HCA Health Services of Florida, Inc. v. Department of Health & Rehabilitative Services

8 Fla. Supp. 2d 176
CourtState of Florida Division of Administrative Hearings
DecidedSeptember 27, 1984
DocketCase No. 83-3330R
StatusPublished

This text of 8 Fla. Supp. 2d 176 (HCA Health Services of Florida, Inc. v. Department of Health & Rehabilitative Services) is published on Counsel Stack Legal Research, covering State of Florida Division of Administrative Hearings primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
HCA Health Services of Florida, Inc. v. Department of Health & Rehabilitative Services, 8 Fla. Supp. 2d 176 (Fla. Super. Ct. 1984).

Opinion

OPINION

WILLIAM E. WILLIAMS, Hearing Officer.

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, William E. Williams, held a public hearing in this cause on February 8, 1984, in Tallahassee, Florida.

This proceeding involves a challenge filed by Petitioner, HCA Health Services of Florida, Inc. (“Petitioner”), to the validity of Rule 10-17.008(l)(a)(l), Florida Administrative Code. The challenged rule was adopted by the Department of Health and Rehabilitative Services (“HRS”), and defines Brevard County as a single subdistrict for purposes of certificate of need review for acute care hospital beds. Petitioner contends that the rule is invalid as arbitrary, capricious, and not rationally related to the need for planning for health services in the area.

[177]*177At the final hearing in this cause, Petitioner called Phillip Rond, William F. Madden, Gene Nelson, Carol Anderson, and Phil Unger as its witnesses. Petitioner offered Petitioner’s Exhibits 1 through 12, which were received into evidence. Respondent called Steve Windham as its only witness, and offered Respondent’s Exhibits 1 through 19, which were received into evidence.

Counsel for both Petitioner and Respondent have submitted proposed findings of fact for consideration by the Hearing Officer. To the extent that those proposed findings of fact are not included in this order, they have been specifically rejected as being either irrelevant to the issues presented for determination, or as not having been supported by evidence of record.

FINDINGS OF FACT

Rule 10-17.008(a)(l), Florida Administrative Code, as adopted by HRS, defines Brevard County as a single subdistrict for purposes of certificate of need review for acute care hospitals. Brevard County is located in HRS District VII. Petitioner has applied for a certificate of need to build a hospital in Brevard County. Proceedings concerning this certificate of need are currently pending before the Division of Administrative Hearings. The challenged rule will be applied by HRS in determining whether to grant or deny Petitioner’s application for a certificate of need. Petitioner is, therefore, substantially affected by Rule 10-17.008.

Rule 10-5.11(23), Florida Administrative Code, which is not challenged in this proceeding, established a “uniform bed need methodology” for establishing the need for hospital beds in Florida. By application of this rule, HRS derives a total number of beds needed for each of 11 HRS districts statewide.

HRS is required by Section 381.494(6)(c)(l), Florida Statutes, to review certificate of need applications based on applicable district plans developed by local health councils pursuant to Section 381.494(7)(b)l, Florida Statutes. HRS is required to develop as its only rule the elements of any approved district plan which HRS considers necessary to the review of certificate of need applications. It is this statutory requirement which led HRS to adopt Rule 10-17.008(l)(a)(l), Florida Administrative Code, which is challenged in this proceeding.

Rule 10-5.1 l(23)(d), Florida Administrative Code, requires local health councils, as necessary, to adopt acute care service subdistrict designations according to guidelines developed by HRS. These guidelines were developed by HRS and were sent to local health councils in April, 1983. These guidelines provided as follows:

[178]*1781. Local Health Council District should be divided into subdistricts for purposes of planning acute care general hospital services.
2. Rural subdistricts (i.e., those outside SMSAs) shall be county or multi-county county areas.
3. Urban subdistricts (i.e., those including all or part of an SMSA) may be multicounty, county or subcounty areas. As appropriate, an urban subdistrict may include part of an urban county and all of an adjoining rural county.
4. All subdistrict designations shall conform to population base zone boundaries. Each urban subdistrict shall contain within it a sufficient number of population base zones to meet the following size criteria:
Minimum 150,000 to 200,000 population in base year 1980 unless the SMSA population is less than 150,000, in which case SMSA = subdistrict.
Maximum geographic area 25 miles diameter along longest axis.
5. Rural subdistricts shall be limited in size such that no area is greater than 60 miles in diameter along its longest axis, or 45 minutes driving time to a general hospital for 90% of the population.
6. To the extent possible, subdistrict designations shall take into account existing patient flow patterns, and specialized services.
7. In dividing the total number of beds allocated to the district among subdistricts and in specifying bed distribution by service category, the Local Health Council shall take into account the level of care offered by existing facilities, net flow to facilities, the age characteristics of the population as these relate to service needs and the potential degree of seasonal peak demands (as per the proposed acute care rule).

Since the HRS “uniform bed need methodology” establishes only the total number of beds needed districtwide, this number must be allocated districtwide by bed type and location by the local health councils through designation of subdistricts in their local plans. In August, 1983, the local health council for District VII submitted to HRS its local health plan, entitled “Policies and Priorities for Community Medical Facilities Component.” The plan identified 23 policies, one of which was the designation of subdistricts along county lines. Of the 23 policies enumerated by the local health council for District VII, HRS adopted in Rule 10-17.008 only the policy designating subdistricts along county lines.

The HRS guidelines were intended to acquaint local health councils [179]*179with the types of factors to be considered in setting subdistrict lines. None of these factors were strictly binding, and the councils were intended to balance the various criteria according to local consideration such as geography, population dynamics, and availability of and access to existing services. For example, Brevard County had a population in 1980 of 273,000 and is approximately 78 miles long. It was, therefore, impossible to strictly adhere to the population and geographic criteria contained in the HRS guidelines. The local health council resolved this conflict by determining, based upon its data and experience, that residents of Brevard County had experienced no problems with access to or availability of hospital services. Hospital facilities in Brevard County are well distributed. While Brevard County is 78 miles long, a large portion of its area in both the northern and southern parts of the county are sparsely populated, consisting of marshland, the government space center, and a military base.

Neither HRS nor local health councils were required to further subdivide a county unit. County units are generally accepted as reasonable subdivisions for health planning purposes. Many populous counties throughout Florida were designated by their respective local health councils as subdistricts. These include Broward, Hillsborough, Escambia, Polk, Manatee, and Sarasota counties.

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Cite This Page — Counsel Stack

Bluebook (online)
8 Fla. Supp. 2d 176, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hca-health-services-of-florida-inc-v-department-of-health-fladivadminhrg-1984.