Mississippi Trauma Care System

Passage of legislation during the 1991 Mississippi legislative session designated the Division of Emergency Medical Services (DEMS), Mississippi State Department of Health (MSDH), as the lead agency to develop a trauma care plan for the state. The law provides that the State Department of Health, Division of Emergency Medical Services, acting as lead agency, in consultation with and having solicited advice from the Emergency Medical Services Advisory Council, shall develop a plan and submit to the Legislature a plan for the triage, transport, and treatment of major trauma victims that at a minimum addresses the following:

A.	The magnitude of the trauma problem in Mississippi and the need for a statewide system of trauma care;
B.	The structure and organization of a trauma care system for Mississippi;
C.	Pre-hospital care management guidelines for triage and transportation of major trauma victims;
D.	Trauma system design and resources, including air transportation services, and provision for interfacility transfer;
E.	Guidelines for resources, equipment, and personnel within facilities treating major trauma victims;
F.	Data collection and evaluation regarding system operation, patient outcome, and quality improvement;
G.	Public information and education about the trauma system;
H.	Medical control and accountability;
I.	Confidentiality of patient care information;
J.	Cost of major trauma in Mississippi; and
K.	Research alternatives and provide recommendations for financial assistance of the trauma system in Mississippi, including, but not limited to, trauma system management and uncompensated trauma care.

In 1992, DEMS took the first steps in developing a statewide trauma system by implementing a statewide trauma registry. The trauma registry was originally installed in five regional hospitals strategically located throughout the state. To date, each hospital participating in the Mississippi Trauma System is actively collecting trauma data and submitting it to DEMS. This data provides a stable foundation for the development of the Mississippi Trauma System.

In 1997, the Mississippi Legislature established a 17-member Trauma Care Task for (TCTF) to review the status of trauma and its impact on the public’s health. The Legislature authorized the Trauma Care Task Force to:

A.	Assist the State Department if Health by studying the status of trauma care in Mississippi during 1997;
B.	Further develop the Mississippi Trauma Care Plan, which shall address the nature of the state’s trauma care system and any additional legislation that may be needed to further enhance the plan;
C.	Further empower the MSDH in its authority to develop the state’s trauma system.
D.	Research financial mechanisms appropriate for offsetting uncompensated trauma care provided to victims of traumatic injury; and
E.	Present the findings of the trauma care study and the revised Trauma Care Plan to the Governor and to all members of the Legislature for consideration during the 1998 Legislative Session.

The recommendations of the TCTF were formalized into a report that was presented to the Governor and Legislature on December 15, 1997. The report was used as a guideline for drafting and subsequent passage of House Bill 966, “an act relating to a statewide Trauma Care System”.

Based on the TCTF report, the 1998 Legislature passed legislation (HB 966) giving the Division of Emergency Medical Services, Mississippi State Department of Health the authority to develop a statewide trauma care system. This legislation also established a permanent funding source through a $5 assessment on all moving traffic violations, creating the Trauma Care Trust Fund. This money is available for administrative functions at both the state and regional levels. The legislation also expanded the Mississippi Emergency Medical Services Advisory Council to include trauma professionals, which make up the Mississippi Trauma Advisory Committee (MTAC).

The Office of Emergency Planning and Response is committed to the development of the statewide trauma system to ensure Mississippians receive quality trauma care.

The passage of this legislation means many things to different entities. Participation in the statewide system is voluntary. Hospitals and medical staff make the decision on whether or not to participate. If an acute care facility decides to participate, they work in conjunction with other facilities in its region to develop regional trauma plans and protocols. Pre-hospital providers receive new trauma specific training, new field triage protocols, and they become more involved in the evaluation of patient outcomes.

The Mississippi Trauma Advisory Committee (MTAC) was developed as a subcommittee of the EMS Advisory Committee. In 1998, they developed the Mississippi Trauma Care Regulations and subsequently were adopted by the State Board of Health in October. These Regulations describe the requirements for Regional Plan development and the trauma center designation process. They also state the hospital requirements for trauma program development which includes the entire continuum of care from injury to rehabilitation.

The Mississippi legislature added $6 million to the Trauma Care Trust Fund during the 1999 Legislature Session. These additional monies brought the total amount in the Trauma Care Trust Fund to about $8 million per year. Legislators authorized annual funding for regional support and uncompensated trauma care as defined by the trauma registry through regional contracts with the Department of Health payable from the fund.

The funds became available on July 1, 1999, for designated Trauma Care Regions through annual contracts with the State Department of Health, Division of Emergency Medical Services. The first checks were distributed in April 2000 after hospital designations were announced for Level I and II trauma centers. A total of $6,538,545 was distributed from the Trauma Care Trust Fund for reimbursement of uncompensated care. The fund was divided between designated trauma center hospitals and eligible physicians based on allocation of 70% to hospitals and 30% to eligible physicians.

Additionally in 1999, seven trauma care regions were designated by the Mississippi State Department of Health. Each designated Trauma Care Regions are 501c3 not-for-profit organizations, in which the Department contracts with the Region to develop and implement a Regional Trauma Plan.