Funds to set up the state's trauma system should be delivered by September or October as officials encourage as many hospitals as possible to participate.

 

Arkansas has been one of three states without a statewide trauma system and the only state without a Level 1 trauma center, but that is about to change. Earlier this year, the State Legislature passed funding to create a system that will cost about $28 million annually and that will be funded by increased tobacco taxes that were first levied March 1.

 

The state is now in a transition period setting up the system over the next couple of years, with organizers hoping to include most hospitals as quickly as possible. The department has not even been able to hire staff because the legislation did not take effect until July 1 of this year.

 

State funds will help reimburse hospitals for costs they are incurring, but Arkansas Department of Health Director Paul Halverson said many hospitals will no doubt face additional costs.

 

"Even though we're allocating substantial investment of public dollars to help support and prop up and to encourage this trauma system, it doesn't even come close to being the total costs that would be required to actually operate the system," he said. "In other words, hospitals and physicians are going to have to continue to contribute their efforts, their funds, to make this trauma system work."

 

Halverson said that in a recession, that could lead some hospitals to opt out, which in turn could mean that participants would treat more trauma patients than they expected. "Our goal continues to be that we would like to see every hospital in the state be a part of the trauma system from Level 1 to Level 4," Halverson said. "Realistically, we know that's not going to happen, especially by July 1."

 

Groups including the Arkansas Medical Society and the Arkansas Hospital Association supported the concept during the legislative session, but hospitals will decide on their own whether or not they want to participate. Naturally, success is not assured. The state has had the ability – but no funds – to designate trauma centers since 1993 and had only one taker, a hospital in Batesville, that participated only a short time.

 

Much work already has been done.

 

The state took the first concrete step last year by establishing a statewide Trauma Dashboard, an online system in which the 45 participating hospitals can access the capabilities of their counterparts. Regulations governing the upcoming system were written and then signed by the governor earlier this year before he signed the legislation creating the system itself.

 

Hospitals were required to submit self-assessments by July 1 describing which of four trauma levels is appropriate given their present-day and near-future capabilities. Level 1 hospitals will provide the highest level of trauma care and will receive $1 million in state funding. Approximately 7-10 hospitals will qualify as level 2 hospitals and receive $500,000 a year, while 10-15 level 3 hospitals will receive $125,000 annually. The rest will be rated level 4 hospitals and will receive $25,000 a year. The Regional Medical Center at Memphis, which treats many Arkansans, will receive $500,000 annually.

 

According to Halverson and Donnie Smith, director for the Department of Health's Center for Health Protection, levels will be assigned after panel reviews of those self-assessments in July and August, and then half of the appropriate funds will be disbursed, perhaps in September or early October. The balance of the funds will be disbursed after officials make an onsite designation visit.

 

Central to the trauma system's operation will be a call center, which will begin operating sometime in 2010.

 

It will be manned by trained staff who will be governed by protocols and who will be knowledgeable about each participating hospital's capabilities as well as travel times required from each particular trauma incident. Information will even be available about the hospitals' current levels of activity. That data will allow the call center and trauma responder to jointly decide where and how to transport severely injured patients, while conscious patients can be informed of treatment options and possible delays.

 

The system will allow operators to record and defend decisions, compare hospitals, and improve quality of care. Meanwhile, regional advisory committees will be organized throughout the state to maintain lines of communication and to address concerns.