Current Trauma Status Report - Southern Nevada Health District

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Governance: • A local system would make sense. • I would lean away from state. Other: • Emergency department waits are a big issue. • A neurosurgeon in attendance reported he was from a neurosurgery group that takes 60-70 percent of ED call in addition to trauma and on-demand care. He additionally reported that there are only 3,100 neurosurgeons nationwide, down from 3,400 a few years ago. Malpractice insurance has increased to $156,000 from $50,000 a few years ago. He is concerned about putting the political discussion before the care discussion. He said that it is an apparent reality that we need a trauma system and that we need to look at care that can be provided based on what is available now rather than what might be in the future, and we need to improve everything including EMS. He suggested expanding the UMC trauma center or adding a trauma center or centers, adding that he trained in Houston, where there are two Level I centers next door, and that a system needs that collaboration. • This forum is a good opportunity for discussion. We need to have a great EMS system for residents and visitors. The question isn’t how many but how they respond to make the best system for the community. Page 77
Trauma Center Funding Comparison Study Introduction Providing a stable source of funding for trauma centers has been an ongoing issue since the early development of trauma systems in the country. Changes in funding sources, particularly insurance payers, have created instability over the years. 18,19,20 Improving revenue cycle management and payer contracting has helped, but in some communities these efforts have not been substantial enough to stabilize their trauma system. Below, The Abaris Group provides an overview of identified funding sources for trauma care. State Funding Sources Many states provide funding for the administration of their state’s trauma system at the state level. However, there are only four states that provide ongoing funding to support their trauma centers: Illinois, Mississippi, Oklahoma, and Washington. California had a one-time funding program that expired in 2003. Arizona During November 2002 the state voted to approve doubling the state’s tobacco tax on cigarettes to $1.18 a pack and use the $150 million strictly for the trauma centers. The measure passed two to one. California During the 2001 legislative session, the California Legislature passed AB1430, The Trauma Fund Act, which encouraged the development of a statewide network of trauma centers and established a one time source of funds for trauma centers in the state. The $20 million allocated from this bill was renewed during 2002 and provided support to the trauma centers through 2003. The funding was allocated on a fixed and volume basis. Each trauma center received a fixed amount according to their designation level (e.g. $150,000) and then an allocation based on volume of patients as determined by trauma registry entries. Illinois The State of Illinois established a fund for uncompensated trauma care in 1993. The funding comes from a $5 fee placed on every moving violation over $55. In 1994 a $30 fine from each DUI conviction or order of suspension was added. Since 1993, they have expended approximately $20.4 million. The amount of funding each hospital receives depends on the number of trauma patients treated. Additionally, funding is provided to those hospitals that care for Medicaid trauma patients. There is no funding for physicians. Mississippi In 1998 the State of Mississippi began allocating between $8.0 – 8.5 million annually for uncompensated trauma care. The funds come from revenue generated by Mississippi’s Tobacco Settlement principal ($6.0 million) and from moving traffic violations ($2.5 million). There are seven 18 Trauma Care: Saving Lives Despite Setbacks, Zoller, M. Medical World News, June 1988. 19 Trauma Collapse, Can the system be saved, Williams, MJ. California Hospitals, October 1999. 20 Trauma Care: “Lifesaving System Threatened by Unreimbursed Costs and Other Factors”, GAO, May 1991. Page 78
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SOUTHERN NEVADA CURRENT TRAUMA STAT
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Table of Contents Executive Summary
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Chronology of Trauma Care in Southe
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Exhibit 33 - Map Displaying Trauma
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• From January through April 2004
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Clearly trauma center staffing and
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A series of focus groups was also c
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• Information Management • Fina
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(This study did not attempt to meas
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County Health District Board of Hea
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on an average length of stay of 3.4
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Exhibit 8 - Projected Population Ch
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Trauma Stakeholder Interview Result
Page 27 and 28: three years, and felt that a Level
Page 29 and 30: EMS providers ranked Acute Care Fac
Page 31 and 32: Town Hall Meeting Comments A series
Page 33 and 34: (CAAS) and the air ambulance provid
Page 35 and 36: Triage Criteria The determination o
Page 37 and 38: With the exception of the year 2000
Page 39 and 40: Exhibit 20 - Trauma Patients by Age
Page 41 and 42: The following chart shows that abou
Page 43 and 44: Exhibit 27 - Trauma Ground Transpor
Page 45 and 46: E codes enable the classification o
Page 47 and 48: The day of the week with the greate
Page 49 and 50: A different view of the 2002 trauma
Page 51 and 52: As part of The Abaris Group’s tra
Page 53 and 54: The table below summarizes the key
Page 55 and 56: All EMS and ED stakeholders appear
Page 57 and 58: Exhibit 43 - Specialty Physician Co
Page 59 and 60: Clark County Health District has id
Page 61 and 62: Trauma Center Standards by Level Th
Page 63 and 64: Nevada Trauma Registry Submission R
Page 65 and 66: Trauma Center Capacity Benchmark Da
Page 67 and 68: ED Diversion Hours by Hospital ED D
Page 69 and 70: • This region would not pass a ta
Page 71 and 72: • Instead of calling it a tax, we
Page 73 and 74: Mesquite Town Hall Meeting The foll
Page 75 and 76: North Las Vegas Town Hall Meeting T
Page 77: Las Vegas Town Hall Meeting The fol
Page 81 and 82: Los Angeles County, CA Los Angeles
Page 83 and 84: Chronology of Trauma Care in Southe
Page 85 and 86: January 22, 1999 December 10, 2001
Page 87 and 88: List of Trauma System Assessment St
Page 89 and 90: Southern Nevada Trauma System Asses
Page 91 and 92: to hospitals that accept Medicare r
Page 93 and 94: ehabilitation - services that seek
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