Major parts of the state’s nationally recognized trauma care system could be added to the budget chopping block.
Senate Appropriations Chairman Buck Clarke, R-Hollandale, raised concerns this week about hospitals in Memphis and Mobile, Ala., receiving money from Mississippi’s trauma care fund for treating Mississippians.
Clarke, one of the state’s top budget writers, said Mississippi may not be getting its money’s worth from the payments it makes to those hospitals, which sit near state borders, and that the Legislature would need to discuss whether the hospitals are a necessary part of Mississippi’s system.
“We don’t get any reciprocating funds coming back to our state. I think that (relationship) needs to be reevaluated … And when we get to the appropriations process we’ll look at that,” Clarke said this week.
But supporters of the trauma care-system argue that the Mobile and Memphis hospitals, which operate as level-one trauma centers, are integral to the state’s trauma system. While four level-one trauma centers make up Mississippi’s system, the state itself is home to only one—University of Mississippi Medical Center in Jackson, which is almost four hours away from some parts of the state.
Jim Craig, the director of health protection for the state department of health, said the decision to fund the system is up to the Legislature, but offered a caveat to lawmakers.
“They should understand that they’re funding Mississippians. It’s not money that’s taking care of non-Mississippians. It’s not taking care of Tennessee residents in a Tennessee hospital. It’s taking care of our patients,” Craig said.
Sen. Clarke’s comments came in the middle of heated debate on Senate Bill 2625, which seeks to address some of the problems caused by legislation approved in 2016 that swept trauma-care funds into the general fund.
Paying for the state’s trauma care system has been a hot-button issue since then, with supporters of the system arguing that relying on general fund appropriations could destabilize the system.
Payments to out of state hospitals in Mississippi’s trauma care network totaled $2.35 million over the last twelve months, which is just over 10 percent of the system’s nearly $22 million annual budget. As comparison, the trauma fund paid $2.87 million to University of Mississippi Medical Center over the same time period.
Over 80 hospitals make up the state’s trauma care system. The trauma fund makes payments to each hospital twice a year; the size of the payment is determined by the level of trauma care it provides, with level one centers receiving the most funding.
Although approximately one third of the trauma care system’s $22 million budget was included in last year’s sweep, legislation crafted this year designed to fix problems with the sweeps bill does not address trauma care. As a result, the Legislature will continue controlling trauma-care funds for the time being, Clarke told Mississippi Today.
“I think the only thing left to do at this point is to make (the funding) a line item in the health department appropriation,” Clarke said. “We’ll look at what amount they need. Speeding tickets can go up and down, ATV (fees) can go up and down. But we’ll make sure they (the trauma care system) get what they need.”
When the Legislature created the trauma fund in 2008, lawmakers chose to fund it through a series of fees, generally attached to risky behaviors that might result in a need for trauma care, such as traffic tickets and ATV purchases.
During Senate debate this week, Sen. Hob Bryan, D-Amory, said that giving the Legislature control over the funds would make the trauma centers vulnerable to cuts in tight budget years.
“If I’m a hospital, I would be concerned about losing this guaranteed amount of income,” Bryan said, adding that any line-item appropriation would be arbitrary. “If this is going to be a general fund appropriation, how are we going to decide how much it should be?”
However, the fees and assessments that fund trauma care have consistently failed to meet projections. This, Clarke argued, makes a state appropriation a more reliable funding source.
Craig, of the state health department, cautioned against interfering too much with a trauma care system that, he said, has been a rare win for health care in Mississippi.
“You’ve heard of the golden hour, trying to get patients to the surgeon in the quickest time possible. So if it’s faster for the people in Memphis to go to the Med or for those near Mobile to go there, then it’s better outcomes for Mississippians,” Craig said. “They are valued members, valued players and they do improve outcomes of trauma in the state of Mississippi. We know they’re across the state line but they’re part of our system.”