Mike Klein Online

Supporters: Trauma Care Funding Amendment Slain by Angry Voters

Leading advocates for statewide dedicated trauma care funding said Wednesday afternoon that they will plead their case with Georgia Governor-elect Nathan Deal and the new General Assembly, but they are not optimistic about chances to find $80 million in the current state budget or anytime soon.

Georgia Trauma Care Network Commission chairman Dr. Dennis Ashley said voters are angry and they distrust politicians to take their money and do the right thing.  “I’ve never seen anything like this,” Ashley said.  “We felt like if we got out there and showed the facts we could overcome it.”

Constitutional Amendment #2 asked voters to approve a $10 annual vehicle registration tax that would be dedicated to improve trauma care throughout the state but mostly in rural Georgia.  The ballot question lost 52.6% to 47.4% and it failed in 145 of the state’s 159 counties.

“I don’t think this was about $10 or trauma care.  It was about government,” said Kevin Bloye, vice president of the Georgia Hospital Association.  “What we heard was (voters) didn’t feel like the money would be used for trauma.   They felt like it would be money flushed down another hole.  As much as we tried to tell them the dollars were locked into trauma care, they weren’t buying it.”

Tuesday was the first time Georgia voters were asked to consider dedicated trauma care funding.  “Even with unemployment the way it is and anti-government sentiment, we still got 1.2 million people that thought trauma care was enough of a problem that they were willing to pay $10 per year,” said Ashley.

“That’s no small number.  The ones who voted no, they were supportive of trauma care.  They thought it was a good idea to save 700 lives a year.  They just wanted no more taxes and they want the money to come from the general fund.”

Despite its defeat, the amendment overcame a perception north Georgia voters would not approve funds that would primarily assist south Georgians.  Three large population counties in metropolitan Atlanta – Cobb, DeKalb and Fulton – approved the measure by slim margins, as did Chatham County (Savannah) on the southeast coast.  But much needed rural support never materialized.

“The irony was the people who needed this amendment to pass the most were the ones who rejected it,” Bloye said.  “Without doubt the major gaps in trauma care are in south Georgia, southwest Georgia and northeast Georgia. Those are the areas that rejected the amendment.”

Georgia’s General Assembly created the constitutional amendment path when it could not or would not fund trauma care from the state’s general budget.  Ashley said he discussed trauma care funding with Governor-elect Deal “two weeks ago.  He talked like he was supportive of (dedicated trauma care funding) but we didn’t get into any details. We’ll just have to see how that plays out.”

Bloye pointed to “an unprecedented time in state government.  Collections remain down.  There are huge funding holes.  Frankly, it’s going to be very difficult the next few years to get anything done with trauma care. Does that mean we will stop working on it?  Absolutely not.  We will work as hard as ever but this is going to be a huge uphill climb.”

Mike Klein is Editor at the Georgia Public Policy Foundation.

November 3, 2010 Posted by | Uncategorized | , , , , , , , | Leave a comment

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 | Uncategorized | , , , , , , , , | Leave a comment