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ATS Legislative Update-Summer 2010
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The American Trauma Society has actively advocated for a number of important initiatives this summer. As has been widely covered in the mainstream media, Congress has considered funding for the Health Care infrastructure both in the Recovery Act and the annual federal Appropriations process, and has worked this summer to advance Health Care Reform. First, ATS worked with the House and Senate Appropriations Committees to include language that supports the functions of the Trauma Information and Exchange Program. ATS is pleased to report that this effort has been so far successful; the Senate Appropriations Report includes the language we suggested and both the House and Senate propose modest increases to the CDC?s National Center for Injury Prevention and Control. Thank you to all of our membership who were involved in advocating on behalf of this provision. Second, ATS has continued working with the Centers for Disease Control to continue work on the Trauma Information and Exchange Program, the Trauma Survivor Network, and the Terrorism Injuries: Information. Dissemination, and Exchange program. Representatives of ATS traveled to Atlanta in August to meet with the new leadership at the CDC and discuss ATS? continuing work with CDC on trauma care issues. ATS received a warm reception for its accomplishments and is considered a worthwhile partner going forward. Last, drafts of House and Senate Health Care Reform bills (titled The Affordable Health Choices Act) have been taking shape over the past two months. While Congress is on their annual August District Work Period, we anticipate that negotiations will continue on the more controversial pieces of the plans. Though deadlines have somewhat softened, President Obama is pressuring lawmakers to complete work by the end of the year. Both bills in current form advocate for a public insurance option, an emphasis on primary care versus specialty care, and are silent on medical liability reforms. Below is a summary of what is included on behalf of trauma centers in the available House and Senate drafts- both of which have cleared several committees: SENATE: Included in Sections 214 and 215 of the ?Affordable Health Choices Act? is language drafted by trauma coalition colleagues ACS and NFTC, respectively, and supported by ATS. Section 214 is entitled ?Design and implementation of regionalized systems for emergency care? and would provide grants, through the HHS Assistant Secretary for Preparedness and Response (ASPR) for pilot projects that ?that design, implement, and evaluate innovative models of regionalized, comprehensive, and accountable emergency care and trauma systems.? This language is taken directly from a bill introduced by then-Senator Obama in the 110th Congress. The system must: show coordination with public health services, emergency medical services, medical facilities, trauma centers and others in a region (more than one state or local authority) to develop an approach to emergency medical and trauma systems; include a transport communications system for regional medical direction (to appropriate facilities); allow for the tracking of prehospital and hospital resources (beds, specialists, etc); include a consistent interfacility data management system that ?submits data to the National EMS Information System, the National Trauma Data Bank, and others?. Applications must, among other things, include a plan to address pediatric patient coordination. Grants must be matched, cash or in-kind, at a rate of $1 for every $3 the federal government allocates, and priority will be given to underserved areas. This section also authorizes new studies on emergency medicine and pediatric emergency services, as well as impact research on the economic savings from implementation of coordinated emergency care systems. There is no specific dollar amount authorized for this section, only ?such sums as necessary?. Section 215 is the Trauma Center Stabilization Act, which has been introduced in the 110th and 111th Congresses and creates grant programs to address uncompensated care and emergency closures in trauma systems. These funds are meant as a safety net for trauma centers. Trauma centers receiving funds under this section ?may be required to provide data to a national and centralized registry of trauma cases, in accordance with guidelines developed by the American College of Surgeons?. This section is authorized at a level of $100,000,000 for fiscal year 2009, and such sums as necessary through FY2015. Section 215 also addresses ?Trauma Service Availability? by providing grants to States to award to trauma centers to provide for physician compensation, 24-hour service ability, reduce overcrowding, establish new trauma services in underserved areas, enhance collaboration between trauma centers and emergency services personnel, make capital improvements, enhance surge capacity, ensure expedient receipt of trauma patients via ground or air, and enhance interstate trauma center collaboration. This section is authorized at $100,000,000 per year. Of note is also Section 216, entitled ?Reducing and Reporting Hospital Readmissions?, which provides for a system to gather and analyze information on readmissions and provide recommendations for reductions. Trauma centers are not mentioned specifically, nor are supplemental services beyond direct care. HOUSE: Though the bill as introduced contained no provisions specifically tailored to emergency or trauma care, an amendment offered by Representative Frank Pallone of New Jersey added several provisions that are nearly identical language to the Senate HELP Committee Bill. Both the Trauma Center Stabilization Grants and the regionalization language are included. Additionally, the House bill authorizes the Emergency Care Coordination Center under the Department of Health and Human Services as put forth by the American College of Surgeons. Further, the House bill extends the definition of emergency health providers that should be included in coordinated emergency care systems to include dentists. Finally, the Pallone amendment includes a provision authorizing research and outreach on pain management, as it is one of the leading reasons Americans seek medical care. In related news, the House Small Business Committee held a hearing on July 8 entitled ?The Looming Challenge for Small Medical Practices: The Projected Physician Shortage and How Health Care Reforms Can Address the Problem?. Dr. George F. Sheldon of ACS and Dr. Robert E. Harbaugh of the AANS/CNS testified. Both explained the acute crisis in specialty care, and that even specialty care physicians have private practice?and are small business owners. Both suggested that medical liability reforms were absolutely necessary to bring down the cost of health care. Reforms to CGME are necessary. Additionally, Dr. Sheldon warned that the trend towards emphasis of primary care would exacerbate the problem of costs and further shrink the physician supply. It is unclear what role the Committee on Small Business will have in health care reform. The American Trauma Society works to advocate for the needs of trauma care professionals and their patients to improve the entire system. If you have questions about our advocacy, please contact Harry Teter at (310) 574-4300 |
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