More than two years ago, Pasco County got its first trauma center when Regional Medical Center Bayonet Point expanded its emergency care operations. But how long it will stay is completely up to government officials from the courts, to the Legislature, and especially the Florida Department of Health.
The Bayonet Point hospital, owned by HCA’s West Florida Division, is fighting to keep its trauma center despite the objections of nearby facilities like Tampa General Hospital and BayCare Health System’s St. Joseph’s Hospital. Both already have trauma centers, and believe adding more will dilute a costly service to one that no longer can be sustained financially.
Dr. Scott Norwood, the trauma medical director at Bayonet Point, believes in the exact opposite. To him, it’s not that Florida has too many trauma centers. In fact, it doesn’t have enough — and dealing with traumatic injuries comes down to how quickly a victim can get to a hospital that can treat it.
“Trauma is a time-sensitive disease,” Norwood recently told members of the Central Pasco Chamber of Commerce. “It’s just like heart disease or a heart attack, the quicker you can get to a facility to deal with the problem, the more likely you are to survive. And that’s reflective of what’s happening in Florida right now.”
Before the trauma center opened at Bayonet Point, anyone hurt in a fall or accident would have to be transported south to Hillsborough or Pinellas counties, a distance that could exceed 100 miles and tick precious time off the clock.
“We call it the ‘golden hour of trauma,’ that if you can get into a trauma center or to a facility that can manage your problem within 60 minutes of your injury, your likelihood of survival goes way up,” Norwood said. “If you get in a wreck and are out in the middle of nowhere, your odds of surviving are not really good already.”
Since 2011, when Bayonet Point opened its trauma center, mortality rates have dropped across the state — especially in Pasco and Hernando counties, which saw rates plummet 21 percent and 15 percent respectively, Norwood said.
Yet, the more trauma centers there are in the state, the larger the strain on existing resources to serve those people, say representatives from other hospitals with older trauma centers. The more centers there are, the harder it will be to find the best doctors and medical teams trained in trauma.
At the same time, available money for these trauma centers would be spread out, making it difficult for any of them to stay open, opponents said. Although insurance carriers and patients themselves typically fund trauma centers, there are public pools of money available. They include $2 million from a vehicle registration tax, more than $12 million from red-light cameras, and $46 million in federal funds, according to a report last year by the American College of Surgeons.
Lawsuits have flown back and forth, and judges have sided against the new trauma centers like Bayonet Point’s, saying the Department of Health used an invalid rule to green light them, according to published reports. Since then, state health officials have been working around the clock to streamline department rules, and find common ground between the older trauma centers and the new ones.
State health officials started hearings in January and February to work out the trauma center issues, and have developed a plan that would allow at least one trauma center in each of the state’s 19 designated trauma areas, according to published reports. If the rule moves forward as planned, it would keep all of the new trauma centers, including Bayonet Point, in place.
This rule, however, would most likely end up in the courts as well. That’s been made clear by increased lobbying efforts by both sides, including bringing in the conservative-leaning 60 Plus Association to spend $250,000 on television advertising supporting the efforts of hospitals like Bayonet Point.
And now the Florida Legislature is looking to weigh in. State Sen. Denise Grimsley, R-Sebring — and a registered nurse — filed S.B. 1276 last week that, among other things, would limit the number of trauma centers in each of the 19 regions.
However, it’s a limit that would be in favor of hospitals like Bayonet Point, since Grimsley is asking that Pasco and Pinellas counties be limited to three centers, while Hillsborough would get only two. It also removes the ability for other hospitals to protest the addition of more trauma centers.
Including pediatrics at All Children’s Hospital, the Pasco and Pinellas region would have three trauma centers, Bayonet Point joining Bayfront Medical Center on the list.
Still, the entire trauma center system would be reviewed each year under the bill, with a final report heading to state officials at the beginning of February. It also sets expectations that trauma centers like Bayonet Point would be able to treat a minimum of up to 1,000 patients each year.
That’s something the hospital already is doing, Norwood said.
“When we started this thing, we thought we would probably get 800 patients each year,” Norwood said. “In my first year, we had 1,456 patients. In our second year, we got 1,685 patients.”
And 65 percent of those patients come right from Pasco County, he said, and nearly 90 percent come from Pasco or points north of Pasco.
“We are not stealing patients from anywhere,” Norwood said. “This is not happening.”
State health officials said they could move the department’s new rule forward later this spring.
By the Numbers
94.66 — Florida’s trauma center survival rate
95.56 — Survival rate of Regional Medical Center Bayonet Point’s trauma center
27 — Number of trauma centers in Florida
715,500 — Average population each Florida trauma center serves
$2.2 million — Average local, state, federal funding for each trauma center
Published March 5, 2014