Miami-Dade County

Jackson to file second legal challenge of state’s rejection of trauma center

Jackson Health Systems
Jackson Health Systems El Nuevo Herald file photo, 2012

Miami-Dade County commissioners and trustees for the county’s public hospital network both agreed Tuesday to give Jackson Health System authority to challenge the state’s refusal of an application for a new Jackson trauma center in South Miami-Dade.

The approvals came one day after Jackson administrators filed a petition with the Florida Department of Health requesting a rehearing and accusing the state agency of making up rules and ignoring the law in its decision.

Jackson trustees are expected to file a second challenge Wednesday. The state turned down Jackson’s application for a trauma center at Jackson South Community Hospital last month.

While it’s unclear what the basis for the second challenge will be, the moves echo a similar set of actions taken by Jackson in January 2013 contesting the state’s decision to award a trauma center to Kendall Regional Medical Center. Jackson, which for years had the county’s only trauma center, voluntarily dismissed those petitions a month after filing them.

The resolution adopted by Miami-Dade commissioners Tuesday authorized the Public Health Trust, which runs the hospital system, to take legal action against the health department and Aventura Hospital and Medical Center, which received provisional approval to operate a trauma center beginning May 1.

Jackson trustees may be trying to protect the system’s financial interests. In the first two months after Kendall Regional opened its trauma center in 2011, Ryder Trauma Center at Jackson Memorial saw revenues decline by about $3 million. And in a 2012 memo to Jackson’s board of trustees, Jackson CEO Carlos Migoya warned that private competition could siphon away 50 to 60 percent of the patient volume at Ryder.

The amount of funding received by trauma centers from the state depends on the number of patients treated.

Also Tuesday, Jackson trustees approved a list of projects to be paid for using $830 million in bonds approved by Miami-Dade voters in 2013 and paid for with a property tax increase.

In addition to approving two new urgent care centers announced Friday for North Miami and Country Walk at a cost of $1.4 million each to build and equip, Jackson trustees gave the green light for 10 projects to be funded with the bond money, including: $2.79 million to begin consulting services for a children’s ambulatory pavilion and stand-alone emergency department in Doral; $2.6 million for expansion and renovation of the Behavioral Health Crisis Unit and $3.3 million for the purchase of a new linear accelerator for oncology patients and other equipment.

Joe Arriola, a Jackson trustee elected to become the panel’s next chairman beginning in June, said he was excited to see a 2013 bond campaign promise fulfilled with the two new urgent care centers, which are scheduled to open in June 2016. A total of eight to 12 urgent centers were promised during the campaign.

“It kind of shows that we know what to do when they give us the money,” Arriola said.

Chris Wing, associate vice president of urgent care development, said sites for the new urgent care centers were chosen in part for their high visibility and abundant traffic. Wing said it was important for Jackson to have the ability to “encroach on competitors’ market share and make people more aware of the services Jackson can provide.”

Martha Baker, president of Jackson’s labor union for doctors and nurses, said the criteria for selecting urgent care sites should correlate with a strategic plan that has yet to be created, and that the centers also would meet the hospital system’s mission to serve all residents regardless of ability to pay.

“I would hope that we don’t just consider market share,’’ she said.

At Tuesday’s meeting, Florida Rep. Carlos Trujillo, a Miami-Dade Republican and a member of Jackson’s board of trustees, said state legislators are still waiting for federal officials to make a decision on a funding program set to expire June 30 that provides $1.3 billion a year to state hospitals that treat large numbers of uninsured and Medicaid patients. Jackson could lose about $200 million a year if the program, called the Low Income Pool or LIP, is not renewed or replaced.

Trujillo said the Florida House’s “doomsday scenario” in the event LIP is not renewed or replaced by federal regulators would be to tap state reserves of more than $3 billion to draw matching funds through a different federal program.

“We could absolutely fund the program 18 months, 24 months,” he said. “The conversation that has to take place is what happens after that, whether it’s truly focusing money on hospitals that provide the super majority of charity care or something else.”