Draft offers insight into proposed trauma center approval process

trauma drama
Members of the Southern Nevada Health District’s Regional Trauma Advisory Board meet on Wednesday, Oct. 16, 2019. (Photo by Pashtana Usufzy)
trauma drama
Members of the Southern Nevada Health District’s Regional Trauma Advisory Board meet on Wednesday, Oct. 16, 2019. (Photo by Pashtana Usufzy)

Draft guidelines released this month by the state’s public health department would authorize a new, lower-level form of trauma center and establish guidelines for the state to approve trauma center proposals.

The guidelines, developed by the Division of Public and Behavioral Health and dated Oct. 1, are the result of the June passage of AB317. That law shifted initial approval of trauma center proposals to the state from district boards of health.

State Assemblywoman Maggie Carlton, D-14th District, previously said the law was intended to “take local politics out of trauma designation.” In the past, the  Southern Nevada Health District’s Board of Health received recommendations from its Regional Trauma Advisory Board (RTAB) on whether or not to approve the addition of trauma centers in Clark County.

Joseph Iser, outgoing chief health officer of the Southern Nevada Health District, previously told the Current that the decision to shift trauma center approval to the state was “poorly informed and probably doesn’t help to protect our patients and our visitors.”

The new guidelines clarify the process the state will follow when approving new trauma centers. 

Those steps would include a biennial assessment of trauma care, a scoring mechanism to assess shortages of care and publication of a request for applications 

The guidelines would also authorize creation of level IV trauma centers and exempt hospitals on federal land from the traditional application process.

Instead, hospitals on federal land will be allowed to apply at any time for designation. The state will review to ensure they are in areas with demonstrated need.

Mike O’Callaghan Military Medical Center, the hospital at Nellis Air Force Base, was one of five applicants that attempted to establish a level III center in 2018.

Despite the power shift, RTAB was still working Wednesday at their monthly meeting to finalize a recommendation that argues “there is no urgency to add additional new level III trauma centers” in Southern Nevada at this time and that any future additions should be made one at a time.

“The current data suggest the future projected trauma center needs are located peripherally of the populated portions of the Las Vegas Valley,” according to the draft of the report, which cites the northeast, southwest and northwest as areas in which trauma centers may be needed in the future.

Though several local hospitals have attempted to establish themselves as level III trauma centers for years, the debate over whether or not the Valley needs more trauma centers was reignited in the wake of the mass shooting on the Las Vegas Strip on Oct 1., 2017. Some of the controversy surrounding the issue of trauma center approval involves the thousands of dollars of so-called “activation fees” that the facilities can charge. Those funds and sparring over availability of patients for the existing trauma centers have turned the debate into a wide-ranging one that has drawn in, over the years, the Las Vegas City Council, the hotel industry, the Culinary Union and others.

In 2016, RTAB recommended against accepting three applications for new level III centers, and five applications submitted in late 2018 were put on the back-burner while RTAB tried to create its own method for assessing applications. Despite the new role of the state in trauma center approval, the health district has no plans to eliminate RTAB, health district spokeswoman Jennifer Sizemore said.

Sizemore also confirmed the district staff did not participate in drafting the new state guidelines, but said their staff plans to attend workshops to provide input.

The state is seeking feedback on the guidelines by Oct. 31.

Currently, there are three trauma centers in Southern Nevada. UMC is the only level I trauma center in the region, the highest level.

Sunrise Hospital and Medical Center is the only level II and St. Rose Dominican – Siena Campus is the only level III.

UMC spokeswoman and RTAB media representative Danita Cohen said UMC will “support any regulations that include thoughtful planning for our community.”

Pashtana Usufzy
Pashtana Usufzy is a freelance general features and health reporter based in Las Vegas. She previously worked as a health care reporter at the Las Vegas Review-Journal and prior to that as a local news reporter at the Las Vegas Sun.

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