NEWS ARTICLES

Hospital calls for trauma care tax

By Phil Galewitz

Palm Beach Post Staff Writer

Saturday, March 10, 2007

FORT PIERCE- — Lawnwood Regional Medical Center & Heart Institute said Friday it wants St. Lucie County homeowners to pay an average of $50 a year to support a trauma center it plans to open in October.

Palm Beach County property ownershave paid an extra tax for nearly two decades to have a trauma system, which experts say greatly improves the odds of surviving a car wreck or gunshot.

Without the extra $7 million in annual county funding, Lawnwood will reconsider its decision to open the first Treasure Coast trauma center. Martin and St. Lucie county residents now go to trauma centers in West Palm Beach or Melbourne for care.

"Every time we have to fly an injured person to Palm Beach or Melbourne, we lose precious minutes that can make a difference in saving a life or minimizing lifelong complications," St. Lucie County Sheriff Ken Mascara said. "The ability to transport within our county saves minutes, which saves lives."

The proposed St. Lucie trauma funding would be achieved through an extra 25 cents per $1,000 of assessed property value that property owners would pay each year.

A public referendum on creating a taxwill likely occur June 12. Later this month, county commissioners are expected to schedule the referendum.

"Through the creation of this trauma unit, the community will be able to ensure these services are available 24/7 to residents f the county," said Tom Pentz, Lawnwood's CEO.

Palm Beach County trauma officials say they would warmly welcome a Treasure Coast trauma center, largely because it would alleviate their burden of treating those out-of-county patients.

About a third of the trauma patients at St. Mary's Medical Center now come from the Treasure Coast — an issue that irks Palm Beach County health officials because neither Martin nor St. Lucie counties provide any financial support.

Palm Beach County taxpayers have been paying to have a trauma system at St. Mary's and Delray medical centers since 1990.

County homeowners now pay an average of about $360 a year to the Health Care District of Palm Beach County. In addition to operating a trauma system, the district owns Glades General Hospital in Belle Glade, runs a program that helps about 25,000 residents who lack health insurance and places a nurse in every public school in the county.

The districthas asked Martin and St. Lucie counties to financially support the Palm Beach County trauma system but has consistently been rebuffed.

The money collected for a St. Lucie system would be overseen by the existing St. Lucie County Fire Board, which is made up of elected officials from Fort Pierce, Port St. Lucie and the county commission.

Lawnwood said it needs county funding to help with start-up costs and to pay numerous medical specialists to be based at the hospital 24 hours a day. After three years, the hospital said it hopes it would need a lower subsidy.

About half of Florida's 23 trauma centers get local taxpayer support.

Because the state provides only limited funding to the trauma centers, the specialized emergency care can be a drain on hospitals, which see a number of patients without health insurance. However, the presence of a trauma center also can give a hospital added prestige and help in attracting physicians."There is a halo effect that we are counting on," Lawnwood spokeswoman Beth Williams said.

Lawnwood is one of five hospitals in Palm Beach County and the Treasure Coast owned by for-profit hospital giant HCA Inc. Lawnwood expects the trauma center to handle about 950 patients a year. By comparison, more than 3,000 patients are treated by the Palm Beach County trauma system.

"I am cautiously optimistic there will be support in the region for having a trauma center," said Doug Coward, a St. Lucie County commissioner. "Generally, people are willing to pay higher taxes if they can see where the investment is being made."

St. Lucie County Commission Chairman Chris Craft said he had no problem with a referendum.

"Let the people decide if they want trauma care and are willing to pay for it," Craft said.

He added: "It could be a tremendous benefit to the community to have it."

Letter to the editor: Hospital shouldn't receive money from taxpayers

March 15, 2007
A recent article was published for a new Lawnwood trauma center, asking St. Lucie County to fund the project using taxpayers' money. Perhaps a noble idea but bad, bad news for ailing taxpayers already overburdened by high property taxes and high insurance rates.

I recently sent an e-mail to the St. Lucie County commissioners about granting free funding and tax credits to businesses on the backs of taxpayers: It is not right to fund companies and pay for their company expenses (such as electricity) without getting it returned (as, for example, if a loan were granted). By giving handouts, they not only set precedent but provide a perfect blueprint for anybody who wants free stuff from our county.

