Analysis

Topic: Trauma Commission
Sponsor: Representative DeWeese
Date Ordered Enrolled: December 14, 2000
Date of Analysis: December 19, 2000

Position: The Department of Consumer and Industry Services supports the bill.

Background: Trauma is the medical term for injury. Although only 5 to 7 percent of patients seen in hospital emergency departments would be classified as trauma, appropriate treatment within one hour is vital to reducing the risk of loss of life and permanent disability for these patients. A 1996 study concluded that as many as 18 percent of traumatic injury fatalities in Michigan were preventable. A 1994 study estimated that a trauma system could reduce trauma mortality by an estimated 1,350 lives and prevent another 15,000 permanent or long-term disabilities. Michigan is now one of only nine states that do not have a statewide trauma system.

As originally introduced, the bill was identical to Senate Bill 404, which made changes in the Public Health Code related to emergency medical services. The current language was substituted in the House as a strategy to break a deadlock on Senate Bill 404. It was hoped that support for creation of a Trauma Commission would generate additional support in the House for the Senate Bill 404.

Bill Content: The bill amends the Public Health Code to create a Statewide Trauma Care Commission in the Department of Consumer and Industry Services. Members will be appointed by July 1, 2001 for a two-year term by the Governor. The Commission will consist of 17 members as follows:

· Eight health professionals who are experts in trauma and emergency services,
· Two representatives of hospitals,
· Two representatives of health care purchasers or payers,
· One representative from ambulance service providers,
· Two consumers,
· One representative from the Department of Community Health, and
· The chair of the Emergency Medical Services Coordinating Committee.

The Governor is required by the bill to designate a chairperson for the Commission. The Commission's first meeting is required to occur within 30 days after the appointment of members.

The Commission is required to do the following:

· Assess the status of trauma care,
· Hold public hearings throughout the state, including at least 1 public hearing in each of the state's eight health planning areas,
· Obtain information on trauma care systems in other states.

The Commission is required to prepare and file a report with the Governor, the Legislature, CIS Director, and the Emergency Medical Services Coordinating Committee by July 1, 2002. The report is required to make recommendations on statewide trauma care delivery and administrative structure, fiscally responsible model policies for a statewide trauma care system, and the unique needs and constraints of rural trauma care. The Senate added an amendment related to trauma care issues in border areas.

The Commission's report is required to be available to the public at no charge. Meetings of the Commission are open meetings and Commission documents are subject to the Freedom of Information Act. The Department of Consumer and Industry Services is required to provide office space and administrative support. Per diem compensation for Commission members will be as established by the Legislature. The bill contains no other provision relating to per diem compensation or a schedule of reimbursement for members.

The section of the Public Health Code added by this bill is repealed on July 1, 2004.

Arguments For: Injury is a leading national health problem. Each year nearly one fourth of all Americans suffer an injury that requires medical attention or results in restricted activity. Injury is the nation's third leading cause of death, accounting for one out of every 14 deaths in the United States. Trauma is the number one killer of children under the age of 14. Unintentional injuries or accidents are the leading cause of death of persons aged one to 37. A statewide trauma system can save lives by assuring that those with injuries reach a hospital with the appropriate resources to help them as soon as possible. The Office of Technology Assessment in the United States Congress has estimated that 20 to 45 percent of those who die after reaching the hospital alive could be saved if regional trauma care systems existed throughout the nation. Experiences in Orange County, California; San Diego; Portland, Oregon; and Washington, D.C. have documented the life-saving potential of trauma care systems.

Arguments Against: The proposed Trauma Commission is unnecessary. The non-profit Michigan Trauma Coalition has been working on the development of a statewide trauma system since 1991. Great strides have been made toward improved trauma care. Although the Commission believes that they have progressed as far as they can on a voluntary basis, it is possible to do much more. The study will interrupt continued process and delay resolution of this problem.

Supporters/Opponents: The Michigan Trauma Coalition, the Michigan College of Emergency Physicians, the Michigan Association of Ambulance Services, the Michigan Health and Hospital Association, the Detroit Medical Center, and the Economic Alliance for Michigan support the bill. The Department of Community Health had concerns, which were substantially addressed in Senate amendments.

Fiscal Impact: It is estimated that the proposed study will cost the Department of Consumer and Industry Services $150,000.

Administrative Rules Impact: No administrative rules will be needed to conduct the proposed study.