|
|
| You are here: DOH Home » HSQA » CHS Home » Trauma Designation, Registry & QA • Trauma Care Fund |
| Site Directory: |
Trauma Care Fund |
||||||
|
• • Home • About Us • Complaints • EMS Education, Training & Regional Support » Injury and Violence Prevention • EMS Licensing & Certification • Office Policies and Interpretive Statements • Policy, Prevention & Trauma Fund » Regional EMS and Trauma Information • Statutes (RCW) & Rules (WAC) » Trauma Designation, Registry & QI
|
|||||||
|
Files contained on this page require you to obtain the Free Adobe Acrobat Reader to open and view the document. Documents posted in .pdf version on the Department of Health Web site will be made available in an alternative format on request to users who are unable to download or view .pdf files on the Web. To request an alternative format, contact the Web Coordinator. We have a comprehensive statewide Trauma System that ensures a continuum of care for trauma patients. Our Trauma Care Fund provides financial support to hospital, physician, prehospital and rehabilitation services in the trauma system. Our Legislature established the Trauma Care Fund in 1997 to help offset the high costs of trauma care (RCW 70.168.040). The law required getting the most value from state funds by matching a share of them with federal funds. We (the Department of Health or DOH) administer the fund. We work with the Department of Social and Health Services (DSHS) to secure federal matching funds through enhanced Medicaid payments for trauma care. The fund budget for the 2009 – 2011 biennium is approximately $49 million. These funds will be distributed as grants and enhanced payments. Of this total, $27 million is from revenue appropriated by the legislature. The fund draws on two sources of revenue: (1) $4.00 from a $6.50 fee on the purchase or lease of a new or used vehicle and (2) $5.00 surcharge on moving violations. The remaining $22 million comes from federal match funds through DSHS. We distribute all funds according to a spending plan. We develop this plan each biennium with input from DSHS and the Governor’s EMS and Trauma Care Steering Committee. DOH Trauma Grants - Hospitals. FY 2009 Hospital
Grant Amounts Uncompensated Care Grants - Levels I & II. We distribute these grants each year to Levels I and II designated trauma services. They subsidize uncompensated and under-compensated trauma costs. We base the grant on a hospital's proportionate share of uncompensated trauma care. We use figures for bad debt, charity care, and total patient revenue to calculate this grant. This information is taken from the most recent, complete calendar year of hospital patient data. The sum of the Injury Severity Scores (ISS) is extracted from our Trauma Registry for the same period. This includes cases that meet both the trauma registry inclusion criteria and one of the following criteria.
Figure 1 shows how this grant is calculated.
Uncompensated Care Grants - Levels III, IV, & V. We distribute these grants each year to Levels III-V designated trauma services. They subsidize uncompensated or under-compensated trauma care costs. We base the grant calculation on designation level and trauma patient volume. The level bases are: $10,000 for level IIIs, $5,000 for level IVs and $2,500 for levels Vs. Volume data includes trauma patients that meet the Trauma Registry inclusion criteria and report either “Medicaid”, “self-pay”, “charity care”, or “none” as a primary payer. Figure 2 shows how this grant is calculated.
Hospital Participation Grants - Levels I - V. We distribute these grants each year to all designated trauma services for both general and pediatric designations. We award this grant to help offset the costs of participating in the trauma system. We use three criteria to calculate this grant.
The total grant funds available are divided among the criteria: 65% for level, 17.5% for volume and 17.5% for location. Each service is grouped by volume. Table 1 shows the volume group levels.
Location information is taken from the 2005 Washington State Office of Financial Management population data. Hospital Rehabilitation Participation Grants - Levels I and II. We distribute these grants each year to Levels I and II designated trauma rehabilitation services for both general and pediatric designations. We award this grant to help offset the costs of participating in the trauma system. We base the amount of the grant on level of designation only. Of the total grant funds available 60% is for Level I services the remaining 40% is for Level II services. These amounts are then divided by the number of levels to give the individual grant amount. DOH Trauma Grants - Prehospital. Medical Program Director (MPD) Grants. We distribute these grants each year to all current MPDs. We award this grant to help offset their costs. MPDs provide medical oversight for EMS and Trauma prehospital personnel. Prehospital Participation Grant. We distribute these grants each year to all trauma verified prehospital agencies. We award this grant to help offset the costs of participating in the trauma system. These costs can include equipment, training, supplies, and staffing. The individual grant amount is the total amount of funding divided by the number of applicants. The grant amount per agency for State fiscal year 2009 was $1,726. We mail grant applications and instructions to trauma verified agencies in January each year. Prehospital Needs Grants will no longer be offered. These funds were shifted to the Prehospital Participation Grant. DSHS Enhanced Medicaid Payments. Supplemental Hospital Trauma Care Medicaid Distributions - Levels I, II, & III. DSHS supports hospitals through supplemental Medicaid distributions for Levels I, II, and III. DSHS payments apply to trauma cases that meet or exceed the ISS of 13 for adults and 9 for children less than 15 years of age, and to cases received in transfer. Supplemental hospital distributions are made on a quarterly basis. They are based on each participating hospital's percentage share of all eligible trauma claims for the relevant quarter. Increased Physician Trauma Care Medicaid Payments. DSHS supports clinical providers through Increased Physician Payments. DSHS payments apply to trauma cases that meet or exceed the ISS of 13 for adults and 9 for children less than 15 years of age, and to cases received in transfer. Physicians and other clinical providers receive increased payments for trauma services on a claim-specific basis. Claims for professional services are reviewed at the line item level; some procedures (e.g. laboratory) are not eligible for increased payment. For an eligible procedure, the payment amount is DSHS’s maximum allowable fee multiplied by the enhancement percentage. The ISS is used to describe patients with multiple injuries. The Abbreviated Injury Scale (AIS) is used to score the severity of a patient’s injuries. The AIS is used to classify each injury by body region on a scale from 1 to 6 -- the higher the number the more severe the injury. The AIS is used to calculate the ISS. The sum of the squares of the highest AIS scores, in the top three most severely injured body regions, gives the ISS. For information on the Trauma Care Fund please contact Eric Dean. Eric Dean, Trauma Fund
Manager For information on DSHS enhanced payments please contact Ayuni Hauea-Wimpee. Ayuni Hautea-Wimpee http://hrsa.dshs.wa.gov/HospitalPymt/ For information on Trauma Service Designation please contact Sandi Shaw. Sandi Shaw, Trauma
Designation Administrator http://www.doh.wa.gov/hsqa/emstrauma/traumadesig.htm. For information on Prehospital Trauma Verification please contact Mike Routley. Mike Routley, EMS
Specialist |
|||||||
|
DOH Home | Access Washington | Privacy Notice | Disclaimer/Copyright Information Office
of Emergency Medical Services and Trauma System Last
Update :
10/23/2009 02:46 PM
|
