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The Florida Department of Health has 40 legal challenges stemming from rules and decisions on trauma care and will spend more than $1 million on litigation over the next five years, according to Assistant Secretary for Health Cindy Dick.

House Health Quality Chairman Rep. James Grant, R-Tampa, said Wednesday he wants to pass a bill during the 2018 session that would return stability to the trauma planning process.

He advised panel members that they ask tough questions but remain neutral.

“I would encourage us to not be so quick to jump into how can we intervene in litigation,” he said, later adding, “I think if we really dive into this issue we can probably get to a place where we're proposing some stability for the market in general but not just walking into litigative proceedings and saying, 'Well, these are the new rules.' ”

Florida law limits to 44 the number of trauma centers allowed in the state, with limits also in 19 separate regions. Dick said interest in the trauma centers has been on the uptick since 2010 after a National Uniform Billing Committee move that authorized trauma activation fees. The fees are intended, Dick said, to offset the costs of facilities having trauma resources available on call.

Much of the litigation in Florida has come after the HCA health care company began seeking in recent years to open trauma centers at hospitals in various parts of the state. Other hospitals that already operated trauma centers challenged the HCA proposals and the Department of Health.

In a presentation before the committee, Dick said there is a strained relationship between the state, hospitals and stakeholders and said hospitals have filed challenges “related to basically anything the agency has done in the development of the trauma system.”

The result, she said, is the state hasn't been able to move forward with new rules to determine the need for new trauma centers since 2012.

Safety Net Hospital Alliance of Florida general counsel Mark Delegal told the committee that the litigation Dick discussed isn't frivolous. Many of the challenges filed in recent years have come from members of the safety-net group, which represents teaching, public and children's hospitals.

“I don't want to be disparaging, but my side of the equation has won much of the litigation. The department has been found to be in violation of your statutes,” Delegal told the House members.

Christine Sexton reports for the News Service of Florida.