Reiff v. Northeast Florida State Hosp.

710 So. 2d 1030, 1998 Fla. App. LEXIS 5874, 1998 WL 264482
CourtDistrict Court of Appeal of Florida
DecidedMay 27, 1998
Docket97-377
StatusPublished
Cited by3 cases

This text of 710 So. 2d 1030 (Reiff v. Northeast Florida State Hosp.) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reiff v. Northeast Florida State Hosp., 710 So. 2d 1030, 1998 Fla. App. LEXIS 5874, 1998 WL 264482 (Fla. Ct. App. 1998).

Opinion

710 So.2d 1030 (1998)

Harry REIFF, Psy. D.,
v.
NORTHEAST FLORIDA STATE HOSPITAL, Appellee.

No. 97-377.

District Court of Appeal of Florida, First District.

May 27, 1998.

*1031 M. Christopher Bryant and Kenneth G. Oertel of Oertel, Hoffman, Fernandez & Cole, P.A., Tallahassee, for Appellant.

Dennis M. Flath, Northeast Florida State Hospital, MacClenny, for Appellee.

ERVIN, Judge.

Dr. Harry Reiff, a licensed psychologist and Director of Psychological Services at Northeast Florida State Hospital (NEFSH), appeals a final administrative order which dismissed his rule challenge to certain bylaws approved by the Professional Staff Organization (PSO) of NEFSH. Dr. Reiff argued that the bylaws met the definition of rule, as provided in section 120.52(16), Florida Statutes (1995); hence they were invalid in that they had not been formally adopted. We agree and reverse.

In addition, Dr. Reiff alleged in his petition that the bylaws violate section 395.0191, Florida Statutes (1995), because they exclude licensed psychologists from obtaining certain clinical privileges and rights of staff membership that they are otherwise authorized to perform under the licensing laws of chapter 490. Section 395.0191(1) prohibits licensed hospitals from discriminating against licensed health care professionals, including psychologists, when awarding clinical privileges. Because we conclude that NEFSH should have promulgated the bylaws as a rule, we do not decide whether they are discriminatory.

NEFSH is a treatment hospital for the mentally ill, most of whom are involuntarily committed under the Baker Act and some of whom are admitted as forensic patients. The PSO bylaws, applicable only to NEFSH employees, establish the privileges available to licensed health care professionals at the hospital and include privilege request forms enumerating the various privileges permitted.

Under the bylaws, only NEFSH physicians are privileged to engage in admission and discharge from the hospital, hospital policy-making, authorization of outside clinical procedures, treatment of life-threatening emergencies, and participation in emergency drills. Patients are admitted by court order, but there is an internal admitting procedure—the process of beginning the evaluation, diagnosis, and treatment of each patient—which is the exclusive province of physicians, including psychiatrists, but not psychologists. Only physicians, including psychiatrists, may be assigned as attending professionals to determine care and enter treatment orders in the patients' records. In addition, each patient is monitored by a core treatment team, which consists of a psychiatrist, nurse, social worker and mental health professional, but, once again, not a psychologist. Only a psychiatrist or other medical doctor may enter an order recommending discharge of a patient to the hospital administrator.[1] Florida law authorizes psychologists to perform each of the responsibilities enumerated above that the PSO bylaws permit only physicians/psychiatrists to perform.

Following the rule-challenge proceeding, the administrative law judge (ALJ) determined that Dr. Reiff did not have standing to challenge the PSO bylaws. In so ruling, the ALJ recognized that an expansion of privileges might have an impact on Dr. Reiff's right to seek a raise in salary, which Dr. Reiff testified was a possibility if he were given attending status, or might enhance his level of professional knowledge and expertise, but the ALJ rejected these as reasons to find standing. Although the bylaws limit the range of activities that Florida law permits psychologists to perform, the ALJ also concluded that this did not deprive Dr. Reiff of a property right that would constitute an injury in fact. Finally, the ALJ concluded that the limitations on psychologists' privileges *1032 are premised upon the hospital's reasonable needs; thus, they did not violate section 395.0191(1) by discriminating against psychologists as a class. Accordingly, he concluded that Dr. Reiff was not injured in fact by the hospital's right to "exercise discretion in creating job requirements by class of health care providers."

Even assuming that Dr. Reiff had established standing, the ALJ next decided that although the governing body of the hospital is an "agency" and the PSO bylaws meet the definition of "rule," as provided in section 120.52(16), Florida Statutes (1995),[2] the bylaws constitute internal management memoranda under subsection (16)(a) thereof, and thus are exempt from rulemaking. First, he determined that they do not affect any plan or procedure important to the public, because the issue of right to treatment is addressed by statute, whereas the bylaws in question simply detail who delivers care to the patients at NEFSH. Next, he stated that the bylaws do not affect Dr. Reiff's private interests, because they apply to classes of employees, that is, psychologists, rather than any one psychologist in particular.

We are unable to agree with any of the ALJ's holdings. In regard to the ALJ's conclusion that Dr. Reiff lacked standing, we note that a showing of an adverse effect on an economic benefit has never been considered the litmus test by which standing is determined. For example, in Coalition of Mental Health Professions v. Department of Professional Regulation, 546 So.2d 27 (Fla. 1st DCA 1989), the Coalition was denied standing to intervene in a proceeding challenging the validity of rules regulating the Coalition's members. This court stated: "The fact that [the Coalition's] members will be regulated by the proposed rules is alone sufficient to establish that their substantial interests will be affected and there is no need for further factual elaboration of how each member will be personally affected." Id. at 28. In a comparable manner, the PSO bylaws establish the clinical privileges which Dr. Reiff may exercise; thus, he is substantially affected by their implementation.

The ALJ next decided that the bylaws did not meet the definition of rule, as provided in section 120.52(16)(a).[3] It is important to observe that the ALJ initially examined the criteria outlined under the first paragraph of section 120.52(16), and determined that the bylaws comply with the general definition of rule in that they create rights and require compliance, and have the consistent effect of law. Consequently, he concluded that the bylaws in question were self-executing, and, as such, they could not be administered through the discretion of the Medical Executive Director. The ALJ then decided that the memoranda exception of subsection (16)(a) applied. From our reading of the plain language the legislature used in creating the exception, proof of its application is established in either of two ways: by showing that the memorandum does not affect the private interests of a person, or that it does not affect the interests of the public. In our judgment, NEFSH presented insufficient evidence as to either prong.[4]

Turning first to the ALJ's determination that the internal management memorandum exception applied because Dr. Reiff's "private interests" were not affected by the bylaws' operation as to him, the ALJ essentially reached the same conclusion as he had *1033 in deciding that Dr. Reiff lacked standing to challenge the agency's policy statements as rules. The ALJ noted that the limitations created by the bylaws were designed to affect the class of psychologists as a whole, not the private interests of any individual psychologist, such as Dr. Reiff.

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710 So. 2d 1030, 1998 Fla. App. LEXIS 5874, 1998 WL 264482, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reiff-v-northeast-florida-state-hosp-fladistctapp-1998.