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Public Health Trust of Miami-Dade County v. Department of Health

Florida Court of Appeals, First District

December 6, 2017

THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY, FLORIDA d/b/a JACKSON SOUTH COMMUNITY HOSPITAL, Appellant,
v.
DEPARTMENT OF HEALTH, Appellee, KENDALL HEALTHCARE GROUP, LTD. d/b/a KENDALL REGIONAL MEDICAL CENTER, Appellee/Cross-Appellant,

         NOT FINAL UNTIL TIME EXPIRES TO FILE MOTION FOR REHEARING AND DISPOSITION THEREOF IF FILED

         An appeal from an Order of the Department of Health.

          Thomas F. Panza, Paul C. Buckley, and Brian S. Vidas of Panza, Maurer & Maynard, P.A., Fort Lauderdale, for Appellant.

          Jay Patrick Reynolds, Chief Legal Counsel, and Sarah Young Hodges, Chief Appellate Counsel, Tallahassee, for Appellee Department of Health.

          Stephen A. Ecenia, J. Stephen Menton, and Gabriel F. V. Warren of Rutledge Ecenia, P.A., Tallahassee, for Appellee/Cross-Appellant Kendall Healthcare Group, Ltd. d/b/a Kendall Regional Medical Center.

          PER CURIAM

         The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson South Community Hospital (Jackson South) appeals an order of the Department of Health (Department) dismissing as moot Jackson South's petition for a formal administrative hearing to contest the Department's decision to deny Jackson South's application to operate a provisional Level II trauma center after Jackson South was granted a provisional license in the following application cycle. Because we conclude that an actual case or controversy continues to exist with respect to Jackson South's first application, we reverse and remand for the Department to consider Jackson South's administrative challenge on the merits.

         I.

         We begin with a brief overview of the statutory and regulatory framework governing the trauma center application and selection process. The Florida Legislature has delegated the primary responsibility for the planning and establishment of a statewide inclusive trauma system to the Department. § 395.40(3), Fla. Stat. (2015). As part of this legislative mandate, the Department is charged with allocating, by rule, the number of trauma centers needed for each of the state's 19 trauma service areas (TSA), subject to the limitations that each TSA should have at least one Level I or Level II trauma center and there may be no more than 44 trauma centers statewide. § 395.402(4)(a)-(c), Fla. Stat. (2015). Relevant to this appeal, TSA 19, which comprises Miami-Dade and Monroe counties, is permitted a maximum of three trauma centers. Fla. Admin. Code R. 64J-2.010(3).

         A. Application and Selection Process

         The trauma center application and selection process is a lengthy, multistage process that begins each year with the Department notifying acute care hospitals and trauma agencies that it is accepting letters of intent from those hospitals interested in becoming trauma centers. § 395.4025(2)(a), Fla. Stat. (2015). Letters of intent are due by October 1, and the Department thereafter distributes an application package to each hospital that timely submitted a letter of intent. § 395.4025(2)(a)-(b), Fla. Stat. (2015). The completed application is due by April 1 of the following year. § 395.4025(2)(c), Fla. Stat. (2015).

         After the Department receives a trauma center application, it conducts a provisional review "for the purpose of determining that the hospital's application is complete and that the hospital has the critical elements required for a trauma center." Id. If the Department finds the hospital's application acceptable based on the provisional review, the hospital is "eligible to operate as a provisional trauma center." § 395.4025(3), Fla. Stat. (2015).

          Between May 1 and October 1, the process entails an "in-depth evaluation" by the Department of all applications found acceptable in the provisional review. § 395.4025(4), Fla. Stat. (2015). And between October 1 and June 1, a review team of out-of-state experts assembled by the Department conducts onsite visits of all provisionally approved trauma centers. § 395.4025(5), Fla. Stat. (2015). Based on the recommendations from the review team, the Department selects verified trauma centers by July 1 of the second year following the filing of the letter of intent. § 395.4025(6), Fla. Stat. (2015). If the number of qualified provisional trauma centers exceeds the number of available slots for verified trauma centers in the applicable TSA, the Department applies a tiebreaking process developed by rule to make the final selection(s). Fla. Admin. Code R. 64J-2.016(11). Upon final verification, the trauma center is granted approval to operate for seven years, provided it continues to maintain trauma center standards and acceptable patient outcomes, and may thereafter apply for renewal. § 395.4025(6), Fla. Stat. (2015).

         B. Jackson ...


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