New Trauma Plan Doesn't Cure Old Divisions

, Daily Business Review

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After more than two years of legal and political battles in the hospital industry, the Florida Department of Health is moving forward with a new plan for divvying up trauma centers across the state.

But based on a hearing Wednesday in Orlando, the battles appear to be far from finished.

Supporters of opening—or keeping open—trauma centers at hospitals in areas such as Osceola, Marion and Clay counties turned out to the hearing to support the department's plan, arguing that residents and tourists need to be able to get specialized trauma care faster and without having to travel long distances to other hospitals.

"Access equals lives saved," said surgeon Erik Barquist, trauma medical director at Osceola Regional Medical Center, which has been seeking to open a trauma center. "Decreased transportation time equals lives saved."

But the plan drew criticism from representatives of hospitals in the Tampa Bay, Jacksonville and Gainesville areas that have operated trauma centers for years. They argued, in part, that community support is not enough to justify opening trauma centers, which are costly to operate and need highly trained doctors and other staff members.

"There is a question of who is going to pay for this," said surgeon Steven Epstein, director of the trauma program at Bayfront Medical Center in St. Petersburg.

The hearing focused on a draft rule drawn up by the Department of Health, which oversees approval of trauma centers. Under the draft rule, the department would use a scoring system that takes into account factors such as population, transportation times and community support to determine how many trauma centers should be allowed in each of 19 areas of the state.

Overall, the proposal could lead to a maximum of 43 trauma centers sprinkled across Florida, compared to the 25 trauma centers that are currently operating, according to a department chart. As an example, an area that includes Marion, Citrus and Hernando counties has one trauma center at Ocala Regional Medical Center but could have a maximum of three under the draft rule.

State officials drafted the plan after an administrative law judge and an appeals court found that a previous trauma rule was invalid. Bayfront Medical Center, Tampa General Hospital, St. Joseph's Hospital in Tampa and UF Health Jacksonville challenged the old rule in 2011 as they tried to prevent the department from approving new trauma centers at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Orange Park Medical Center in Clay County.

In the course of the legal wrangling, trauma centers were allowed to open at Blake Medical Center, Regional Medical Center Bayonet Point, Orange Park Medical Center and Ocala Regional Medical Center—all affiliated with the HCA health care chain. But continuing litigation has raised questions about whether the Blake, Bayonet Point and Ocala Regional trauma centers should be allowed to stay open. The Orange Park trauma center was closed for another reason, though the hospital has sought to reopen it.

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