Lawnwood Medical Center, Inc. v. Seeger
| Decision Date | 28 August 2008 |
| Docket Number | No. SC07-1300.,SC07-1300. |
| Citation | 990 So.2d 503 |
| Parties | LAWNWOOD MEDICAL CENTER, INC., etc., Appellant, v. Randall SEEGER, M.D., etc., Appellee. |
| Court | Florida Supreme Court |
Stephen J. Bronis of Zuckerman, Spaeder, LLP, Miami, FL, and Charles W. Hall, William A. Kebler, and Mark D. Tinker of Fowler, White, Boggs and Banker, P.A., St. Petersburg, FL, for Appellant.
Major B. Harding of Ausley and McMullen, Tallahassee, FL, and Richard H. Levenstein of Kramer, Sewell, Sopko and Levenstein, Stuart, FL, for Appellee.
Harold R. Mardenborough, Jr., of Carr, Allison, Tallahassee, Florida on behalf of American Medical Association and Florida Medical Association, and Glenn J. Webber, Stuart, Florida on behalf of The Association of American Physicians and Surgeons, as Amici Curiae.
The issue before us is whether a special law passed by the Legislature violates the constitutional prohibition against special laws that grant a "privilege to a private corporation" set forth in article III, section 11(a)(12), of the Florida Constitution. Both the trial court and the First District Court of Appeal held that chapter 2003-372, Laws of Florida, entitled the "St. Lucie County Hospital Governance Law" (HGL), violated this constitutional provision. See Lawnwood Med. Ctr., Inc. v. Seeger, 959 So.2d 1222 (Fla. 1st DCA 2007). Because the HGL was declared unconstitutional, this Court is mandated to review this case under article V, section 3(b)(1), of the Florida Constitution. The parties do not dispute that the HGL is a special law applicable to private corporations only in St. Lucie County; instead, they dispute whether the HGL grants a privilege to a private corporation.1 As more fully explained in this opinion, we conclude that the HGL impermissibly provides a privilege to Lawnwood Medical Center, Inc., a private corporation. Accordingly, we affirm the decision of the First District holding the law unconstitutional.2
Lawnwood Medical Center, Inc., is a for-profit corporation that owns and operates Lawnwood Regional Medical Center and Heart Institute in St. Lucie County, Florida. The corporation operates the hospital through its Board of Directors and through delegation of duties to the corporation's officers and Board of Trustees ("Board"). The Board's bylaws, which were adopted in 1988, state that the Board has final decision-making authority in the areas of credentialing, peer review, and quality assurance after considering the recommendations of the medical staff. In 1993, the medical staff at Lawnwood adopted the Medical Staff Bylaws, which were subsequently approved by the Board. The adoption of the Medical Staff Bylaws, although not the specific terms, was a requirement for Lawnwood to maintain its accreditation through the Joint Commission for the Accreditation of Healthcare Organizations. The Medical Staff Bylaws state its purpose as providing "for the organization of the Medical Staff of Lawnwood Regional Medical Center to provide a framework of self-government in order to permit the Medical Staff to discharge its responsibilities in matters involving the quality of medical care and to govern the orderly resolution of those purposes."
After adoption of the Medical Staff Bylaws, several disputes arose between Lawnwood and the medical staff which generated multiple lawsuits. One controversy involved the medical services rendered by two pathologists, Dr. Leonard Walker and Dr. John Minarcik. Lawnwood requested that the medical staff, through the Medical Executive Committee (MEC),3 conduct peer review as to Dr. Walker and Dr. Minarcik based on its assertion of their commission of health care fraud and a history of misdiagnoses. The parties dispute whether the medical staff initiated peer review procedures regarding the pathologists, but it is undisputed that the staff did not recommend any disciplinary action against the doctors. The Board then summarily suspended the privileges of Dr. Walker and Dr. Minarcik, but their privileges were reinstated by the trial court in a separate lawsuit filed by the doctors. See Lloyd v. Lawnwood Med. Ctr., Inc., No. 99-CA-001180BC, 2000 WL 309305, at *4 (Fla. 19th Cir.Ct. Feb. 16, 2000) () aff'd, 773 So.2d 114 (Fla. 4th DCA 2000). The trial court order in Walker enumerated various options other than Lawnwood's unilateral suspension of the doctors that Lawnwood could utilize if it believed that the MEC was not discharging its responsibilities regarding peer review. The trial court's order was affirmed by the Fourth District Court of Appeal without opinion. Lawnwood Reg'l Med. Ctr. v. Walker, 746 So.2d 459, 1999 WL 1220180 (Fla. 4th DCA 1999).
