Attempts by Florida lawmakers to resolve a long-running dispute about the state's trauma system crumbled Friday in the final hours of the annual legislative session.
The House and Senate sought to ensure that three disputed trauma centers in Manatee, Pasco and Marion counties remain open. But the issue became tangled in broader health-care bills, and lawmakers could not resolve their differences.
Just minutes before the session ended, the House took up a health-care bill and approved a 115-page amendment that included the trauma issue and a grab bag of other proposals. The Senate did not take up the bill, but even House Speaker Will Weatherford joked about the massive amendment --- known as a legislative "train."
"Can you say choo choo,'' Weatherford said to Rep. Jason Brodeur, a Sanford Republican who proposed the amendment. "That is a health care train, my friend."
The issue focused on trauma facilities at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Ocala Regional Medical Center in Marion County that the Florida Department of Health approved to open in 2011 and 2012.
Some major hospitals in the Tampa Bay and Gainesville areas (including Tampa General Hospital, St. Joseph’s Hospital in Tampa and Bayfront Health in St. Petersburg) challenged the approvals, and judges found that the department used an invalid rule in making its decisions. That has spurred a series of additional legal cases that could threaten the continued operation of the three trauma centers.
Also, the disputes spurred the Department of Health to draw up a new rule proposal for approving trauma centers. But that proposal also has drawn legal challenges.
Tony Carvalho, president of the Safety Net Hospital Alliance of Florida, which includes hospitals that challenged the Manatee, Pasco and Marion County facilities, said after the session adjourned that he hopes the parties and the Department of Health can still negotiate an agreement on the trauma issue. He said such an agreement would involve a rule that is fair, guarantees access to care and has quality standards.
"I'm always optimistic,'' Carvalho said. "I think all sides are tired of this."
Residents and community leaders from areas such as Marion County traveled to Tallahassee during the session to urge lawmakers to step in and pass a bill that would ensure trauma centers stay open. The idea also was pushed by the HCA Healthcare hospital chain, which includes the Manatee, Pasco and Marion hospitals.
But critics of the department's decision-making have raised concerns about care being diluted if too many trauma centers are allowed to open. They say trauma centers, which are costly to operate and rely on highly trained staff, need certain volumes of patients.