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State of Florida scrambling in wake of trauma center ruling

Tallahassee, FL - December 31, 2012

After an appeals court tossed the rules Florida uses to approve new trauma centers, state health officials are scrambling to rewrite the approval process.

The court said in November that the rule used to approve new trauma centers, which has not been updated since 1992, was outdated and no longer valid. The ruling came after four hospitals that operate trauma centers, including Shands Jacksonville, challenged the approval of three new trauma centers, including one at Orange Park Medical Center.

Though the court tossed the rule, the three trauma centers continue to operate. A second lawsuit was also filed in late December challenging the approval of a new trauma center at Ocala Regional Medical Center. Shands Jacksonville is also involved in that challenge.

During a public hearing last month in Tallahassee, trauma center stakeholders said the new rule should include provisions that would not allow the market to become over saturated.

“We would ask that one of the criteria to be considered in any trauma center … are they going to be able to stay in business?” said Mark Vaaler, the chief medical officer for St. Joseph’s hospital in Tampa.

Several speakers echoed those sentiments, saying too many centers will affect patient care.

“So if we are diminishing quality by dilution of experience, decreasing expertise, increasing cost … rather than focusing on the problems of our system, then we are decreasing values,” said J.J. Tepas, a professor of surgery and pediatrics at the University of Florida.

One specific example of over saturation increasing costs was tied to the fight for specialists. Doctors with specialties are often not on staff and are in high demand when trauma patients arrive.

“If we have to compete for more and more of those specialists, it will only continue to grow and our health-care costs will continue to spiral out of control,” Vaaler said.

Nearly every speaker also said that a “needs analysis” should be conducted to determine what the state’s trauma center system needs moving forward. There was $650,000 in an early version of the 2011 budget, but it did not make it into the final spending plan.

The hearing came a day after Munroe Regional Medical Center in Ocala, Shands Gainesville and Shands Jacksonville filed a lawsuit challenging the new Ocala trauma center.

The new challenge relies, in part, on the appeals court decision. It contends that until a new rule is in place, the department can’t approve new trauma centers.

There are four additional public hearings scheduled, including one in Jacksonville.

The News Service of Florida contributed to this report.

Posted December 31, 2012 on Jacksonville.com

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