Trauma Drama Continues As New Law Challenged

Part of a new Florida law touted as a way to end years of disputes over trauma centers is being challenged by a Miami-based hospital.

Nicklaus Children’s Hospital filed a challenge in Leon County circuit court seeking an injunction to block a section of the law that would allow a competitor, Kendall Regional Medical Center, to operate what is known as a Level I trauma center.

Nicklaus Children’s Hospital “is likely to suffer irreparable harm because any final approval of Kendall’s Level I status, and the significant damage flowing therefrom, cannot be undone,” attorneys for the facility wrote in the lawsuit filed Thursday.

The filing added that “given the importance of trauma centers, Florida’s regulation of a unified trauma system should place the needs of trauma victims and citizens over private corporate interests.”

With Kendall upgraded to a Level I trauma center, the lawsuit contends that pediatric patients will be diverted to Kendall instead of going to Nicklaus.

The children’s hospital argued that the portion of the new law is unconstitutional because the Legislature didn’t follow proper procedures when passing what Nicklaus contends is a “special law” or a narrowly targeted local law that benefits Kendall Regional Medical Center.

The Constitution requires that lawmakers provide advance notice to the public before they enact a special law or that a referendum be held for local voters to weigh in on the issue.

Attorneys also maintain that the law is unconstitutional because it unfairly benefits one private corporation, which is prohibited in the state Constitution.

Kendall Regional Medical Center is owned by the Hospital Corporation of America, or HCA, and is the only hospital that qualifies as a Level I trauma center under that section of the law. The challenge contends the law “impermissibly grants a ‘privilege to a private corporation’ that others do not receive and is therefore a constitutionally prohibited special law.”

In May 2016, the Florida Department of Health gave Kendall --- which had been operating as a Level II trauma center --- provisional authority to operate as a Level I trauma center. Nicklaus, which is part of the Miami Children’s Health System and has a pediatric trauma center, challenged the move that same month.

During the 2018 legislative session, Senate Health Policy Chairwoman Dana Young, R-Tampa, and other lawmakers tried to resolve long-standing disputes that have largely come as HCA has moved in recent years to open trauma centers at many of its hospitals. Among other things, the new law changed the number of trauma-service areas from 19 to 18 and put a new “need formula” in law for the approval of trauma centers. It passed the Legislature unanimously.

The provision in the law that concerns Nicklaus requires the state to provide Level I trauma status to any facility that had provisional Level I approval before January 2017 and had been operating as a Level I trauma center but had not received final verification by December 2017.

The law is “a special law that allows Kendall --- and only Kendall --- to automatically bypass in depth review, including a determination of need, and to receive the department’s final approval as a Level I trauma center without meeting the same requirements and standards, and undergoing the same approval process, as other hospitals,” the suit alleges.

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