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Arkansas Continues Effort to Develop Statewide Trauma System

LITTLE ROCK — The Regional Medical Center at Memphis should be a key partner in the development of Arkansas’ statewide trauma system, Tennessee and Arkansas hospital officials said Tuesday.

The center, also known as The Med, is one of six Level I trauma centers in Tennessee that provide the highest level of emergency care. It treated 1,966 Arkansans between July 2006 and June 2007, at an estimated loss of $10.5 million, said Sylvester “Skip” Reeder, the hospital’s chief executive officer.

“Pain and misery do not stop at the [Mississippi] River,” Shelby County, Tenn., Mayor A.C. Wharton Jr. told Arkansas legislators Tuesday during the first of two days of meetings of the Hospital and Medicaid Study Subcommittee.

Arkansas is the only state without a Level I trauma center and one of only three without a statewide trauma system.

The subcommittee is meeting to discuss the relationship between Arkansas and The Med. It is one of three government entities responsible for evaluating Arkansas’ need for a trauma system.

Efforts to establish a trauma system during last year’s legislative session failed after a stalemate between the House and Senate on how such a system would be funded.

The estimated cost is $25 million from the state, with an additional $15 million in Medicaid reimbursements from the federal government, said Rep. Denny Sumpter, D-West Memphis.

“We all see the need, we all know the role The Med plays,” Sumpter said. “The question now becomes how is it going to look, how will it be paid for.” But Joe Thompson, Arkansas’ surgeon general, said the state is moving toward finding a solution. It’s a top issue for legislators, Gov. Mike Beebe’s Trauma Advisory Council and the Governor’s Roundtable on Health Care.

“I think there’s wind here in the sails that say that this is … a challenge that we need to solve,” Thompson said.

Jamie Carter is chief executive officer of the 152-bed Crittenden Regional Hospital in West Memphis. He said the hospital relies on The Med being able to accept patients.

More than 80 percent of the trauma-related injuries in the county go to The Med, Carter said. The Memphis hospital is just eight miles from Crittenden Regional, while patients would have to travel 130 miles to a Little Rock hospital.

“The Med is a fundamental partner in the formation of an Arkansas trauma program,” Carter said.

Reeder said such a system is desperately needed because it would mean more funding from Arkansas to help cover the cost of treating Arkansas patients. The Med serves a six-state area encompassing three million people and has a deficit of about $70 million.

During fiscal 2007, the hospital treated 586 Arkansans in its trauma, burn and neonatal intensive care units. Of those, about 40 percent were uninsured, Reeder said.

“The patient that breaks our back is the patient that looks like you and me,” Reeder said. “It’s not the derelict on the street or the lady addicted to crack … it’s the patient that for one reason or another has a condition that makes them uninsurable.” The hospital received $31.367 million from Shelby County, $35.661 million from Tennessee, $2.399 million from Mississippi and $1.086 million from Arkansas that year.

Wharton said that the hospital’s “long-term diagnosis is critical,” and that participation from all stakeholders, including Arkansas, is “an absolute necessity.” The hospital risks losing its status as a Level I trauma center without adequate funding to maintain its services.

“It is an impending crisis any way you look at it,” Wharton said.

Loss of The Med would mean loss of lives, he said.

“I am of a firm belief that we will solve this challenge,” Wharton said. “This is not an option we’re working on. This is not a recreational challenge. We’re talking about the right to live.” Thompson used the example of a patient with serious head injuries. Under Arkansas’ current system, such a patient would likely be transported to the closest hospital whether the hospital had a neurosurgeon or not. The emergency room staff would then have the task of finding the closest hospital capable of treating the patient’s injuries.

“We have no system so there’s no telling where they go, probably wherever the ambulance driver wants to take them,” he said.

With a statewide trauma system, emergency responders could immediately identify the nearest hospital with the appropriate specialist, and get the patient there faster, saving valuable time and possibly the patient’s life.

Wharton said Shelby County is willing to think “outside of the box” in trying to develop a solution, and even suggested building a satellite facility of The Med in Arkansas. It would cost Arkansas a lot more to build its own Level I center in the eastern part of the state than it would to include The Med in its system, he said.

“There simply becomes a point in time where your equipment, your inability to recruit the best and the brightest will eventually impact the level of care you’re providing,” Wharton said.

“There’s a danger in flying too close to the ground, you tip your wing and there’s a disaster. The Med, out of necessity, is flying too close to the ground.” Other designated trauma centers are in Joplin and Springfield, Mo., Greenville, Miss., and Shreveport.