RD197 - Use of Funds in Improving Virginia’s Trauma System and Review of Feasible Long Term Financing Mechanisms and Potential Funding Sources for Virginia’s Trauma Centers


Executive Summary:
In Virginia, 13 hospitals voluntarily undergo trauma center designation and commit to provide a higher level of care necessary to the seriously injured. Despite the value trauma centers provide to the community, trauma centers face a variety of challenges that have led to a loss of trauma center designation or downgrades in coverage across the nation as well as in Virginia. These challenges are deterring additional hospitals from seeking trauma center designation.

Trauma Fund Summary

In the 2004 General Assembly Session House Bill (HB) 1143 amended the Code of Virginia by adding section 18.2-270.01 which established the Trauma Center Fund for the Commonwealth of Virginia (Appendix A). This was the first step in addressing the challenges faced by Virginia’s trauma centers.

This bill required that persons convicted of criminal violations pursuant to §§ 18.2-36.1, 18.2-51.4, 18.2-266 or 46.2-341.24 (DUI), and who had also been previously convicted of one or more of these violations, pay a fine of $50 into the Trauma Center Fund.

House Bill 2664 (Appendix B), passed during the 2005 Legislative Session, required that before granting or restoring a license or registration to any person whose driver's license or other privilege to drive motor vehicles or privilege to register a motor vehicle has been revoked or suspended, the Commissioner of the Department of Motor Vehicles must collect from that person a fee of $40 in addition to all other fees provided for in this section. The additional $40 fee must be paid into the Trauma Center Fund.

The 2006 Appropriations Act had provided $1,884,877 in general funds (GF) in both FY07 and FY08 for the Trauma Center Fund (Appendix C). The Governor’s 2008 Budget Bill increases the non-general fund (NGF) appropriation to the Trauma Fund by $4.2 million each year. This action was taken in response to the fact that NGF revenues to the fund have been much greater than originally projected. The 2008 Budget Bill also takes a corresponding action of reducing GF to the fund by $1.9 million each year. However, with the increased NGF the 2008 Budget Bill contains an overall increase in financial support for the trauma fund. The 2006 Appropriations Act also included language regarding how the new dollars were to be used and reported. The language describing how trauma funds are to be used and reported is still being followed.

The Appropriations Act, Item 286D requires the Virginia Department of Health (VDH), in consultation with the State Emergency Medical Services Advisory Board’s Trauma System Oversight and Management Committee, to (i) review the criteria used to distribute funding to the trauma centers, (ii) make refinements as necessary to encourage existing trauma centers to upgrade their trauma designation, and (iii) assess whether this additional general fund support can be used as matching funds to maximize federal Medicaid revenues. The Department shall report on the use of these funds in improving Virginia's trauma system to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees by December 1 of each year.

Additionally, Item 297 (Appendix C) requires that the Commissioner of Health review current funding provided to trauma centers to offset uncompensated care losses, report on feasible long-term financing mechanisms, and examine and identify potential funding sources on the federal, state and local level that may be available to Virginia's trauma centers to support the system's capacity to provide quality trauma services to Virginia citizens. As sources are identified, the Commissioner shall work with any federal and state agencies and the Trauma System Oversight and Management Committee to assist in securing additional funding for the trauma system.