Instead of following any of the options set out by the trial court in Walker, Lawnwood summarily removed the elected medical staff officers and the MEC. Once again, Lawnwood's unilateral actions were challenged in court. The trial court reinstated the individuals and again stated the legal options Lawnwood had available if it believed that the MEC was failing to "comply with the policies, procedures, or directives of the risk management program or any quality assurance committees of the hospital" pursuant to section 395.0193(3)(g), Florida Statutes (1999). Lloyd, 2000 WL 309305, at *4 n. 9. Instead of utilizing any of those options, the Lawnwood Board adopted new bylaws, which provided in part that the Board could unilaterally amend the Medical Staff Bylaws after exhausting reasonable attempts to gain medical staff approval. However, this new provision directly conflicted with the existing Medical Staff Bylaws, which required a vote of sixty percent or more of the medical staff for any substantive amendment. Thus, the medical staff deemed the new provision invalid.
At this point, Lawnwood sought relief from the Legislature. In 2003, the Legislature enacted the HGL as a special law.4 It is uncontroverted that the special law affected only the two private hospitals in St. Lucie County, which are both owned by the same private parent corporation. After enactment of the law, the Board presented the medical staff with proposed amendments to the Medical Staff Bylaws, this time to reflect the provisions of the HGL, but the medical staff rejected the amendments.
Lawnwood then brought a declaratory judgment action, seeking to have the HGL declared constitutional.5 Dr. Randall Seeger, as president of the medical staff, opposed the Board's petition and both parties filed motions for summary judgment. In its Summary Final Judgment, the trial court first questioned whether a "special act is a constitutionally permissible method for affecting the internal business affairs of a private corporation." Without reaching that basic question, the trial court then proceeded to find the HGL unconstitutional on four grounds: (1) the law provided a privilege to a private corporation in violation of article III, section 11(a)(12), of the Florida Constitution; (2) the law unconstitutionally impaired the contract between the medical staff and the Board; (3) the law amended section 395.0193, Florida Statutes, by implication and did not reference the amendment in the law's title, in violation of article III, section 6, of the Florida Constitution; and (4) the law violated the equal protection clauses of the state and federal constitutions by creating two classes of hospitals—the two private hospitals in St. Lucie County and all other hospitals in the state.6
On appeal, the First District concluded that the HGL "dramatically alters many of the rights and obligations specified in the contract between the appellant's medical staff and board of trustees," constituting an impermissible privilege and an impermissible impairment of contract. Lawnwood, 959 So.2d at 1224. The district court further concluded that the "legislation was not required to protect the public health, ensure the quality of care at Lawnwood, or accomplish some other legitimate public purpose." Id. It thus affirmed the trial court's rulings on the privilege and impairment of contract grounds and declined to address the other arguments.7 Lawnwood now appeals the First District's holding that the HGL is unconstitutional.
This Court reviews de novo a lower court's ruling on the constitutionality of a statute. Fla. Dep't of Children & Families v. F.L., 880 So.2d 602, 607 (Fla. 2004). We do not take lightly a contention that a statute passed by the Legislature is unconstitutional and we start with the well-established principle that a legislative enactment is presumed to be constitutional. See Fla. Dep't of Revenue v. City of Gainesville, 918 So.2d 250, 256 (Fla.2005). In this case, however, the power of the Legislature is limited by the Florida Constitution itself, which prohibits the Legislature from passing certain special laws.8 Specifically, article III, section 11(a)(12), states that "[t]here shall be no special law or general law of local application pertaining to . . . private incorporation or grant of privilege to a private corporation." Indeed, the language of article III, section 11(a)(12), acts as a limitation on legislative power. See generally Bush v. Holmes, 919 So.2d 392, 406 (Fla.2006) ().
According to article X, section 12(g), of the Florida Constitution, a special law is defined as "a special or local law." More specifically, a special law is
one relating to, or designed to operate upon, particular persons or things, or one that purports to operate upon classified persons or things when classification is not permissible or the classification adopted is illegal; a local law is one relating to, or...
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