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November 15, 2009

Ark. trauma system still on track despite budget cutback

By Carolyne Park
The Arkansas Democrat-Gazette

LITTLE ROCK, Ark. — The state's new $25 million trauma system will take a $1.2 million hit from state budget cuts announced last month, but the loss won't interfere with getting the system in place, Arkansas Department of Health officials said Thursday.

Even so, members of the state Trauma Advisory Council said they need to move quickly to establish regional councils to manage the system at the local level to help ensure that the budget reductions don't hinder the system's progress.

"I think we're way overdue in getting our regional tracks out and finding out who we're dealing with," said Jamie Carter, chief executive officer of Crittenden Regional Hospital in West Memphis and a council member representing the Arkansas Hospital Association.

The money is part of the $3.6 million in total cuts the Health Department had to make to its overall budget after Gov. Mike Beebe's announcement last month of $100 million in state budget cuts, because of lower-than-expected tax collections.

Council Chairman Dr. James Graham, chief of emergency medicine at Arkansas Children's Hospital, said the trauma system is taking a "disproportionate" share of the reductions compared with other Health Department programs.

"It seems to me that onethird of the total cut is falling on the trauma system," he said during the council's monthly meeting Thursday.

But Health Department officials insisted that the system remains a top priority and that the cuts will have a minimal effect.

"We would not do anything that would have hurt the trauma system's chances of getting up and running," said Charles McGrew, the Health Department's deputy director and chief operating officer.

Signed into law by Beebe on March 13, the trauma system is a network connecting hospitals, ambulance services and other emergency responders statewide. The goal is to get people as quickly as possible to the facility best able to treat their specific injuries after a car wreck, fall, shooting or other traumatic injury.

For example, it would ensure that a person with severe burns is taken directly to a burn unit or that someone with serious head injuries is taken to a hospital with a neurosurgeon trained to operate on such injuries.

The $1.2 million in trauma system cuts include $900,000 that was to be used to improve communications systems for ambulance and emergency medical services statewide, as well as to buy defibrillators for schools.

Another $261,000 in cuts is coming from money set aside to hire Health Department staff members to help manage the new system. Those positions are not yet filled, and therefore the money is unused, said Mary Leath, Health Department director for administration.

"It was felt that reducing $261,000 from unspent money in the trauma system would be unfelt," Leath said. The Health Department has made two recent hires to help lead the trauma system.

Bill Temple took his post Oct. 5 as the Health Department's branch chief for injury prevention and control. He previously spent 30 years in the FBI, including serving as special agent in charge of the FBI's Little Rock field office from 2002-08. Temple retired when he turned 57 because that is the bureau's mandatory retirement age.

Dr. Todd Maxson, the new trauma medical director at Arkansas Children's Hospital, will also serve as the Health Department's trauma medical consultant. Maxson previously served on the Texas' governor's trauma advisory council and led the establishment of trauma centers at Dell Children's Medical Center in Austin and Children's Medical Center of Dallas.

Maxson said he thinks the council needs to work to get other pieces of the trauma system in place - such as the regional councils - to begin training people who will be involved in the trauma system on the ground level and make sure they know what they need to be doing.

"We need in the state a base line of education for nurses and other healthcare professionals," Maxson said.

Terry Collins, council member and trauma program manager at the University of Arkansas for Medical Sciences Medical Center, said there's already confusion among medical providers.

"My phone's ringing every day from hospitals in the state that are saying, `What do we do now, where do we go now?'" Graham said council members will meet next week with the goal of establishing the regional councils early next year.

Also, Temple said he is writing job descriptions for several positions under the new section. A total of 19 positions are funded within the Health Department for the trauma system, including the consultant job that was filled by Maxson.

"We're going to try to do everything we can to get positions filled as quickly as possible," McGrew said. "In state government you can't do things as quickly as you would like to."

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