Venice HMA, LLC v. Sarasota Cnty.
| Decision Date | 14 August 2015 |
| Docket Number | 2D13–5753.,Nos. 2D13–5752,s. 2D13–5752 |
| Citation | 198 So.3d 23 |
| Parties | VENICE HMA, LLC d/b/a Venice Regional Medical Center, Appellant, v. SARASOTA COUNTY and Sarasota County Public Hospital District, Appellees. Sarasota Doctors Hospital, Inc. and Englewood Community Hospital, Inc., Appellants, v. Sarasota County and Sarasota County Public Hospital District, Appellees. |
| Court | Florida District Court of Appeals |
Geoffrey D. Smith, Timothy B. Elliott, Kara L. Gross, and Susan C. Smith of Smith & Associates, Tallahassee, for Appellant Venice HMA, LLC d/b/a Venice Regional Medical Center.
Raoul G. Cantero III and David P. Draigh of White & Case LLP, Miami; and Stephen A. Ecenia and J. Stephen Menton of Rutledge Ecenia, P.A., Tallahassee, for Appellants Sarasota Doctors Hospital, Inc. and Englewood Community Hospital, Inc.
Raymond T. Elligett, Jr. and Amy S. Farrior of Buell & Elligett, P.A., Tampa; Stephen E. DeMarsh, County Attorney, Sarasota; and Frederick J. Elbrecht, Deputy County Attorney, Sarasota, for Appellee Sarasota County.
David A. Wallace, Carol Ann Kalish, and Jennifer L. Grosso of Williams Parker Harrison Dietz & Getzen, Sarasota, for Appellee Sarasota County Public Hospital District.
LaROSE
, Judge.
In these consolidated appeals, Sarasota Doctors Hospital, Inc., Englewood Community Hospital, Inc., and Venice HMA, LLC d/b/a Venice Regional Medical Center (collectively, “the Private Hospitals”) challenge the final summary judgment entered in favor of Sarasota County and Sarasota County Public Hospital District (collectively, “the County”). The Private Hospitals sought entitlement to reimbursement under a special law of the legislature for providing medical care to indigent Sarasota County residents. The trial court correctly ruled that the portion of the special law requiring the County to make such reimbursement granted an unconstitutional privilege to private corporations. Indeed, the reimbursement would force local taxpayers to fund the Private Hospitals' charity care, a benefit not enjoyed by similarly situated private hospitals in Florida. Consequently, we affirm.
We have jurisdiction over these appeals. See Fla. R. App. P. 9.030(b)(1)(A)
. We review, de novo, the determination of a statute's constitutionality as well as the interpretation of a constitutional provision. See
Shands Teaching Hosp. & Clinics, Inc. v. Mercury Ins. Co., 97 So.3d 204, 209 (Fla.2012).
Background
A general law is one “that operates universally throughout the state, uniformly upon subjects as they may exist throughout the state, or uniformly within a permissible classification.” Dep't of Bus. Regulation v. Classic Mile, Inc., 541 So.2d 1155, 1157 (Fla.1989)
. In contrast, “a special law is one relating to, or designed to operate upon, particular persons or things....” Id. (quoting State ex rel. Landis v. Harris, 120 Fla. 555, 163 So. 237, 240 (1934) ).
For at least 130 years, Florida has shown solicitude toward indigent residents needing health care. The 1885 Florida Constitution, for example, anticipated that all counties would provide hospital and medical care to the indigent: “The respective counties of the State shall provide in the manner prescribed by law for those of the inhabitants that, by reason of age, infirmity or misfortune, may have claims upon the aid and sympathy of society.” Fla. Const. of 1885, art. XIII, § 3. In 1936, section 3 was amended to add a provision authorizing statewide relief and old age benefits:
The respective counties of the State shall provide in the manner prescribed by law for those of the inhabitants who, by reason of age, infirmity or misfortune, may have claims upon the aid and sympathy of society; provided, however, the Legislature may by general law provide for a uniform Statewide system for such benefits, and appropriate money therefor .... ”
Fla. Const. of 1885, art. XIII, § 3 (1936) (emphasis added).
Even before this amendment, however, the legislature expressed concern with the health-care needs of the indigent. For example, in 1935, the legislature authorized boards of county commissioners in all counties with populations between 6418 and 6500 to levy and spend up to one mill of tax revenue annually to create an indigent aid fund. Ch. 17169, Laws of Fla. (1935), repealed by ch. 61–1338, at 794 Laws of Fla. (1961). That same year, it passed a law authorizing counties with populations between 2750 and 2800 to levy up to three mills in property taxes to pay indigent citizens' “hospital bills, medical bills, doctors bills and nurses bills.” Ch. 17168, Laws of Fla. (1935).
