Current Trauma Status Report - Southern Nevada Health District

Los Angeles County, CA
Los Angeles County has funded trauma centers for nearly 15 years through a combination of general
fund and tobacco tax funds. The reduction of tobacco tax dollars over recent years put the trauma
network in crisis, which along with serious County budget shortfalls put the entire Los Angeles County
public hospital system at risk. A ballot measure introduced to provide for $168 million in funding was
approved by a 73 percent vote in November 2002. Measure B raised property taxes by three cents, or
about $42 for a 1,400 square foot home. In addition to funding trauma centers and emergency
departments the money was proposed to be used for bio-terrorism. The funding is going to be heavily
used to stave off the closing of Harbor-UCLA Medical Center, a Level I trauma center, and Olive View-
UCLA Medical Center, an acute care hospital. There is some hope that these funds will help entice
hospitals that used to be trauma centers in the Pomona and Antelope Valleys to come back in as
trauma centers. There are three public (LA County Department of Health) and ten private trauma
centers in the county. It is not clear how much of these funds will be available to support the private
trauma centers once the public hospital needs are met. This was the first countywide increase in
property taxes in Los Angeles County since 1978.
Palm Beach County, FL
The Palm Beach County, Florida funding mechanism is an independent taxing district authorized
through the state for Palm Beach County. The tax district charges a property tax of about $1 per $1,000
assessed value. It generates over $100 million in revenue annually, with $24 million budgeted for
trauma. The remaining funds go to other indigent care, school nurses in the public schools, etc. Of the
$24 million budgeted for trauma, two trauma centers each receive $6 million per year, with on-call
physicians receiving about $8 million and an air medical program taking up the balance. Funding to
the hospitals has remained fairly static. The funds had been allocated to the trauma hospitals in
grants, but currently the County is using a formula based on percentage of uncompensated charges. In
addition to paying for on-call coverage, the fund also pays some malpractice insurance costs for the
trauma physicians.
Other Initiatives
There are other trauma funding tax activities in Florida. Dade County uses a half cent sales tax to fund
their one trauma center. Broward County has two taxing districts for funding indigent care including
the indigent care for trauma center patients. The tax revenue goes to reimbursing hospitals and their
physicians for trauma care at Medicare rates. Lee County, FL authorities proposed a trauma center
sales tax to raise $35 million for their single trauma center and multiple emergency departments but
the initiative failed. Five million was earmarked for the trauma center. 57 percent of the voters voted
against the measure.
California has under taken several other emergency department and trauma center funding activities.
A couple of years ago, Senator Gloria Romero (D-Los Angeles) proposed a “nickel a drink” tax (SB108)
to support the emergency departments and trauma systems in the state. During February 2003, the
Los Angeles County Board of Supervisors voted to ask the State Legislature for permission to levy a
similar alcohol tax in the county.
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