Governor Rick Scott and state lawmakers hope a new law will end fights between hospitals over establishing new trauma centers. The law is a compromise between key players in Florida’s hospital industry.
The compromise involves how many trauma centers can be in one area. Right now, there can be no more than 44 trauma centers in the entire state. And licenses are granted according to region. Those regions, or Trauma Service areas are determined by population. The state has 19 of them. But in recent years, healthcare providers have clashed—over the current rules, the designation of what is and isn’t a trauma center, and over whether other trauma centers should be allowed to open.
“We’ve done a good job between safety nets HCA and the Senate in order to get to what some would believe is a significant compromise," says Republican Rep. Jay Trumbull.
“The department will create an analysis of the statewide trauma system every three years, beginning August 2020; the application approval process is revised so that the Department will only accept a letter of intent to open a new trauma center only if there is need," he said during a February legislative hearing on the measure, laying out key points of the deal.
The new law changes the regions from 19 to 18 and lowers the statewide cap on trauma centers to 35. It keeps the population rules in place. For example, a there can be no more than two trauma centers in an area with 1 and a quarter million people. In areas with 2.5 million, there can be four trauma centers. The Department of Health would be able to determine if more are needed: Steve Acenia works with the hospital chain Columbia-HCA.
“It’s a delicate balance to present a product to you the entire state can be proud of," he said.
The fights have often pitted safety net hospitals which serve large numbers of uninsured and under-insured patients against private hospitals like Columbia HCA. Safety-nets have argued new facilities take away patients and doctors, but HCA has argued adding new centers provides greater access. The new law also allows existing centers to be grandfathered in, good news says Mark Delegal of the Florida Safety Net Hospital Alliance.
“We have worked hard with the stakeholders with Representative Trumbull. We appreciate the work to resolve this decade-long battle over trauma. I think we’ve reached a good place. I don’t think everyone got what they thought was necessary but I think t the same time we can be proud of this work product in the future.”
A final staff analysis of the measure notes the language should resolve most of the existing lawsuits surrounding trauma centers.