Amid an industry fight about new trauma centers in Clay, Pasco and Manatee counties, a House committee Thursday approved a bill that would eliminate limits on the number of trauma centers in the state.
The bill, HB 1419, would overhaul a process the Department of Health uses in reviewing proposed trauma centers and appears likely to make it easier to move forward with trauma projects.
In recent months, Shands Jacksonville, Tampa General Hospital, St. Joseph's Hospital in Tampa and Bayfront Medical Center in St. Petersburg have fought Department of Health approvals of the Clay, Pasco and Manatee trauma facilities.
The House Health & Human Services Committee approved the changes in an 11-page amendment to a broader bill that deals with health facilities.
Rep. Carlos Trujillo, a Miami Republican who sponsored the amendment, urged a free-market approach that would allow hospitals to decide whether to pursue trauma centers.
"I think we should open it up,'' Trujillo said. "Let competition decide.''
But critics said, in part, the state has a scarcity of specialty physicians who work in trauma centers. They said allowing more trauma centers would increase demand and costs for those doctors.
"There are only so many of these specialists to go around,'' said Rep. Ronald "Doc" Renuart, a Ponte Vedra Beach Republican who is an osteopathic physician.
The Health & Human Service Committee voted 12-6 to approve the broader bill, which also sparked opposition because of a controversial provision that deals with contracting between HMOs and hospitals.
Currently, state law includes a cap of 44 trauma centers and gives the Department of Health power to determine how many should be allowed in 19 different regions of the state.
The bill would eliminate the cap and the department's power to allocate the centers. Also, it would eliminate other department rule-making powers that deal with deciding whether trauma centers should be allowed.
The proposed changes come after months of legal sparring about new trauma centers at Orange Park Medical Center in Clay County, Regional Medical Center Bayonet Point in Pasco County and Blake Medical Center in Manatee County.
Those hospitals are part of the HCA hospital chain, which is working with the University of South Florida in an effort to add trauma care in various parts of the state.
Trying to block the trauma centers, the Jacksonville and Tampa Bay-area hospitals last year filed a legal challenge to a 1992 rule that outlined the Department of Health's process for approving trauma facilities. An administrative law judge in September found that the rule was invalid, spurring the department to file a still-pending appeal at the 1st District Court of Appeal in Tallahassee.
The department said it could approve new trauma centers while the appeal remained unresolved, which led it to give what is known as "provisional" approval in November to the Clay, Pasco and Manatee facilities and a trauma center at Kendall Regional Medical Center in Miami-Dade County.
Those hospitals quickly started operating trauma centers, which touched off more legal challenges by the Jacksonville and Tampa Bay-area hospitals. Those challenges so far have been unsuccessful.
Stephen Ecenia, an HCA attorney, said in an e-mail Thursday that the company has not taken a position on the bill approved by the House committee. But he said the four trauma centers that received provisional approval in the fall, along with a trauma center that opened in 2009 at Lawnwood Regional Medical Center in Fort Pierce, "are providing these essential and much-needed services in the communities we serve."
But lobbyists for the Florida Hospital Association and the Safety Net Hospital Alliance of Florida said they have concerns about the bill's changes to the approval process.
