South Florida hospitals still accepting new Haiti patients, doctors say

MIAMI — South Florida hospitals are not refusing to accept new trauma patients from earthquake-ravaged Haiti, as U.S. military spokesmen have suggested, prominent doctors said Saturday.

Military planes stopped flying critically injured Haitians to Florida on Wednesday, prompting Dr. Barth Green, the chairman of neurological surgery at the University of Miami Miller School of Medicine — who wears several hats as part of UM’s Haiti team — to declare that patients will die because they can’t get sophisticated treatment in Haiti.

“These are the sickest of the sick and we can’t care for them either on the ground in Haiti or on the USNS Comfort,” a hospital ship off the Haitian coast, said Green in Haiti
on Saturday. “We all agree they need to be medivac-ed out, but all
medivacs by the armed forces have been stopped and Homeland Security
will not give us paroles for the people.

“We have hospitals waiting to receive them. But at
the highest level of the U.S. government, they can’t seem to get them
out. And this is really not what America is all about.”

The controversy surfaced after Gov. Charlie Crist wrote to Kathleen Sebelius, secretary of Health and Human Services, on Wednesday asking for federal help to cover millions of dollars in care that hospitals around the state are providing.

Crist warned that Florida hospitals were “at capacity,” and asked her to activate the National Disaster Medical System.

Friday, Maj. James Lowe, deputy chief of public affairs for the United States Transportation Command, told the New York Times
that “the places they were being taken, without being specific, were
not willing to continue to receive those patients without a different
arrangement being worked out by the government to pay for the care.”

Not so, said Dr. William O’Neill, executive dean of clinical affairs at the University of Miami’s Miller School of Medicine.

Although “there hasn’t been a well-defined plan to
pay for uninsured people … we are still willing to take people even
if we don’t know who is going to pay,” O’Neill said Saturday. He said
UM doctors in Haiti are not putting injured patients on planes because they’ve been told they won’t be flown to Florida.

He estimated that the treatment for about 50 patients brought to JMH’s Ryder Trauma Center would range from $50,000 to $100,000,
per patient and called the dustup between the state and the feds “a
little bit of a power contest … to see who will blink first.”

Private planes still can carry Florida-bound patients, but they’re expensive, Green said.

He and a spokesperson for Miami Children’s Hospital, which has accepted serious pediatric cases from Haiti, have said they plan to raise private money for their efforts.

Saturday, Navy Capt. Kevin Aandahl, a spokesman for Transportation Command, which handles the airlifts out of Haiti, confirmed that “Transcom
has temporarily suspended air medical evacuation flights regarding
Haitian nationals. The capability exists to resume those flights at any
time.

“It comes down to this: U.S. Transportation Command
cannot do an air evacuation medical mission without an accepting
medical hospital on the other end. And some states are unwilling to
approve patients’ entry for follow-on medical care, as I understand it,
because of some issues regarding reimbursement.

“Bringing them to the continental United States is half the issue. We’ve been dealing with individual states saying basically, ‘Don’t bring them here.’ “

But Jaime S. Caldwell, vice president of the South Florida Hospital and Healthcare Association, also denied the claim that hospitals are not accepting injured Haitians.

“I have been active in this effort since the
beginning,” Caldwell said in an e-mail to association members on
Friday. “At no time have I heard any hospital in Southeast Florida
say that they wouldn’t take a Haitian earthquake survivor because of
financial reasons. On the contrary. At every point along the way the
healthcare industry has been advised to rigorously document their
expenses associated with the care provided to these unfortunate
patients and that efforts were underway to determine financial
responsibility.

“At no time did any hospital say, ‘Don’t send any more to us because we aren’t getting paid!’ “

He said that “about 60 percent of the hospitals in Southeast Florida have, or had, (patients) transported from Haiti.”

Crist insists he neither asked for a halt to the flights nor suggested it.

During a Tampa
street-festival breakfast on Saturday, Crist said that his letter to
HHS was intended to make clear that “we need help from our federal
friends. Florida, because of its proximity to Haiti,
is really bearing the brunt of this, and we’re happy to do that, but if
our sister states and the federal government could help — that was the
intent.”

It was not, he continued, “to stop anything. We’re humanitarians.”

He said that Secretary of Florida’s Department of Children and Families, George Sheldon, told him several days ago that the state’s costs had reached about $7 million, and that Sebelius and Homeland Security chief Janet Napolitano “are both pushing for (federal assistance) and it should come soon.”

According to Trancom spokesman Aandahl, the matter was being handled “literally at the policy level.” He referred calls to Washington and stressed the “very robust medical presence in Haiti between the U.S. government, military” and non-profit aid groups.

“They are getting care in their country. There’s the
USNS Comfort, our U.S. medical facilities ashore, and we’re giving them
the best care we can possibly provide.”

The ship, however, is at capacity and unable to accept new cases.

Since the quake, he said, Transcom has airlifted out 92 injured Haitian nationals.

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