In what one supporter called a "reset for the trauma system," a House panel Tuesday approved a controversial bill that would ensure the continued operation of three disputed trauma centers in Manatee, Pasco and Marion counties.
The 8-4 vote by the House Health Innovation Subcommittee was the first public decision in what promises to be a hospital-industry lobbying battle during this spring's legislative session.
Major industry players and the state Department of Health have been embroiled in nearly three years of legal fights about the approval of new trauma facilities.
The bill, (PCB HIS 14-01), seeks to guarantee that trauma facilities at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Ocala Regional Medical Center in Marion County would continue operating.
They are threatened because of ongoing legal challenges by hospitals in the Tampa Bay, Gainesville and Jacksonville areas.
Subcommittee Chairman Jason Brodeur, R-Sanford, said indicators show that the disputed trauma centers are helping improve the quality of care for patients.
Officials from Marion County testified that the Ocala Regional trauma facility, which opened in late 2012, has saved crucial time in transporting injured people for treatment. In the past, those people would have gone to hospitals in Gainesville or Orlando.
"Today what we're talking about is access to health care,'' Marion County Commissioner Stan McClain said.
But critics said the bill would circumvent the state's longstanding process of determining whether a "need" exists before each new trauma center is approved. They say determining need is critical because of the high costs of operating trauma centers and limited numbers of trauma physicians and specialists.
"I don't believe that injecting politics into this is the right answer,'' said Rep. Ronald "Doc" Renuart, a Ponte Vedra Beach Republican and physician who voted against the bill.
The long-running dispute has largely focused on attempts by the HCA health-care chain to open trauma facilities at various hospitals, including the Manatee, Pasco and Marion hospitals.
But those efforts have faced opposition from Tampa General Hospital, St. Joseph's Hospital in Tampa, Bayfront Medical Center in St. Petersburg, UF Health Shands Hospital in Gainesville and UF Health Jacksonville --- all of which have run trauma facilities for years.
An administrative law judge in 2011 found that the DOH used an invalid rule in approving new trauma facilities, a decision that was later upheld by the 1st District Court of Appeal. The department, however, approved the Manatee, Pasco and Marion trauma facilities, and has allowed them to continue operating.
The department in recent months has worked on a new rule for approving trauma centers, but many of the same divisions remain in the hospital industry about the proposal. Meanwhile, pending legal cases threaten the continued operation of the Manatee, Pasco and Marion facilities.
That has helped lead Brodeur to file the House bill and Sen. Denise Grimsley, R-Sebring, to file a broader measure (SB 1276) that also would allow the three trauma facilities to remain open.
Grimsley's bill would address the process for approving future trauma centers, while Brodeur said his bill is more narrowly focused on keeping open the three facilities.
The House bill calls for allowing trauma facilities to keep their doors open if they have "operated continuously" for a 12-month period and submit an application for a site visit by the American College of Surgeons Committee on Trauma.
Critics, however, questioned whether the bill could have broader effects than allowing the Manatee, Pasco and Marion trauma facilities to remain open. Those questions centered, in part, on whether the bill could allow Orange Park Medical Center in Clay County to reopen a trauma center that was allowed to start operating in 2011 but was later shut down by the state.
Brodeur said he was willing to make changes in the bill to address those questions. He also said the bill might be only part of resolving broader issues in the trauma system.
"I don't think the trauma issue is done with this bill, quite frankly,'' Brodeur said.