Trauma System Gets $11.2-Million Transfusion

In a bid to save Los Angeles County’s troubled trauma-care system, the Board of Supervisors on Tuesday provided another $11.2 million for the trauma network to try to dissuade more hospitals from abandoning the program for at least the next six months.

The board, which has seen an exodus of private hospitals from the beleaguered trauma system, approved more money for emergency physicians, county hospitals and private medical centers that are expected to treat an estimated 14,000 trauma patients next year.

But both county and hospital officials made it clear that while they applauded the additional funds, it represents only a temporary fix for a vexing issue.

“This is a short-term, Band-Aid solution to a long-term problem,” said Supervisor Ed Edelman, who voted against funding private hospitals but went along with the rest of his colleagues in providing the money for the rest of the trauma network.

The new funds, which will include $6.9 million from excess property taxes and $4.25 million in revenues generated by a surcharge on court fines, are not expected to woo back the six private hospitals that have already abandoned or announced plans to leave the trauma system. The network currently consists of 18 hospitals out of the original 23. Two of the 18 have threatened to pull out by the end of the year.

But Stephen W. Gamble, president of the Hospital Council of Southern California, said that one of the hospitals threatening to leave the system--Antelope Valley Hospital Medical Center in Lancaster--may reconsider its decision after the board’s action Tuesday.

Gamble had urged supervisors to spend the $16 million that he said was needed to restore the trauma system to its full capacity, and he viewed the board action as a signal that the board “intends to salvage the system.”

However, he added that the money will not be enough to help some trauma victims.

“It funds part of the trauma system, a large portion, but there will be holes in Los Angeles County where people will not be able to get trauma care,” Gamble said.

Serious Accidents

The county’s trauma network was established four years ago to guarantee victims of serious accidents or wounds a maximum 20-minute ambulance ride to a highly specialized emergency room with a specially trained staff.

When the network was forming, private hospitals competed fiercely to become a designated center.

But faced with staggering costs in treating indigent and uninsured patients, private hospitals began dropping out.

Pomona Valley Community Hospital, California Medical Center Los Angeles and Hollywood Presbyterian left the trauma program, followed by Daniel Freeman Memorial and Santa Monica Hospital Medical Center. Queen of the Valley Hospital in West Covina and Antelope Valley Hospital Medical Center in Lancaster announced plans earlier this year that they would leave by the end of the year.

On Tuesday, the board agreed to provide some of the money for 30 additional hospital beds for trauma patients in county hospitals and approved a priority system to allow patients from trauma hospitals or from private hospitals that care for large numbers of indigents to have first crack at county transfers.

Costly Issues

The board also directed Robert Gates, director of the county Department of Health Services, to negotiate with individual hospitals over such costly issues as the 24-hour staffing of anesthesiologists in some trauma centers.

Among those testifying before the board Tuesday was Ethel Edmonds, a registered nurse at Martin Luther King Jr./Drew Medical Center, who linked overcrowded conditions in emergency rooms and intensive-care units to the threatened collapse of the trauma-care system.

“The trauma system has turned into our worst nightmare,” she said, adding that county nurses are underpaid and overworked at county facilities.