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Trauma System Budgets OK'd

LITTLE ROCK -- The State Board of Health approved budgets for the first two years of a statewide trauma system Thursday night but left room for flexibility as the state moves forward with establishing the new system.

The budgets call for $25 million for fiscal year 2010 and $28 million for fiscal year 2011, with money coming from an increase in state cigarette and tobacco taxes signed into law in February.

The Arkansas Department of Health and the Governor's Trauma Advisory Council have spent years laying the groundwork for the trauma system - developing rules and regulations and guidelines on how it will work.

But there are some unknowns as those plans start to come to fruition, said Dr. Marvin Leibovich, chairman of the emergency medicine department at the University of Arkansas for Medical Sciences.

The biggest of those is how many hospitals will choose to participate in the voluntary system.

"It is very difficult to come up with a very precise $25 million budget when we don't know who all's going to be participating," said Leibovich, also a member of the State Board of Health.

Gov. Mike Beebe signed the trauma system into law March 13, giving state officials the go-ahead to establish a statewide system of emergency care meant to ensure people injured in serious car wrecks, falls or other traumas are able to get the medical care they need as quickly as possible.

It will link hospitals, ambulance services, rehabilitation centers, and other medical providers and ensure they're operating under the same guidelines in treating trauma patients. It also will create a communications network to help emergency responders get patients directly from the accident scene to the hospital best able to treat their injuries.

Hospitals will be designated as Level I to Level IV trauma centers, depending on the level of emergency care they can provide.

Level I centers, for example, must be able to provide the highest level of care, with general and specialized surgeons on-site 24 hours a day ready to treat patients. Level IV hospitals, on the other hand, aren't required to have surgeons but must have an emergency physician on call.

Donnie Smith, director of the Health Department's Center for Health Protection, said application kits were mailed to 89 hospitals Wednesday, outlining everything the facilities must do to become trauma centers. Among those were three out-of-state hospitals: Christus St. Michael Health System in Texarkana, Texas; and Le Bonheur Children's Medical Center and Regional Medical Center, which are both in Memphis.

Hospitals wanting to participate in the system are asked to submit an application by July 1. Reviews are expected to take four to six weeks, after which the Health Department will begin issuing "start-up grants" to help hospitals get what they need to meet the trauma center criteria.

Grants will range from $1 million for Level I trauma centers to $25,000 for Level IV centers, according to the budget. Specialty centers, such as the burn and hand centers, would be eligible for $250,000.

The first grants are expected to be issued in early fall, Smith said.

Hospitals will then have 12 to 18 months to meet the criteria, after which they'll undergo an extensive review to become designated trauma centers.

"It's a much more rigorous process," said Dr. James Graham, chairman of the Governor's Trauma Advisory Council and division chief of emergency medicine at Arkansas Children's Hospital.

Once they're designated, hospitals will be eligible for annual sustaining grants to help maintain their trauma-center status, he said.

The system budgets call for $13.5 million for the start-up and sustaining grants in fiscal year 2010, and $20.3 million for fiscal year 2011.

A total of $500,000 a year is designated for the Regional Medical Center in Memphis, which treats about 2,000 Arkansans annually and is already a Level I trauma center under Tennessee's trauma system.The budgets also include $2.32 million for fiscal year 2010 and $2.5 million for fiscal year 2011 for emergency medical services, to ensure there are enough trained emergency medical technicians and paramedics to serve the state's trauma patients.

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