How Can We Fix This Crisis?

Situation

Florida's trauma centers are experiencing a funding crisis. This crisis will eventually affect every Floridian and visitor to our state.

The funding for our trauma center and their critical services has been inadequate and unpredictable in Florida. The Legislature has recognized that "many hospitals which provide services to trauma victims are not adequately compensated for such treatment," (Florida Senate Interim Report). Nearly 30 trauma centers have permanently closed in Florida since 1982, and the cost to operate our state's remaining 21 trauma centers is estimated at over $126 million per year. Declining trauma center revenues do not meet the mounting expenses associated with clinical expertise, administrative expenditures, and outreach and education programs. Currently, Florida has 21 trauma centers located throughout the state (seven Level I centers, 12 Level II centers and two pediatric centers).

In addition to funding shortfalls, the current trauma system network has significant gaps in coverage in North Florida and North Central Florida-particularly in Leon, Bay, and their surrounding counties. Injury victims in these underserved areas must be transferred to trauma centers several hours away. Medical personnel refer to the first hour after an injury as the "golden hour." If patients receive treatment within the golden hour, their chances of survival greatly increase. Trauma centers have teams of specialists ready to meet critically injured patients as they arrive-every minute matters, especially within the golden hour.

Trauma centers also play an important role in emergency response capabilities and would be utilized in the event of a mass casualty incident, infectious disease outbreak, or biological attack.

High-quality trauma care is an important asset to local communities and the Florida economy by bringing high-tech\high-touch jobs to the state. Many physicians, nurses and flight personnel are attracted to the high-level of care practiced at trauma centers. In addition, businesses and industry considering relocating, regard the availability of quality healthcare as a top priority.

Florida Senate Recommendations

The Senate Committee on Appropriations has issued an Interim Project Report (Number 2004-108) on trauma care planning and funding in Florida. The report noted that, "The need for a viable trauma and emergency response system is now greater than ever. Expansion of the current trauma network has been at a standstill for several years and, if any facility loses its designation, the network may diminish significantly." The report included the following recommendations:

• Florida should consider adopting a stable, predictable funding source to fund the trauma system and should direct those resources to system development, center operations, staff development, recruitment and retention.
• Florida should create incentives for expansion of the trauma center network if the state expects to attain statewide coverage of trauma services.

Additionally, the Senate Committee on Home Defense, Public Security and Ports issued Interim Project Report 2004-148 on Hospital Response Capacity, recognizing that trauma centers play a vital role in homeland security. Since September 11, 2001, we are more focused than ever on the response capacity and quality of hospitals and emergency service providers. Trauma centers would be called on in the event of a mass casualty incident, disease outbreak, or biological attack and need to be adequately funded to meet these potential demands.

Solution

We risk losing trauma care throughout the state unless the Legislature takes action. The delays, inconveniences and hardships of providing an airlift or ambulance transport to another community if an existing trauma center closes, or in an area that has a gap in trauma care, is outrageous to anyone who values quality patient care. We cannot put a price tag on the inevitable lives lost in this event.

The Alliance to Save Florida's Trauma Care is a group of representatives from every Florida trauma center, along with various statewide advocate groups, that has been formed to educate Floridians about the importance of our state's trauma centers and to ensure that adequate funding is secured for future operation and expansion of our trauma system. The Alliance supports new, long-term, statewide, sustainable funding for trauma centers.

The Alliance is working closely with the Florida Legislature to implement legislation providing long-term funding to state-designated trauma centers. Since motor vehicle crashes comprise over 50% of trauma incidents in Florida, one of the initiatives the Alliance supports is legislation that will increase penalties for certain dangerous driving infractions, such as DUIs and red light violations. Funding for trauma centers should be generated through penalizing those very individuals who create the trauma.

Fast Fact: The number of trauma patients continues to increase due to a growing population and visitors. Currently, no ongoing funding exists for this lifesaving care.