Now the corporate welfare idea is taking off — with vigor.

With the slump in real estate sales, burgeoning and still unsolved property tax escalations and rampant insurance rate increases and cancellations, this is not the time to keep charging corporate welfare expenses to taxpayers. This is the time to start cutting — everywhere — and plan the budget wisely. Counting your chickens from the egg carton is a perfect recipe for doom.

FYI: HCA Inc., the parent company of Lawnwood Medical Center, fourth quarter 2006 results include gains on investments of $103 million, gains on sales of facilities of $159 million, with fourth quarter revenue of $6.5 billion. This company does not need money from the struggling taxpayers.

Nelly Spengler

Editorial: Trauma center raises issues

March 14, 2007

The Treasure Coast could have its own hospital trauma center by the fall.

That's if St. Lucie County voters agree in June to create a new tax district that the average homeowner would pay $50 to per year. The money would fund the center's specialty doctors and staff. Lawnwood Regional Medical Center and Heart Institute in Fort Pierce has received state approval to operate the center for St. Lucie, Martin and Okeechobee counties. The center likely would also be used by trauma patients in Indian River County, rather than Holmes Regional Medical Center in Melbourne.

Lawnwood is seeking County Commission approval for a June 12 referendum. The hospital wants the rapid vote so the trauma center can open by the end of September.

Whether voters will be able to make an informed choice prior to the vote is up in the air. While Lawnwood should be commended for initiating potential creation of the center, there are numerous questions and issues that must be addressed beforehand.

One of the biggest philosophical issues that must be addressed is whether taxpayers should channel $7 million a year into a for-profit hospital. Another is the tax issue.

With Treasure Coast residents — and residents across the state — fighting over high property taxes, are voters in the county really willing to increase their property taxes for a trauma center? Is this a county must-have priority?

On Lawnwood's side is that it has agreed to fund the cost of the referendum, estimated at $150,000.

Last year, the Hospital Corporation of America invested $12 million in Lawnwood to handle trauma cases. A medical director for the trauma center was recently hired.

While Lawnwood is a for-profit hospital, Beth Williams, director of public relations and marketing, noted the hospital is a major contributor to nonprofit groups in the county and last year wrote off $70 million in charity care.

The tax — 25 cents per $1,000 of taxable property value — would $4 million for specialty doctors, such as neurosurgeons, and $3 million for staff hiring and training.

The county's fire board, operating as a trauma board, would administer the funds.

Local taxpayers support about half the state's 23 trauma centers. Many of the trauma cases that originate on the Treasure Coast are taken to St. Mary's Medical Center in Palm Beach County. Even though about a third of the patients at St. Mary's are from the Treasure Coast, neither St. Lucie nor Martin County contributes to operation of the trauma center.

The trauma center at St. Mary's, which is owned by Tenet Healthcare, is funded by Palm Beach County taxpayers as part of $360 they annually pay to the Health Care District of Palm Beach County. But Palm Beach County is not the smaller Treasure Coast.

The Treasure Coast will need a trauma center; it might need it now. How to pay for it and who operates it are other key questions that must be answered. Perhaps one day Martin Memorial might be willing to pay the the load, at St. Lucie West, without new taxes.

Let the debate begin.

MARTIN'S TAKE

Martin Memorial Health Systems officials do not believe there are enough trauma patients on the Treasure Coast to justify a trauma center, according to Mark E. Robitaille, chief operating officer.

A higher priority for the area is building more emergency rooms in St. Lucie West and its growing population. The hospital will try again this week to get state approval for an 80-bed hospital there with a focus on emergency care and obstetrics.

This will be the seventh time Martin Memorial has attempted to build a hospital in St. Lucie, but Robitaille said he believes population growth and increased occupancy rates at area hospitals will demonstrate the need.

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St. Lucie County residents may pay for trauma center

By JAMES KIRLEY
jim.kirley@scripps.com
March 10, 2007

FORT PIERCE — Plans are being made for a June 12 referendum to ask St. Lucie County voters for a new property tax to raise up to $7 million per year to support the Treasure Coast's first trauma-care center at Lawnwood Regional Medical Center & Heart Institute.