In addition to these general laws of local application, the legislature enacted special laws authorizing individual counties to provide health care to the indigent. In 1959, for example, the legislature authorized Duval County to renovate, construct, improve, repair, expand, extend, equip, and furnish hospital units and indigent relief departments and appropriated $558,000 per year through 1960 for that purpose. Ch. 59–1240, §§ 1–2, at 1238, Laws of Fla. Earlier, in 1951, the legislature authorized the Hillsborough County Board of County Commissioners to contract with South Florida Baptist Hospital for hospital and medical services to the indigent. Ch. 27612, Laws of Fla. (1951).
Pertinent to us, here, by special law in 1949, the legislature established the Sarasota County Public Hospital District, one of thirty-four special hospital districts. The special law granted the hospital district its own taxing authority separate from Sarasota County. See ch. 26468, Laws of Fla. (1949). Sarasota County voters approved the special act in a 1950 referendum.1
Almost a decade later, in 1959, the legislature amended the special law. The legislature added an indigent care provision requiring Sarasota County to reimburse the hospital district for medical services provided to indigent patients at hospital district facilities. See ch. 59–1839, § 8(i), at 3884–85, Laws of Fla. Significantly, the indigent care provision also required reimbursement to any other hospital in Sarasota County providing indigent care. See id.2
The indigent care provision was not submitted for voter approval. Our record does not contain documentation of public notice; presumably, such notice was published pursuant to article III, section 20 of the 1885 Constitution
as an alternative to a referendum. The parties do not claim otherwise.
The 1968 Florida Constitution eliminated the 1885 Constitution's indigent care mandate. See art. XII, § 10, Fla. Const. (1968)
. Florida voters relegated article XII, section 3 of the 1885 constitution to statutory status, subject to legislative action. See id.3 The legislature later repealed what was by then but a precatory indigent-care statute encouraging medical care for the needy. See § 11.2422, Fla. Stat. (1985).
It is important to note that counties, by general law, are not required to provide any level of indigent medical care; hospitals, on the other hand, must do so. Florida requires all hospitals with emergency departments to provide emergency care when “[a]ny person requests emergency services and care,” regardless of ability to pay. § 395.1041(1)
, (3)(a)(1), (3)(f), Fla. Stat. (2012). See also § 401.45(1)(b), Fla. Stat. (2012) ; ch. 73–126, § 26, at 206, Laws of Fla.
Similarly, the federal Emergency Medical Treatment and Active Labor Act (EMTALA) requires every hospital with an emergency department, as a condition for participating in and receiving federal funds from Medicare or Medicaid, to provide to all individuals seeking emergency room examination or treatment “an appropriate medical screening examination within the capability of the hospital's emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition” exists. 42 U.S.C. §§ 1395cc(a)(1)(I)(i)
, 1395dd(a) (2012).4 If a patient presents with an emergency medical condition, the hospital must stabilize the patient before transfer to another facility. 42 U.S.C. § 1395dd(c)
. EMTALA forbids hospitals from considering the patient's ability to pay. See
id. § 1395dd(h). To our understanding, therefore, the Private Hospitals are statutorily bound, under federal and state law, to provide some level of emergency care to indigent patients.
Against this backdrop, we note that, in 2003, the legislature repealed the 1959 special law. See ch. 03–359, § 2, at 316, Laws of Fla. It enacted a 2003 special law for “the codification of all special acts relating to [the] Sarasota County Public Hospital District” to provide “a single, comprehensive special act charter for the District including all current legislative authority granted to the District by its several legislative enactments.” See id. § 1. The 1959 indigent care provision, with only minor nonsubstantive changes, remained a part of this 2003 comprehensive legislation. Compare 1959 Laws of Fla. § 8(i), 3884–85 with ch. 03–359, § 8(9), at 321, Laws of Fla. Notice of the 2003 special law was published in compliance with article III, section 10 of the 1968 Constitution
.5
See Fla. H.R. Comm. on Local Gov't & Veterans Affairs HB 1113 (2003) Staff Analysis 5 (Mar. 7, 2003).
For years, the Private Hospitals never sought reimbursement under the indigent care provision of the 2003 special law, section 8(9). The County suggests that no District hospital ever received reimbursement under the indigent care provision. Apparently, however, the Private Hospitals requested and received some reimbursement from the County under ordinance 72–79, enacted a year after Sarasota County became a charter county.6 See Sarasota Cty. Charter (1971). Unlike the indigent care provision of the 2003 special law, ordinance 72–79 authorized, but did not require, the Board of County Commissioners to furnish hospital care to Sarasota County's medically indigent residents. See Sarasota Cty., Fla., Ordinance 72–79, § 2 (1972). The ordinance remains in effect....
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Sarasota Cnty. Pub. Hosp. Dist. v. Venice HMA, LLC
...did indeed grant an unconstitutional special privilege not shared by hospitals elsewhere in the state. See Venice HMA, LLC v. Sarasota County , 198 So. 3d 23, 24 (Fla. 2d DCA 2015). On review, the Florida Supreme Court reversed this court. See Venice HMA, LLC v. Sarasota County , 228 So. 3d......
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