bill that would do away with Florida’s system of regional trauma center caps. (Read Don’t open floodgates on trauma centers.)

HB 1077 was approved by a state legislative subcommittee on March 27. The bill would do away with Florida’s system of 19 trauma service areas (TSAs), each of which has a maximum number of allowed trauma centers. Supporters of the bill believe it will improve patient care by allowing the market to supply patient needs.

The editorial argued that a market-driven system would lead to duplicative services that increase total system costs. It would also increase the risk that low-income areas would be neglected by market-driven providers.

Jay Trumbull (R-Panama City) stated that 30% of patients who could benefit from trauma center care are being treated in non-trauma center hospitals, according to the editorial. However, that figure may actually represent undertriage.

“Mark Delegal, a lawyer representing a group of hospital providers opposed to the bill, pointed out that the 30 percent figure represented patients that emergency responders should have sent to a trauma center, rather than a regular emergency room,” according to the Sun Sentinel. “It does not mean there is a lack of trauma access.”

March 28, 2017: Judge rejects reinterpretation of trauma system regs

An administrative law judge in Florida has rejected a proposal from the state Department of Health that would significantly reinterpret the state’s current trauma system regulations, according to an article on News4Jax.com. (Read Judge tosses out trauma system plan.)

Under the current system, the state is divided into 19 trauma service areas. The law requires the DOH to calculate the number of trauma centers required to meet each service area’s need.

“In the past, the numbers in each region have typically been viewed as a maximum number of trauma centers,” according to the report. “But the proposed rule changed the interpretation to a minimum.” This reinterpretation would effectively gut the system.

The judge ruled that the proposal contravenes two state laws and conflicts with the legislature’s intent. As quoted by News4Jax.com, the judge’s ruling stated, the “case must turn on the Legislature’s use of plain and unambiguous language that clearly establishes that the department is to calculate the maximum (rather than the minimum) number of trauma centers needed in the 19 TSAs.”

March 27, 2017: Florida House panel approves bill that repeals regional trauma center caps

A Florida House subcommittee voted today to approve a bill that would eliminate the state’s current system of trauma regions and regional trauma center caps, according to an article on News4Jax.com. (Read House panel backs revamping trauma system.)

Under the current system, Florida allows a maximum of 44 trauma centers to operate within the state. The state is divided into 19 trauma service areas, each with its own maximum number of allowed trauma centers.

HB 1077, sponsored by Jay Trumbull (R-Panama City), would do away with both statewide and regional caps. Rep. Trumbull argued that the regional limits embedded in the current system have not kept up with state population increases. He also noted that the current system is generating significant legal fees. According to a Department of Health official quoted in the News4Jax.com report, “the department has spent almost $1 million during the past 18 months litigating trauma-center cases.”