Trauma system funding and development
Minimal activity in the state legislatures pertained
to trauma system development and funding, as most
state budgets are still recovering from the recession
and some are still facing budget deficits. In addition,
many states have trauma systems in place with at least
some available funding. Nonetheless, a few state legislatures did consider changes to their trauma systems
or are trying to identify new funding sources. State
lawmakers took unique approaches to reforming
these systems, especially with respect to establishing funding.
In Texas, legislation to repeal the Driver Responsibility Program, which provides funding for the
state trauma system, did not pass this session. S.B. 93
received unexpected support in the legislature and
was passed by the Senate, but the House did not act
before the session ended. The Driver Responsibility
Program imposes surcharges on drivers who receive
citations for traffic violations. As originally written,
S.B. 93 would have repealed the Driver Responsibility
Program entirely, but the amended bill left the program intact. The amended legislation, however, also
removed a provision that would suspend the driver’s
licenses of those individuals who fail to pay the fine.
License suspension is the main enforcement mechanism for the program; if eliminated, it would have led
to a significant decrease in funding for trauma care in
the state. The ACS actively opposed the bill and will
continue to counter efforts to cut trauma funding when
the Texas legislature reconvenes in 2017.
Legislation was introduced in Nevada that would
have required the Department of Health and Human
Services to develop a standardized system for the collection of information for the state trauma registry.
The bill, S.B. 189, also would have created the Fund for
the State Trauma Registry, which would have required
automobile and home insurers to charge an annual $1
fee to fund the development of this system. The bill
did not make it out of committee.
In Ohio, H.B. 261 was introduced to create a new
Ohio Trauma Board and to make other changes to
its trauma system. The Ohio Trauma Board, which
would be administered within the Ohio Department
of Health, would comprise 19 members appointed by
the Governor, the Speaker of the House, and the Presi-
dent of the Senate. The board would be responsible for
operating the state trauma registry, seeking and dis-
tributing grants, and developing a statewide system
for improving the quality of trauma and rehabilitative
care. At least three of the Ohio Trauma Board mem-
bers would be trauma surgeons. The Ohio Chapter of
the ACS would be required to submit nominations for
two of the positions.
In addition, H.B. 261 also would add new designation standards, such as participation in statewide and
regional injury prevention activities and submission
of more timely data to the registry. Furthermore, the
bill would require the Department of Health to hire an
executive director and chief medical director. The ACS
would still verify trauma centers, but additional standards would be added for centers to gain verification.
Currently, the trauma system in Ohio is funded solely
through fees assessed on trauma hospitals, and this legislation does not address that issue. One suggested means
of addressing the funding situation would require hospitals to contribute at least some of the revenue needed
to make the proposed changes in the legislation. Ohio’s
original trauma law was passed in 2000.
A bill introduced this year in Indiana would have
provided some funding for the statewide trauma
system. Although funds have been authorized for
the trauma system through the Spinal Cord and Brain
Injury Fund that became effective through legislation
passed eight years ago, no actual funding is provided
for trauma system development and infrastructure
support. The bill introduced this year, H.B. 1404,
would have used speed cameras to identify drivers
speeding through construction or school zones or
illegally passing a school bus and would have imposed
a fine with a ticket sent through the mail. Half of
the funds received from these fines would have been
directed to the Spinal Cord and Brain Injury Fund,
specifically for use in developing a statewide trauma
hospital network. The bill failed in the Committee
on Roads and Transportation.
In 2015, ACS State Affairs staff has reviewed approximately
200 pieces of trauma-related legislation. Most of these bills
were related to injury prevention efforts, but some were
related to trauma system development and funding.