Stop-Gap Measure to Fund Trauma Centers Proposed

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Stop-Gap Measure to Fund Trauma Centers Proposed

By LAURENCE DARMIENTO

Staff Reporter

With the governor freezing $25 million in funding for the state’s trauma network, L.A. County officials have slapped together a plan to keep the local system afloat, pending a lobbying effort to get the money back.

Meanwhile, hospital industry officials are mulling a voter initiative as a possible long-term funding solution for the state’s 44-hospital trauma system.

The county’s Emergency Medical Services Agency, which had expected $6.7 million of the frozen funding, now plans to pay the 10 private hospitals in the county’s network $9.4 million in order to prevent any hospitals from leaving the system, which also includes three county facilities.

It also proposes to extend the hospitals’ six-month contract which ends Dec. 31 and commits them to the system rather than negotiate a new contract. That’s pending the results of a planned special session of the Legislature in January to consider $3 billion in spending cuts proposed by Gov. Gray Davis.

The cuts, which include the trauma funding, are the governor’s response to the rapidly deteriorating state budget that has been hit hard by the energy crisis and faltering economy.

“We are searching for a way to keep the (trauma centers) functioning,” said Virginia Hastings, director of the emergency services agency, whose plans must be approved by the Board of Supervisors. “We want to start paying them with the funding we have on hand.”

The hospitals are owed money for services they have provided since July 1, but the county had held off paying them pending negotiations on a three-year contract intended to stabilize the system. However, those talks were dependent on the $6.7 million in funding included in the state budget.

Jim Lott, executive vice president of the Healthcare Association of Southern California, the region’s hospital industry trade group, said he couldn’t imagine any hospitals leaving the system with the county’s offer at least for now.

“If there is money on the table and the hospital walks away from a vital community service the public relations alone would be devastating,” he said.

Temporary fix

This Band Aid approach is a far cry from what legislators and hospital industry and county officials had in mind earlier this year.

At the time, the state’s budget was still seeming flush and two local legislators, Assembly Speaker Bob Hertzberg, D-Van Nuys, and Sen. Gloria Romero, D-Los Angeles, authored bills intended to permanently stabilize the costly state network with as much as $300 million in funding.

Trauma centers provide the highest level of emergency care, with teams of surgeons and other specialists ready at a moment’s notice to treat car accident victims, gunshot wounds and other serious injuries.

But operating such centers is costly $2 million or more on average annually since they must accept any victim, whether insured or not. That’s a cost exacerbated by hospitals’ paper thin margins, a result of the state’s vast number of indigent patients and low reimbursement rates for patients covered by private insurance and public programs such as Medi-Cal.

The funding proposals gradually got whittled down to just the $25 million included in the budget bill courtesy of the energy crisis but an amount thought at least enough to keep trauma centers afloat for a while.

Lobbying planned

Now, hospital industry official and trauma network advocates plan a lobbying campaign during the special session to keep that funding, while the state’s hospital industry trade group mulls a possible voter initiative.

Jan Emerson, vice president of external affairs for the California Hospital Association, the state trade group, said an initiative was among a number of solutions being discussed in an effort to guarantee funding for the system.

“This is one of our definite issues,” said Emerson. “There are a variety of discussions, but I am not at liberty to discuss them.”

Prior to agreement on the current six-month contract, five local hospitals had threatened to pull out of the system unless they received greater funding. They were Northridge Hospital Medical Center, Huntington Memorial Hospital, Providence Holy Cross Medical Center, Henry Mayo Newhall Memorial Hospital, and Long Beach Memorial Medical Center.

Connie Matthews, director of public relations for Pasadena-based Huntington Memorial, said the hospital would again have to reconsider its commitment to the system unless it is adequately compensated.

“We haven’t made any decision today and we won’t make any tomorrow, but you have to ask yourself how long you can provide the care,” she said.

Those threats are not idle. The county’s trauma network was established in 1983 with 23 hospitals participating, but by 1989 10 hospitals had pulled out of the system citing losses sustained.

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