Hal Roberts, president of Harbor Federal Savings Bank in Fort Pierce, is co-chairman the Citizens for Trauma Care group in support of the effort. Roberts said his interest in local trauma care increased about one year ago when his son Chris, then 21, was thrown from a Jeep and knocked unconscious in the rural west county.

The elder Roberts initially said no one could tell the family whether Chris Roberts was being flown to a trauma center in West Palm Beach, Melbourne or Orlando.

"Because we did not have a center here in St. Lucie County, we weren't sure where he was being taken," Roberts said, "and we literally had family members heading to Melbourne and Palm Beach at the same time."

Chris Roberts said he was fortunate his injuries proved not serious, and he was treated and released from St. Mary's Medical Center in West Palm Beach. But the idea of his family knowing he was hurt without knowing his whereabouts left him thinking.

"If somebody got into a serious-enough accident, you may not have a lot of time to see them," Chris Roberts said.

The tax would fund an annual $4 million cost of hiring enough specially trained surgeons for round-the-clock staffing of the trauma center, said Beth Williams, Lawnwood's director of marketing and public relations.

She said an initial cost of $3 million to add nurses and other staff could be reduced after the first three years of operation. The center would be within the current hospital.

Officials at Lawnwood, owned by HCA Inc. based in Nashville, Tenn., said they would pay the referendum's cost. County Supervisor of Elections Gertrude Walker estimated it would be about $150,000.

St. Lucie County commissioners first must approve the referendum.

Florida health-care regulators have approved Lawnwood's application for a trauma center, which the hospital hopes to open by October.

Getting advanced medical treatment within 60 minutes after being injured — the so-called Golden Hour — increases the chance for an accident victim's recovery. This was in mind when Florida lawmakers divided the state into 19 separate trauma service areas in 1989.

Today, many of the areas still are without trauma centers. They include District 19 — St. Lucie, Martin and Okeechobee counties — which sends most patients south to St. Mary's.

Indian River County now sends most of its trauma victims to Holmes Regional Medical Center in Melbourne. Some Indian River County patients presumably would go to Lawnwood, because state law says trauma victims are to be shipped to the nearest available center.

Heavily populated urban areas can better support trauma centers, said Rick Minton of Fort Pierce, a Democratic state representative until term limits forced him from office in 2000. During his last year in Tallahassee, Minton championed a law creating a trauma services trust fund to pool state money for subsidizing trauma care.

But little state money since has been put into the fund, and Minton points to large areas of Florida still without nearby trauma care.

"It's unconscionable that rural residents of Florida are second-class citizens when it comes to the availability of trauma care," Minton said. "Five-hundred-thousand seems to be the magic number and St. Lucie, Martin and Okeechobee counties aren't quite there yet."

Vernon Smith, chief executive officer of Riverside National Bank, is co-chairman of the committee with Roberts.

"There is an obvious void in this region for this important public service and our hope is that the community will support this effort," Smith said.

TAX PROPOSED FOR TRAUMA CARE

Officials at Lawnwood Regional Medical Center & Heart Institute will ask St. Lucie County commissioners to have a referendum June 12 that would ask county voter approval to add up to one-quarter mill of property tax to help Lawnwood pay for operating a trauma care center at the Fort Pierce hospital.

WHAT WOULD IT COST ME?

The owner of a home with an assessed value of $250,000 and a standard $25,000 homestead exemption would pay $56.25 if taxed one-quarter mill.

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Lawnwood seeks county funds for trauma center

Friday, March 09, 2007

FORT PIERCE — Lawnwood Regional Medical Center & Heart Institute today said it wants St. Lucie County homeowners to pay an average of $50 a year to support a trauma center that it plans to open in October.

Without the $7 million in annual county funding, the hospital will reconsider its plan to open the trauma center, said hospital spokeswoman Beth Williams. If it opens, the Fort Pierce trauma unit would save residents from delays in going to existing trauma centers in West Palm Beach and Melbourne.

The new county funding would be achieved through an extra quarter mill tax that homeowners would pay each year.

The public referendum likely will be set for June 12. St. Lucie County commissioners are expected to approve the referendum when they meet later this month.

Palm Beach County trauma officials would warmly welcome a Treasure Coast trauma center largely because they receive no funding to care for patients who come from outside the county. About one third of the trauma patients at St. Mary's Medical Center now come from the Treasure Coast.

