31 YEARS AGO IN IDPH HISTORY
Although they were the third largest killer in the country, serious unintentional injuries posed certain challenges for most U.S. hospitals. Recognizing this fact, Illinois launched the nations first statewide system to provide care for the victims of such injuries. The first of these special care centers for the critically injured was inaugurated at a special ceremony in Springfield on July 22, 1971.
The victim of an unintentional injury needs four kinds of assistance: first aid, fast transportation, effective communications and an emergency medical facility equipped to give proper treatment for particular injuries. To ensure that Illinois residents had access to such assistance, Drs. Bruce A. Flashner, deputy director of IDPH, and David R. Boyd, IDPH chief of the Division of Emergency Medical Services and Highway Safety, developed a trauma program aimed primarily at saving the lives of injured persons who would die without expert emergency services. A secondary, but equally important, goal was to significantly reduce the number of injury victims who suffered permanent disability due to improper or insufficient care during the critical phase.
The St. Johns Hospital Regional Trauma Center in Springfield was the first of nine regional centers in a network of hospitals with special services, equipment and personnel for the treatment of serious injuries and linked by special radio and transportation facilities. Similar centers at Loyola University Medical Center in Maywood, Chicagos Cook County Hospital and Doctors Memorial Hospital in Carbondale also became operational the same day as the Springfield facility. St. Francis Hospital in Peoria and Evanston Hospital joined the system soon after.
To get trauma victims to these centers, where advanced care was available around the clock, helicopter and local ambulance services coordinated to provide rapid transport.
A statewide plan was written and 50 ex-military corpsmen were hired as coordinators to manage trauma center programs and to develop emergency medical technician (EMT) programs at each location.
All centers in the state were linked by a trauma registry. This computerized system allowed information regarding the transportation and treatment of accident victims to be collected in a database.
In 1972, the Department received $4 million in federal funding to expand its pioneering state trauma program. In addition to the victims of unintentional injuries, the system expanded its scope to include other emergencies, such as cardiac events, burns, high-risk infants, psychiatric emergencies, and poison, alcohol and drug overdoses.
By July 1, 1973, the Illinois Trauma Program was entering its third year of operation and 46 trauma centers across Illinois had been designated. During the first two years of operation, more than 30,000 patients were treated in the states trauma centers, with an overall mortality rate of less than 2 percent.
Beginning in 1976, the federal government began reducing funds awarded to trauma centers and by 1980, federal funding was eliminated. The trauma center system deteriorated to the point that there was no oversight to assure centers were staffed and equipped to provide optimal care to critically injured patients.
Illinois Emergency Medical Services Act of 1980 was amended in 1986 to reestablish the trauma system in the state. The Department was given the authority to designate trauma centers and the legal authority to regulate them. The following year the legislature provided the Department further direction through the Illinois Trauma Center Code, which permitted any hospital that met Department trauma center standards to be so designated.
The Department received applications from 84 hospitals outside the city of Chicago and by March 1989 the state had designated 10 Level I trauma centers and 64 Level II trauma centers. Trauma centers in Chicago were designated by the city through its home rule authority.
A Level I trauma center offers the most sophisticated care and must be staffed 24 hours a day by an in-house general or trauma surgeon; specialty surgical services, such as neuorsurgery, reimplantation and opthalmologic, must be available within 30 minutes. Level II trauma centers are required to have a general or trauma surgeon available within 30 minutes and some surgical services available within 60 minutes; other surgical services must be available either within 60 minutes or the trauma center must have a transfer agreement with another hospital.
In the states fiscal year 1991, $5 million in general revenue funds were allocated to provide competitive grants to Level I trauma centers. In order for Chicago trauma centers to be eligible for the funds, the city relinquished its home rule authority to designate trauma centers and the citys six trauma centers applied for and received Level I designation. Grants were awarded to 17 Level I trauma centers (six in Chicago and 11 downstate) to help cover the cost of providing for poor, severely injured patients. The funds were allocated based on each trauma centers financial need, the volume of low-income patients and the severity of their injuries.
The following year the appropriation was cut from the budget and efforts were initiated to find a permanent funding source for the system. In 1993, legislation was passed establishing a Trauma Center Fund and assessing $5 for each traffic violation that carried a fine of $55 or more. A $30 surcharge on convictions or orders of supervision for driving under the influence of alcohol or drugs was added in 1994 and raised to $100 effective Jan. 1, 2002.
The Department annually awards half the money deposited in the fund to hospital trauma centers in the geographic regions where the traffic violations occurred. The amount each hospital receives from the regional share is based on the number of trauma patients to whom the hospital provides care.
The Illinois Department of Public Aid allocates the other half from the special fund to trauma centers based on the number of Medicaid trauma patients for whom the hospital cares.
To be eligible for the funds, a hospital must be designated a Level I or Level II trauma center by the Department of Public Health. Since 1993, the Department has distributed more than $28 million to trauma centers.
... Years Ago in Public Health
A Timeline of the Illinois Department of Public Health