AUSTIN — Keeping a funding source for trauma centers — in this case Christus St. Elizabeth — is a top priority for some Southeast Texans.

Dr. David Parkus knows full well the importance of having the trauma center in this area.

“We are the only hospital that has an OR (operating room) open 24 hours a day, full coverage for neurosurgeon, full coverage for trauma surgeon. We’re it. OK?

“There’s a misconception you can go to any hospital and get care. You can’t. Just St. Elizabeth’s,” Parkus told a crowd of more than 300 people during Golden Triangle Days in Austin recently. “We do about $15 million in uncompensated care a year and the Driver Responsibility Program gives us about $800,000. It’s very important to us just to get that.”

St. Elizabeth’s trauma center covers from Jasper and Woodville to Orange, to Crystal Beach over to Liberty in addition to getting some patients from Louisiana because they have no neurosurgeons there, he said.

They cover an area of about 1 million people and take care of about 1,500 traumas a year.

The Driver Responsibility Program is a statewide program that places surcharges on people with certain traffic offenses and is tied to the funding of trauma centers as well as funneling some money to the state’s general fund.

The need for the trauma center is documented — Parkus said the center saw 350 trauma patients last year and expects the number to go more than 400 this year. There are helicopters but they can’t always fly due to inclement weather.

The next closest trauma centers are Hermann Hospital in Houston, Ben Taub in Houston and University of Texas Medical Branch in Galveston.

Problems with the program

Carrie Kroll, vice president, advocacy, quality and public health with the Texas Hospital Association, asked the delegates at the session on healthcare to think of a wheel with spokes and you are trying to get patients from where they have the greatest injury to the highest level of care.

THA represents about 600 of the state’s hospitals and since 2015 the organization has been trying to find alternatives for funding trauma centers.

When the program was created by the Legislature in 2003 it was aimed at those breaking traffic laws the most.

“The problem we’ve seen since then is that there are a lot of people who can’t pay and they get caught up in the system. They have fines and fees and they’re stuck in the county jails, keeping the county courtroom clogged and it’s not helpful for the indigent citizens of our state to help offset the cost from our uncompensated care,” Kroll said.

Kroll said there would be a change to the program and legislation has and will be filed. Some, she said, straight up want to repeal the program and some straight up want to repeal and provide alternate funding.

“It will look at things such as if we get rid of the Driver Responsibility Program how do you level fines and fees for people who drive while intoxicated or while under the influence because in theory they are creating the most problems,” she said. “And while looking at increasing the state traffic fine, you take the responsibility to drive and break the law you are paying some money to ensure that if you have an accident there will be an ambulance there to save your life.”

She said there are other related issues that are being looked at but at the end of the day it all goes to what the legislators feel is reasonable for them to approve.

DRP is tied to the state general fund

The problem with the DRP and trying to fund it is that it funds 50 percent to hospitals and 50 goes to the general revenue fund, which is what legislators use to support the budget.

“So when you take the overall $300 million you just can’t fix the trauma side of it, you also have to fix the revenue side of it so there’s a larger conversation that goes into these discussions year after year,” she said. “We’ve been very successful not losing the program simply because we need the funding but we, as an association, feel like our time is running out. We know that partners of counties would like to see some alleviation from the program as well.”

Kroll is hoping the third time is the charm, as this is the third biennium for the topic. And, with this problem resolved,  it would allow the group to move on to the next big topic, which is trauma infrastructure as the state grows.

Texas State Rep. Dade Phelan, R-Beaumont, said Southeast Texas and the valley area of the state are the only two without Level II hospital funding. St. Elizabeth’s trauma center is a Level III but works as a Level II.

Level I trauma centers are comprehensive, Level II are major trauma facilities, Level III is an advanced trauma facility and Level IV is a basic trauma facility, according to Texas Health and Human Services.

Phelan said he would be filing a bill regarding the DRP.

“It’s going to be an ‘amend it not end it bill.’ There are some offensive aspects of the Driver Responsibility Program that many individuals and many members want removed and some of it is revoking driver’s licenses and debtors prison,” Phelan said. “We’re going to remove all that and we’re gong to sunset it that if you owe money before 2013 we’re going to wipe that out and truthfully this is more difficult than it sounds. But these agencies need to be speaking to each other.”

Persons on the Supplemental Nutrition Assistance Program or the Temporary Assistance for Needy Families program are exempt from the DRP and getting exempt is as easy as filling out a card and mailing it in, he said.

“There is a connection between the habitual DWI offenders and a connection between individuals who repeatedly speed 100, 120 mph. They should be paying for trauma; they’re the ones causing the problem,” he said.

He said the DRP would be rebranded when it is addressed.

“There is no reason you can’t have a driver’s license because you can’t pay a $50 fine,” he said. “That’s a revolving door. …

“It is a very strong source of funding for our emergency rooms. If we’re going to get rid of it I challenge the individual to come up with a funding source that makes sense.”

And while Phelan is for a positive change there needs to be balance.

“It’s hard for me to advocate for Level II trauma funding and not try to at least maintain some sort of Driver Responsibility Program,” he said.