Department Of Health Gets Win In Trauma Case

A state appeals court Tuesday sided with the Florida Department of Health in a long-running dispute about proposed rules for determining whether trauma centers should be allowed to open --- though a law passed this year largely made the issue moot. 

A three-judge panel of the 1st District Court of Appeal overturned a 2017 decision by Administrative Law Judge Garnett Chisenhall, who tossed out the proposed rules.

The case is part of years of legal battles involving the hospital industry and the Department of Health about opening trauma centers in various parts of the state.

The battles focused heavily on a law that limited the number of trauma centers statewide to 44 and divvied up trauma centers among 19 regions.

The proposed rules in Tuesday’s decision dealt with a process of determining "need" for trauma centers in each of the 19 regions, known as trauma service areas.

In the past, the numbers in each region were typically viewed as a maximum number of trauma centers. But the proposed rules changed the interpretation to a minimum.

Chisenhall found that the proposed rules conflicted with state law, but the appeals court disagreed.

“(The) department was tasked with allocating the approximate number of trauma center slots to the TSAs (trauma service areas) to ensure reasonable access to trauma care,” said the 11-page ruling by judges Scott Makar, Thomas Winokur and M. Kemmerly Thomas. “It was rational for the department to reserve slots for TSAs without sufficient trauma centers to satisfy their need assessment under the proposed rules to ensure reasonable access. Because the statute laid out the framework with little guidance regarding implementation, the Legislature granted the department wide berth to make the pure policy decisions that would support the interpretation of need as a maximum or minimum.”

The Legislature this year approved a compromise aimed at resolving the disputes about trauma-center approvals.

The appeals court said that legislation made moot the challenge to the proposed rules. But the court said it decided the issue, at least in part because the outcome could affect the ability of hospitals that challenged the proposed rules to seek attorney fees.

Numerous hospitals were involved in the case, with some challenging the proposed rules and others backing the Department of Health.

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