After a bill to expand trauma centers once again failed in the state Legislature earlier this year, a new legal fight is underway in Jacksonville that could affect how catastrophic injuries are dealt with throughout the state.
UF Health Jacksonville has challenged a state decision to give preliminary approval to a new trauma facility at a rival hospital, according to the News Service of Florida.
The Florida Department of Health decision last month gave what is known as “provisional” approval for a trauma center at Memorial Hospital Jacksonville, according to documents filed in the case.
UF Health Jacksonville also has been in a legal battle over a state decision to allow a trauma center to open at Orange Park Medical Center in nearby Clay County.
The argument by existing trauma centers is that by opening new ones it dilutes the needed medical expertise necessary to respond to these life-threatening injuries. State law caps the number of trauma centers statewide at 44.
In Palm Beach County, there are two Level 1 trauma centers at St. Mary’s Medical Center and Delray Medical Center. The Health Care District of Palm Beach County runs the trauma system, though.
This was the year that Gov. Rick Scott and Republicans in the Florida Legislature delivered on all their talk about opening up competition in health care. Like with medical marijuana legislation, it was a big failure.
One only needs to see every other billboard on Interstate 95 to realize the hospitals are in an all out war for patients in areas of heart surgery and maternity care. But Scott and House Republicans wanted to open up it even more in some very troublesome areas, critics said.
They wanted to add trauma centers across the state and to eliminate the requirement that hospitals prove community need before expanding into an area of practice.
Both bills (HB 7 and HB1077) died on Friday when the Senate refused to take them up. This is not the first time that Scott, a former health-care executive, has tried to get rid of these regulations.
This blog explored both issues during the session that also saw lawmakers fail to implement voter-mandated medical marijuana laws.
When comes to specialized hospitals programs and trauma, hospitals need as many patients as they can get so they can perfect the practice. You know, brain injury and pediatric heart surgery are not exactly easy.
Trauma centers are no different.
Scott called for getting rid of a limit of 44 trauma centers statewide. Right now, Palm Beach County has two level-one trauma centers: St. Mary’s Medical Center and Delray Beach Medical Center.
Dr. Robert Borrego, medical director of the Trauma Center at St. Mary’s Medical Center, told The Post earlier this year that it is important to limit the number of trauma centers.
“Can you imagine coming to a center and you have traumatic brain injury and the neurosurgeons only do about 10 operations a year? Are you going to comfortable there or do you want somebody who does 1,000 operations a year?”
The hospital wars — readily apparent on practically every other billboard down the interstate — has now bled over into trauma with accusations that expansion by a competitor into the area threatens “the entire care system in our country.”
The fight pits two giants against each other: Tenet Healthcare and HCA Healthcare and puts taxpayers in the middle as the whole system is administered by the Health Care District of Palm Beach County.
Currently, the county’s state-designated Level 1 trauma centers are St. Mary’s Medical Center and Delray Medical Center.
Trauma centers handle the most extreme cases of emergencies, such as car accidents, gunshot wounds. Life and death hang in the balance with each case that comes through the doors.
The current trauma drama stems from Tenet competitor JFK Medical Center in Atlanta filing a letter of intent with the Department of Health on Sept. 30 to upgrade its trauma care services to Level 2 that would cater only to adults.
It is a first step in formerly submitting an application next year.
In a letter sent out today by Mark Bryan and Gabrielle Finley-Hazle – the CEOs of St. Mary’s Medical Center and Delray Medical Center respectively – the Tenet hospitals excoriate the competitor’s plan, saying it would undercut a system in place for 25 years.
“There will be a lack of qualified trauma surgeons to cover an excess center and decrease trauma center staff proficiency,” the letter states.
In the letter addressed to its board members, the community, employees and doctors, the CEOs say that the proposal goes against the five-year plan approved and submitted to the Department of Health and the Health Care District.
The district is an independent taxing district that operates Trauma Hawk and provides a health care safety net for the county.
The letter states since JFK is only offering adult trauma services it means if a tragic event occurs involving an entire family, then parents and children will be split up.
The Post plans on interviewing all players in this trauma drama and will update this story as warranted.
Whether its heart surgery or maternity, hospitals are very aggressive in vying for patients in the county.
St. Mary’s closed down its pediatric heart surgery unit last year following criticism that is now being leveled at JFK’s trauma plan: that the program diluted the number of patients and undercut the proficiency of existing programs in South Florida.
In the letter, the Tenet hospitals point to an investigation by the Tampa Bay Times into how HCA is targeting trauma for profit, charging exorbitant fees that pale in comparison to competitors.
“HCA is capitalizing on a marketplace that is unchecked by politicians or regulators. That has allowed one of the nation’s largest for-profit hospital chains to bill injured patients record fees,” according to the March 2014 story.