Plunging into a debate about Florida's trauma system, a Senate committee Thursday approved proposals that could make it easier to open new hospital trauma centers -- and assure that some disputed trauma centers would remain open.
The Senate Appropriations Committee took up a health-care bill (SB 966) and made changes that could help fast-track new trauma centers in four regions of the state and also protect trauma centers that have been embroiled in a series of legal challenges.
Bill sponsor Aaron Bean, R-Fernandina Beach, said lawmakers are trying to make sure people have access to trauma care within what he called the "golden hour" after accidents.
"Are you within the golden hour to make it alive to a hospital?'' he asked.
But the proposals, which popped up as part of a 128-page amendment to the bill and two subsequent amendments, drew criticism from teaching hospitals and safety-net hospitals that provide trauma care. Mark Delegal, a lobbyist for the Teaching Hospital Council of Florida, said the proposals had not been considered by health-care committees that ordinarily would debate such ideas.
"This is the kind of stuff that those of us who work in this process should not do,'' Delegal said.
The move by the Appropriations Committee came two days after a House panel also approved a bill to overhaul the way trauma centers are approved. But the Senate version appears to be more far-reaching.
In part, it would create a special approval process for trauma centers in four regions that it describes as having "limited access to trauma care services." As an example, one of those regions is in the western Panhandle, where Fort Walton Beach Medical Center has been trying to get approval to open a trauma center.
The Senate version also includes changes that could help ensure the continued operation of trauma centers at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County, Ocala Regional Medical Center in Marion County and Bay Medical Center in Bay County. State approvals of the trauma centers in Manatee, Pasco and Marion counties have been targeted in a series of legal challenges filed by other hospitals.
The Senate and House proposals would revamp a trauma-center approval process that has long been under the state Department of Health. But the 1st District Court of Appeal ruled last year that the Department of Health had used an invalid rule in approving the new trauma centers.
That ruling has helped fuel additional litigation, as Blake Medical Center and Regional Medical Center Bayonet Point have continued operating their trauma centers. Also facing a challenge has been Ocala Regional Medical Center, which was allowed to open a trauma center after the appeals-court ruling. The hospitals in Manatee, Pasco and Marion counties are all part of the HCA health-care chain.
HCA and other backers of adding more trauma centers say the facilities will improve access to care. But critics say they are concerned, in part, because more trauma centers would drive up costs, as hospitals would have to compete for specialists.
Amid the legal wrangling, the Department of Health has been holding hearings, gathering information and consulting with experts about a new trauma-approval rule. Pediatric surgeon Joseph Tepas, a University of Florida professor and associate dean who works at Shands Jacksonville Medical Center, urged the Senate committee Thursday to wait for experts to make a report -- and likened the legislative proposals to "gerrymandering."
