Legislation to support trauma care is essential to keep trauma centers open and ready to care for this special population. Not every hospital or emergency department is a trauma center. To be a trauma center a hospital must meet a set of state or national criteria that results in designation and or verification as a trauma center. Even then there are different levels of trauma centers. A Level 1 canter can handle any type of trauma and does research in the field of trauma. A level 2 center is not required to do all the research but can care for most trauma patients. Level 3 centers can stabilize any patient and will transfer the patient to a higher level of care if needed but have trauma specialist within their institution. Currently the cost of being a trauma center lies solely with the hospital that seeks designation as a trauma center.

Here in North Carolina we have a very organized trauma system. Trauma center designation is under the auspices of the North Carolina Office of Emergency Medical Services. The rules approved by the North Carolina Medical Care Commission for trauma include standards for trauma center designation and trauma system design. The rule number is: 10 A NCAC 13P

Why is it important to have designated trauma centers? Following are some facts that will help answer that question.

• Trauma in the leading cause of death in people from 1 year to 44 years of age.
• Severely injured trauma patients have a 25% reduction in mortality when treated at a trauma center.
• Less than 10% of hospitals, nationally, are designated as a Level 1 or 2 trauma center.
• 1 in 5 patients have a better chance of survival from their trauma injury in a state with an organized trauma system.
• An annual cost nationally of $80 billion is attributed to traumatic injury.

At the federal level money has been authorized since the early 1990’s for trauma but unfortunately the money has never been appropriated. Money has never been authorized at the state level in North Carolina although efforts are currently being made to address this issue.

Following are some of the bills that are being considered currently in the legislative system. We would be grateful if you would contact your representatives and encourage them to support these initiatives.

Federal level:

The following act has been put forth in recent years.

Public Health Service Act (includes the following)
National Trauma Center Stabilization Act: includes two programs.
• Trauma Care Center Grants - $100 million/year for grants to prevent trauma center closures by supporting operations, uncompensated care, and emergency needs.
• Trauma Service Availability Grants - $100 million/year to address shortfalls in service and improve access to trauma care.

Trauma Care Systems Planning and Development Act: includes two programs.
• Trauma Care systems Planning Grants - $12 million/year to support state trauma system development.
• Regionalization of Emergency Care Systems - $12 million/year for pilot projects of innovative models of regionalized emergency care systems.

 

In the recent months with the federal budget cut the request for monies has changed to a total request of $28 million rather than the $224 million originally requested.

 

North Carolina State level:

General Assembly of North Carolina: Session 2009: House Bill 945

The Studies Act of 2009:
SECTION 2.31. Statewide Trauma System (H.B. 1375 – Stewart, Neumann) – The Commission may study the current General Statutes and State regulations pertaining to the Statewide Trauma System to determine if any changes are necessary; assess and identify gaps in the Statewide Trauma System with respect to funding and service delivery; assess the financial viability of the Statewide Trauma System; and determine the amount of funds the State should appropriate annually to the Statewide Trauma System.