Mike Klein Online

Trauma Care Amendment Faces Voters, Questions About Funding Levels

Next week Georgia voters will vote YES or NO on a constitutional amendment that would fund expanded statewide trauma care with a new mandatory annual vehicle tag tax.  An advocacy group, Yes2SaveLives, says on its website that the fund would raise $80 million per year.  That is based on $10 per vehicle and some 8 million registered vehicles in Georgia.

This week I asked the state Department of Revenue for its interpretation.  The email reply from a DOR tax policy analyst said, “The proper number for you to reference is:  5.5 million vehicles.”  That would raise $55 million per year, not $80 million cited by Yes2SaveLives.

“That’s the first time I’ve heard that,” said Georgia Hospital Association vice president Kevin Bloye.  “I hope that’s wrong.”  Constitutional Amendment #2 says the $10 annual fee would apply to passenger vehicles including pickup trucks, motorcycles, sport utility vehicles and vans.

Georgia trauma care advocates have sought consistent funding for many years.   The constitutional amendment would create dedicated funding that could be spent for no other purpose by the General Assembly unless voters approved the change.

Both leading candidates for governor, Republican Nathan Deal and Democrat Roy Barnes, support the amendment. But this has been a hard sell.  Three weeks ago pollsters declared that the idea was “being crushed.”   Insider Advantage said one-quarter of Georgians liked the idea, one-half did not and the rest did not know what to think.  It was given little chance for passage next Tuesday.

The Yes2SaveLives television and radio blitz will expand statewide this weekend.  Yes2SaveLives consists of about 70 leading health care and business organizations.  Events in several cities, more news articles, a Facebook page, a Twitter presence, YouTube videos and boots-on-the-ground might improve its chances for passage.

“It’s a sprint to the finish line, it really is, and we’re working around the clock to get there,” said Bloye.  He described selling the $10 vehicle tax idea to voters as “a massive uphill battle.  We’ve talked about this issue for years at the Capitol.  This might be our last chance.”

Bloye said the trauma care proposal must overcome all-time high levels of distrust with government and he conceded some voters are “just worried this money will be flushed down another giant government hole.  The real benefit is every dollar from Amendment #2 will be dedicated to improving our trauma system, just like the HOPE (education scholarship) dollars are locked in.  They are dedicated dollars that cannot be moderated without approval from Georgia voters.”

Dr. Dennis Ashley of Macon began to campaign for better Georgia trauma care about ten years ago.  Ashley describes the state’s current trauma care as being “helter skelter.”   Ashley is director of trauma and critical care at the Medical Center of Central Georgia in Macon.

“If you’re hurt right outside my trauma center you will see the bells and whistles just like on TV, but if you’re just out there driving around, you’re going to be appalled.  That hospital with one or two ER doctors, one or two ER nurses, they will do the best job they can but we’re just not organized.  With the technology we have today we should be able to tie all this together.”

Three years ago the legislature created the Georgia Trauma Care Network Commission.   Ashley was named chair by Governor Sonny Perdue. The legislature provided $58 million in one-time funds to create a blueprint for a statewide trauma care system, upgrade existing trauma centers, hire more trauma care personnel, improve trauma care ambulance capabilities and reimburse hospitals at 40% actual cost for service provided to uninsured patients.

Today Georgia has 17 trauma care hospitals.  Twelve are in north Georgia.  Five are in central and south Georgia.  Large rural sections of Georgia have no trauma care.    The Centers for Disease Control and Prevention says 700 Georgians die each year because they do not receive trauma care that might have saved their lives.  The goal is 30 trauma care hospitals.

“Nobody has a complete model that’s perfect.  Maryland probably has the best system,” Ashley said. “The way they built their system was with a tag fee.  That money goes to trauma.  They can get every citizen they have to a trauma system within 30 minutes.  That’s pretty darn good.  Georgia is bigger.  I don’t know that we can get to 30 minutes but we want to get to one hour.”

This year the commission has a $23 million General Assembly appropriation loosely based on estimated revenue from a super speeder law that went into effect in January.  But Georgians must have slowed down.  The Governor’s Office says Fiscal 2011 super speeder revenue will be $10.5 million, not $23 million.  That will not change funds to the commission but it does help to explain why trauma care advocates have sought more reliable revenue.

Ashley said vehicle tag dollars would create a statewide electronic communications center to link local hospitals to trauma center hospitals.  No-coverage gaps in central and south Georgia would be addressed with upgrades to existing hospitals.  There would be new investments in air and ground patient transport.  Telemedicine resources would link more hospitals by computer and funds would be spent to upgrade pediatric trauma treatment.

Whether this happens will be decided by Georgia voters.  “We’ve made tremendous progress.  I’m cautiously optimistic,” Ashley said.  “All the polls have moved in our favor.  The yes vote is going up; the no vote is going down.  I’m going to hold my breath until Tuesday night.”

Mike Klein is Editor at the Georgia Public Policy Foundation.

October 29, 2010 - Posted by mikekleinonline | Uncategorized | Centers for Disease Control, Dr. Dennis Ashley, Georgia Hospital Assocation, Georgia Public Policy Foundation, Georgia Trauma Care Network Commission, Kevin Bloye, Medical Center of Central Georgia, Mike Klein, Yes2SaveLives