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HCA Trauma Centers Get Reprieve

Wading into a hospital-industry battle, Florida senators began moving forward Tuesday with a plan that would ensure three disputed trauma centers can stay in business --- but also would slap a temporary moratorium on additional trauma facilities in the state.

The Senate Health Policy Committee approved a bill (SB 1276) that would prevent the potential closure of trauma centers at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Ocala Regional Medical Center in Marion County. Those trauma facilities have been at the heart of legal battles that have been ongoing for nearly three years.

Bill sponsor Denise Grimsley, R-Sebring, said closure of the trauma centers would cost jobs and also would come after significant investments in the facilities.

"I just can't see putting people out of business,'' she said.

But the committee also approved a Grimsley amendment that significantly changed an earlier version of the bill. In part, the changes would place a moratorium until July 1, 2015, on the approval of new trauma centers by the state Department of Health and require an advisory council to submit trauma-system recommendations to the Legislature by Feb. 1, 2015.

Grimsley said the moratorium would give lawmakers time to consider how to address the trauma system, at one point saying during the meeting that the Legislature has been "backed into a corner" on the issue. The Senate committee voted 7-2 for the revised bill.

A House panel this week also moved forward with a bill (HB 7113) that would ensure the continued operation of the trauma facilities in Manatee, Pasco and Marion counties, though that proposal does not include the moratorium.

Lawmakers have become embroiled in the heavily lobbied issue amid continuing litigation that involves the Department of Health, the HCA health-care chain and hospitals that have long operated trauma facilities in the Tampa Bay, Gainesville and Jacksonville areas. HCA in recent years has sought to open trauma centers at several of its hospitals, including the Manatee, Pasco and Marion hospitals.

Throughout the debate, HCA and its backers in the local communities have argued that the trauma centers improve access to critically important care. But opponents contend that the new trauma facilities were improperly allowed to open and drain staff and patients from other trauma facilities.

Sen. Arthenia Joyner, a Tampa Democrat who voted against the bill Tuesday, pointed to a need to limit the number of trauma centers.

"It costs too much,'' said Joyner, who was joined in dissent by committee Chairman Aaron Bean, R-Fernandina Beach. "We don't have the doctors to staff them all. We don't have the case mix."

Legal battling began in 2011 and continues to threaten the operation of the Manatee, Pasco and Marion trauma facilities, which were allowed to open in 2011 and 2012. They have faced legal challenges 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.

The opponents of the HCA trauma facilities have won some key legal decisions, including decisions by an administrative law judge and the 1st District Court of Appeal that the Department of Health used an invalid rule in approving the new trauma centers. That has spurred additional litigation raising the possibility that the facilities would have to close.

Mark Delegal, an attorney for the Safety Net Hospital Alliance of Florida, which opposes the bills, said the Department of Health failed to follow the law in allowing the three trauma centers to open.

Along with opposing the effort to ensure the continued operation of the facilities, Delegal said he is concerned the House and Senate bills could be interpreted to allow a trauma center to operate at Orange Park Medical Center in Clay County. Orange Park, another HCA hospital, opened a trauma center in 2011, but the facility was later closed by the state for reasons unrelated to the legal fight.

But officials and residents from areas such as Marion County are backing HCA's lobbying efforts to make sure the already-existing trauma facilities don't close. They point to issues such as reduced time to get care for seriously injured patients.

"This is an important issue to our community," Marion County Commissioner Stan McClain told the Senate panel Tuesday.

Also, the Tampa Bay Times reports that the committee capped so-called "trauma fees" facilities can charge patients at $15,000. A Times investigation found that trauma centers were charging anywhere from $1,500 to more than $30,000 for trauma patients brought into their facilities. The cap is for one year, the Times reports.

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