Palm Beach County taxpayers have been paying for a trauma system at St. Mary's and Delray medical centers since 1989.

The money collected for a St. Lucie system would be overseen by the existing St. Lucie County Fire Board, which is made up of elected officials from Fort Pierce, Port St. Lucie and the county commission.

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Trauma center would 'help everybody' around St. Lucie

By JAMES KIRLEY
jim.kirley@scripps.com
March 3, 2007

FORT PIERCE — The Treasure Coast could be on the verge of getting its first center to specialize in treating victims of highway crashes, gunshot wounds and other traumatic injuries.

Officials at Lawnwood Regional Medical Center & Heart Institute have approached individual St. Lucie County commissioners about tax support — perhaps a half-cent — for a trauma center at the Fort Pierce hospital.

A referendum for county voters could be on the ballot as soon as this summer; if passed, the center could open as soon as October, county and hospital officials said.

Commissioners Doug Coward and Joe Smith said Lawnwood executives have talked to them about a proposed trauma center.

"I think they were interested in a referendum by the summer," Coward said. "It hasn't been officially presented to the County Commission."

Coward said he would want a referendum on the ballot of the next scheduled election to ensure good turnout. Fort Pierce has an election in November. The county would have to pay for a special election.

Smith said he recalled talk about proposing a half-cent tax, but neither commissioner was certain about the particulars of what was being proposed. St. Lucie County currently has a 6 1/2-cent tax.

"I do support a tax-supported trauma center in the county because it helps everybody," Smith said. "I feel it's a health and safety issue."

Hospital officials confirmed they've been talking with community leaders about trauma care.

"We've had some talks," said Beth Williams, Lawnwood's director of marketing and public relations.

Smith noted people seriously injured now in St. Lucie County must be transported by helicopter or ambulance about 60 miles north or south to trauma centers in Melbourne or West Palm Beach.

Coward said Williams, as well as Lawnwood's chief executive officer, Tom Pentz, told him a hospital survey showed support for a local trauma center.

"Their survey included several different funding options," Coward said.

Lawnwood already has hired a medical director for trauma services — a U.S. Army colonel fresh from the battlefields of Iraq, where he was responsible for six combat support hospitals and the battalions that evacuated the wounded by ground and air. Dr. Danny Jazarevic arrived in January, five months after Lawnwood opened the doors on a $12 million renovation of its emergency room that included a specially designed trauma treatment room.

Jazarevic said Lawnwood still needs to recruit another four trauma surgeons, two neurosurgeons, more critical care nurses and technicians to meet state requirements for opening the trauma center.

Martin, St. Lucie and Okeechobee counties now transport their most seriously injured patients to St. Mary's Medical Center in West Palm Beach, with a few in northern St. Lucie County being flown to Holmes Regional Medical Center in Melbourne, where Indian River County sends its trauma patients.

Lawnwood is owned by Nashville-based HCA Inc.

St. Lucie County voters last faced a referendum in November 2006, when they defeated a request to pay for research and education pursuits in the county. Although it would have created a property transfer fee and not a sales tax, many residents voted against the fee because they said they felt it amounted to another tax, which they were against.

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Trauma flights on the rise in St. Lucie County

The two regional trauma centers are working to cope with more cases from the Treasure Coast.

By Derek Simmonsen staff writer
October 19, 2003

ST. LUCIE COUNTY — In just two hours, four people found themselves fighting for their lives.

A pickup truck hit a light pole on U.S. 1 and Orange Avenue; a motorcycle wrecked near 13th Street and Boston Avenue; a vehicle crashed on Orange Avenue and 33rd Street, and a man was stabbed at a restaurant.

The night of Sept. 26, three helicopters flew four injured people to regional trauma centers. It was the busiest night in a week that saw 14 people airlifted with a host of serious ailments.

"Our numbers are steadily increasing," said Battalion Chief Carlos Duran, a St. Lucie County Fire District spokesman. "We're anticipating (flying) about 200 people this year."

The rising number of trauma patients in St. Lucie County has not gone without notice at the region's two trauma centers — Holmes Regional Medical Center in Melbourne and St. Mary's Medical Center in West Palm Beach. They, too, are working to accommodate the growing number of local residents who need advanced care.

