BILOXI, Miss. -- A bill to fund Mississippi's trauma-care system through fees on items such as driver's licenses, car tags and concealed handguns could raise $40 million a year for the ailing program if it passes, one health policy expert said.
Sen. Hob Bryan, D-Amory, chair of the Public Health and Welfare Committee said Thursday he expects House Bill 1405 to be signed into law. The bill was amended before it passed in the Senate. Bryan said it would be sent to conference soon, for House and Senate negotiators to work out minor differences over some of the fees and some language in the bill.
"We just don't have any philosophical differences," Bryan said. "We all want to get to the same place."
The House version of the bill would add a fee of $2 on annual car-tag renewals, $5 on drivers' licenses, $10 on a gun-carry permit and $1 on vehicle inspections.
Mississippi's trauma-care system is in danger due to the high cost of treating the critically injured. Hospitals lose a substantial amount per patient in unpaid bills or low insurance reimbursements.
Providing trauma care is voluntary, so many hospitals choose to reduce their critical-care services or opt out altogether. The public perception that all emergency rooms treat all trauma cases is simply not true, said Therese Hanna of the Center for Mississippi Health Policy in Jackson.
"We're really at a critical juncture," said Hanna. "If we don't do something, more and more hospitals will drop out of the system. The Legislature recognizes what a problem we have."
The fees on driver's licenses and the like are minimal, said Thomas. What better way to fund the trauma system, she said, than through the very things that cause traumatic injuries?
Most Mississippi hospitals can only stabilize a car-crash or burn victim until an ambulance or helicopter can take them to another medical center. And for every hospital that reduces its services, she said, the burden piles up on hospitals that can treat the victim.
There is only one Level I facility in Mississippi in Jackson and no burn facility. Level I facilities are staffed 24 hours each day and are often associated with medical schools. In South Mississippi the most serious injuries and burns go to the University of South Alabama Medical Center in Mobile. In North Mississippi, the worst cases likely go the Regional Medical Center in Memphis. Both hospitals are entitled to funding through this bill.
The closest Level II facility to the Coast is Forrest General Hospital in Hattiesburg. Level II hospitals have their own surgeons, but they work on a call schedule, rather than being on-site all the time.
Written into the bill is a "pay for play" statute, whereby hospitals that opt out of the trauma-network pay fees to fund those that stay in. This statute is popular with trauma experts and local hospital administrators, including Gail Thomas of Mississippi Coastal Trauma Care Region and Chris Anderson, CEO of Singing River Hospital System.
Singing River Hospital and Ocean Springs Hospital are Level III trauma centers. They have the required orthopedic and general surgeons, whom they share, Anderson said. To become a Level II center, Anderson said he would have to staff each hospital with its own surgeons. But cost outweighs the benefit of having two full trauma-surgery staffs within 20 minutes of each other.
Neither he nor Gary Marchand, CEO of Memorial Hospital in Gulfport, thinks the Coast needs a Level I trauma center. The area population doesn't substantiate it. Forrest General, said Marchand, serves 17 counties, and Memorial Hospital serves three. Memorial Hospital is a Level IV trauma center, as are all others on the Coast besides Singing River and Ocean Springs.
Another provision in the bill is a "no show" fee for patients who die en route or who are transferred last minute to another hospital."If you get ready for a patient and the patient doesn't come to your hospital... there is nobody to bill," Bryan said. "You never had a patient, you never provided any service to that patient, but you did incur all the expenses getting ready for the patient."