Congress Breathes New Life into Trauma Care Bill

WASHINGTON, D.C. -- While Congress has resuscitated the Trauma Care Systems Planning and Development Act, it's not breathing on its own yet.

The reauthorized measure -- expected to be signed soon by President Bush -- offers assistance to states developing trauma systems.

While it's authorized for $12 million annually for the first two years, it has not been funded yet. Although that is a major concern, EMS officials say they are pleased that Congress has finally breathed new life in a vital issue.

The legislation focuses attention on establishing trauma centers and enhancing EMS in rural areas.

"This is a good beginning," said Lisa Meyer, of Cornerstone Government Affairs, an EMS legislation watchdog group. "Now, we'll be getting information together about the funding that's needed."

Before its sunset, the program was under the Public Health Service Act. Despite the demise, state EMS officials have continued to meet to share resources, technology and information.

The reauthorization will be a boost to states as they work to develop a trauma care system, said Dr. Robert Bass, executive director of Maryland Institute for Emergency Medical Services Systems.

"Getting it funded is very important," he said.

U.S. Rep. Gene Green, D-Texas, told fellow legislators: "For seriously injured individuals, the first hour after an injury is when medical care is most effective in saving lives and function. This hour is also often referred to as the 'golden hour,' during which trauma and emergency systems must respond both quickly and efficiently.

This golden hour is also the goal that our military has for getting medical attention to our soldiers injured on the battlefield. The military has an impressive, streamlined trauma system..."

The congressman's comments -- part of the Congressional Record -- included instances in which trauma centers may have made a difference in the outcome of patients.

"...Too many Americans do not benefit from trauma systems that facilitate medical intervention during this critical time frame. While the death rate from trauma is 50 percent higher in rural areas than in urban locations, trauma affects each corner of this country. In fact, nearly 25 percent of all Americans sustain injuries each year that require medical attention. Yet without coordinated trauma systems and quick access to care, injuries are too often fatal..."

Green reviewed the successes of the original act passed in 1990. However, he said the nation's trauma centers are struggling for breath.

He explained: "This bill includes changes to the program to ensure that scarce healthcare dollars go to the communities most in need, ensuring that federal funds are utilized to strengthen trauma systems and improve communication and coordination among different trauma systems.

It specifically ensures that grants go to states that coordinate planning for trauma systems with state disaster emergency planning and bioterrorism hospital preparedness planning.

In addition, this legislation would require the secretary to update the model plan for the designation of trauma centers and set triage, transfer, and transportation policies.

Bass said several previous attempts to get the measure reauthorized failed. He said EMS directors are pleased that Congress understands the importance of trauma care.

Among the issues to be addressed are:

• conduct and support research, training, evaluations, and demonstration projects;
• foster the development of appropriate, modern systems of such care through the sharing of information among agencies and individuals involved in the study and provision of such care;
• collect, compile, and disseminate information on the achievements of, and problems experienced by, state and local agencies and private entities in providing trauma care and emergency medical services and, in so doing, give special consideration to the unique needs of rural areas;
• provide to State and local agencies technical assistance to enhance each state's capability to develop, implement, and sustain the trauma care component of each state's plan for the provision of emergency medical services;
• sponsor workshops and conferences; and
• promote the collection and categorization of trauma data in a consistent and standardized manner.