Most of the time, it begins with an accident.

Calling in the chopper

The term "trauma" describes injuries from blunt force (such as car accidents), penetration (such as gunshot or stab wounds) and burns, said Tracy Mahank, director of trauma and critical care for St. Mary's Medical Center.

When paramedics respond to a call, they run down a long "scorecard" to determine whether a patient warrants a trauma alert.

They check the airway and circulation, evaluate motor skills, look for burns or amputations and determine whether any major bones have been broken.

"(Paramedics) do a very good job of getting the patients to us in a hurry," Mahank said. "They're a very important part of the trauma system and they deserve a great deal of credit."

St. Lucie County's Air Rescue 1 helicopter makes most of the flights. When the local helicopter is not available, helicopters from Martin or Brevard counties fill in.

St. Lucie County patients do not have to pay to travel on Air 1. However, they will be charged if they are picked up by Martin County's LifeStar or Holmes LifeFlight.

"The patient is directly responsible for the cost," Duran said. "The fire district does not incur any cost and neither does the sheriff's office."

Insurance will often pay the cost of the ride, but if the patient is indigent, the costs are absorbed by Holmes and CJ Aviations, respectively. CJ Aviations manages LifeStar as a public-private partnership with Martin County.

Which helicopter makes a pick-up on a busy night can be a matter of chance.

The 'golden hour'

The new $2.6 million Air Rescue 1 has had plenty of flight time since it came into service in April.

"In large part, it has a lot to do with population growth and traffic," Chief Deputy Garry Wilson said. "These are factors that we're experiencing all throughout the Treasure Coast."

The average cost to fly the helicopter is about $250 an hour, and the average flight is under two hours, Wilson said. Sheriff's office pilots work 24-hour shifts and fly medical and law enforcement missions, he said.

At least one, if not two, paramedics accompany the patient on the average 20- to 25-minute flight, Duran said.

By the time patients reach a facility such as St. Mary's, there is already a team of nurses, doctors and technicians waiting. Equipment is reserved for severe emergencies and an operating room is always open.

"They don't wait to find out if a patient needs to come to surgery," Mahank said. "When the decision comes, they are ready to go."

When talking about trauma, one phrase often comes up: the golden hour.

"The golden hour starts at the time you're injured," Mahank said. "Trauma is a disease of bleeding. ... The faster you can stop the bleeding, the more likely you are to survive that injury and not develop complications. Sometimes, 10 minutes is life and death for patients."

St. Mary's and Holmes have seen the number of patients from St. Lucie County and the rest of the Treasure Coast increase steadily during the past few years. St. Mary's is awaiting final approval to add a second helicopter pad to handle more than 700 helicopter landings a year.

"The busier you get, the resources are tapped more quickly, more often," said Don Chester, an associate administrator for St. Mary's. "We are now starting to see a volume of patients from other counties where we would start looking for support from those counties."

Holmes LifeFlight bills patients for the flight, often through insurance, but eats the cost of indigent care, said Chris McGahee, a hospital spokesman. In 2001, the trauma center performed about $3 million in charity care.

St. Lucie officials have talked with St. Mary's officials about sharing costs, but the idea is not very popular, County Administrator Doug Anderson said. Another possibility is creating a trauma center on the Treasure Coast, but the cost is a major deterrent.

"There probably would have to be some kind of health-care district," Anderson said.

"I think in the future there is going to be a need for a trauma center in this region," said Beth Tuttle, a spokeswoman for Lawnwood Regional Medical Center & Heart Institute in Fort Pierce.

The high initial expense and ongoing expenses associated with a trauma center would mean that the hospital would need public funds to pay for the increased costs, she said.

- derek.simmonsen@scripps.com

By the numbers

•St. Lucie County expects to fly 200 patients to trauma centers in 2003.

•St. Mary's Medical Center in West Palm Beach treats about 1,600 trauma patients a year.

•Holmes Regional Medical Center in Melbourne expects to treat 1,300 this year.

•Unintentional injuries were the No. 1 cause of death for Floridians ages 1 to 44 in 2000.

Trauma breakdown at St. Mary's:

•80 percent blunt trauma (falls, car accidents)

•19 percent penetration (stabbings, gunshots)

•1 percent burns
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