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Gov. DeSantis, hospitals look to restart procedures

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TALLAHASSEE, Fla. – Florida Gov. Ron DeSantis signaled on Tuesday that he might be ready to follow federal guidelines that call for letting doctors and hospitals again provide procedures that have been halted during the COVID-19 crisis.

DeSantis told reporters in Tallahassee that he wanted to move quickly to help bolster hospitals, which have been losing money during a clampdown on optional surgeries.

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“We need to do it pretty quickly, because if we keep it up the way we are going, I think more people are going to get laid off,” DeSantis said, noting that some hospitals have been forced to shed jobs due to the loss of revenue. “I think there is going to be less financial viability for some of these health care outfits, which is very important.”

The Safety Net Hospital Alliance of Florida and representatives from HCA Healthcare on Monday sent a recommended reopening proposal for the governor to consider. The major hospital industry players also met with members of the DeSantis administration to discuss the plan, which provides two potential dates for resuming surgical procedures: April 25 or May 1.

The hospitals’ proposal would require all visitors to wear masks or cloth mouth and nose coverings and stay in main waiting areas, although there would be exceptions involving death and dying patients, women in labor, and patients with cognitive impairments. One visitor would be allowed for each patient.

The proposal also recommends that no facilities would be allowed to offer optional procedures unless they meet certain requirements, including maintaining COVID-19 and “person under investigation” units.

Hospitals also would be precluded from offering optional surgeries unless the number of available beds is 20 percent greater than the number of beds occupied by COVID-19 patients.

The Safety Net Hospital Alliance of Florida includes public, teaching and children’s hospitals, while HCA is a for-profit company that operates dozens of hospitals in the state.

The Florida Hospital Association also developed a proposed plan for hospitals to begin offering elective surgeries and submitted it to the governor’s Re-Open Florida Task Force, the association said in a news release.

Florida Hospital Association Interim President Crystal Stickle said while hospital capacity has held consistently around 50%, the ban on elective surgeries has had other health repercussions.

"Cancer surgeries that have been put on hold, cardiac procedures that have been put on hold,” said Stickle, who added there have been financial repercussions, as well. “They do support hospitals financially. Many of our hospitals have taken significant financial hits.”

Meanwhile, doctors also are seeking to resume providing procedures.

In a letter Tuesday, Florida Medical Association President Ronald F. Giffler asked DeSantis to lift a March 20 executive order that prevented the delivery of nonessential health care.

“While the state has understandably focused on the immediate needs of fighting COVID-19, it is imperative that we not ignore a potential second crisis: a wave of emergencies and fatalities among the people delaying care or going untreated,” Giffler wrote.

DeSantis issued his March executive order to help conserve necessary personal protective and hospital space as the state prepared for a surge in COVID-19 patients. National health care models showed that Florida would have a surge and that the demand for health care services and hospital beds would exceed the state’s supply.

DeSantis on Tuesday said the dire predictions have not come to fruition.

“You go back a month, month and a half, report after report saying it was just a matter of time that Florida’s hospital system would be completely overwhelmed,” DeSantis said. “Those predictions have been false. Our work is succeeding. We have flattened the curve,”

The hospitals and doctors are asking DeSantis to consider reopening the health care system under nonbinding guidelines that President Donald Trump’s administration issued.

To qualify under the federal guidelines, the state must have had a two-week downward trajectory in documented COVID-19 cases and a downward trajectory in the numbers of positive tests as a percentage of total tests.

Additionally, the federal guidelines call for hospitals to have enough supplies to treat all patients without having to worry about “crisis” care decisions. Moreover, the facilities would be required to have testing programs in place for at-risk health care workers.

But the move to soften restrictions -- under what is known as Phase 1 -- has been met with skepticism from public health officials. After the Trump administration released the guidelines last week, Bill Hanage, an associate professor at Harvard T. H. Chan School of Public Health, told National Public Radio in an interview that “with the state of testing,” no city in the United States is ready under Phase 1 to reopen health care.