GTCNC Feb 2011 Agenda-draftgeorgiatraumacommission.org/minutes-files/3... · Jim Pettyjohn -...

Meeting Agenda

Thursday, 17 February 2011

10:00 am until 1:00 pm Atlanta Medical Center

Health Pavilion-Letton Auditorium 320 Parkway Drive NE-Atlanta, GA 30312

Call to order and Chairman’s Report Dr. Dennis Ashley November 2010 and January 2011 Workshop minutes approval Jim Pettyjohn Administrative Report Jim Pettyjohn

Update FY2011 budget Reports: EMS Subcommittee of Trauma Ben Hinson Performance Based Payment Program Kelli Vaughn

Trauma Communications Center Scott Sherrill

Law Report Alex Sponseller *Trauma Quality Improvement Program (TQIP) Dr. Avery Nathens

American College of Surgeons

DCH Division of Emergency Preparedness and Response Dr. Pat O’Neal Renee Morgan

Old Business Dr. Dennis Ashley New Business Dr. Dennis Ashley Region IX Regionalization Activities Elaine Frantz

Memorial Health University Hospital

Next meeting and adjourn Dr. Dennis Ashley *Due to Dr. Nathens travel arrangements he is scheduled for 11:30 am. We will accommodate him at that time.

Jim Pettyjohn - [email protected] - 706.398.0842

ADMINISTRATIVE REPORT

February 2011

Today’s Presentation: American College of Surgeons Trauma Quality Improvement Program (TQIP) Dr. Avery Nathens and Melanie Neal (TQIP one-pager and Presenter’s Bio Attached) FY 2011 HB 160 Revenue Collections (31 January Revenue numbers attached) HB 160 Revenue Generation Specifics

Part 1: “Increased license reinstatement fees and other fines”

• Effective 01 July 2009 • Driver’s license reinstatement fees moved from flat $210 fee to tiered fees based on

number of offenses (1st=$210, 2nd=$310, 3rd=$410) • Miscellaneous other fines increased • Original revenue estimate ~$17.5M annually

Part 2: “The Super Speeder ticket”

• Effective 01January 2010 • “In addition to any other fines or penalties imposed by any local jurisdiction or the

department, the department shall administer and collect a fee of $200.00 from any driver who is convicted of driving at a speed of 85 miles per hour or more on any road or highway or 75 miles per hour or more on any two-lane road or highway, as defined in Code Section 40-6-187. Such a driver, upon conviction, shall be classified as a 'super speeder.'” “ … All fees collected under the provisions of this Code section shall be deposited in the general fund of this state with the intent that these moneys be used to fund a trauma care system in Georgia and the direct and indirect costs associated with the administration of this Code section.”

• Original revenue estimate ~$5.5M annually Collaborative Systems Inquiry Andrew Young School of Health Policy 08 – 09 March 2011 Introduction to Systems Thinking: Implications for Injury Prevention, Trauma Care and System Development in Georgia (Documents Attached)

Jim Pettyjohn - [email protected] - 706.398.0842

Request from Dr. Gage Ochner. Presented by Elaine Frantz (Letter Attached) FY 2011 Amended Draft Budget for Consideration (Documents Attached) EMS Subcommittee on Trauma: 02 November DRAFT minutes (Document Attached)

2/14/11 3:16 PMAmerican College of Surgeons: Trauma Programs: NTDB: TQIP

Page 1 of 2http://www.facs.org/trauma/ntdb/tqip.html

> Trauma Programs Home > NTDB > TQIP

Trauma Quality Improvement Program (TQIP)The fundamental goal of TQIP is to provide risk-adjusted benchmarking of designated/verified traumacenters to track outcomes and improve patient care. To accomplish this, the American College ofSurgeons Committee on Trauma (ACS COT) utilizes the infrastructure of the National Trauma DataBank (NTDB) to collect valid and reliable data, provide feedback to participating trauma centers, andidentify institutional characteristics that are associated with improved outcomes.

TQIP supports the College’s mission of promoting the highest standards of surgical care through theevaluation of surgical outcomes in clinical practice, and promises to improve the quality of traumasurgical care. The objective of TQIP is to build upon this existing infrastructure through enhancementsin the following areas: data collection, benchmarking, and identifying structures and processes of care.

TQIP now has 65 participating trauma centers. Sign up now for 2011!

Register for the TQIP Annual Meeting and Training. Plan to attend if you are a currentparticipant or if you hope to join for 2011. If you are not a TQIP 2010 participant, please email us [email protected] for specific directions on how to register.

View 2010 TQIP Telephone/Web Conference Presentations:

Trauma Medical Director (895K PDF)Registrar/Data Abstractor/Trauma Program Manager (795K PDF)

Contact TQIPAmerican College of Surgeons Trauma Quality Improvement Program633 N. St. Clair 26th FloorChicago, IL 60611 [email protected]

Melanie Neal, NTDB ManagerE-Mail: [email protected]: 312-202-5536

Chris Hoeft, TQIP CoordinatorE-mail: [email protected]: 312-202-5538

http://www.facs.org/trauma/index.html

http://www.facs.org/trauma/ntdb/index.html

http://www.facs.org/trauma/ntdb/tqip-gs.html

https://www.webregpro.com/coral/register.do?formId=NF19FA47S4SE

mailto:[email protected]

http://www.facs.org/trauma/ntdb/pdf/tqipwebtmd0610.pdf

http://www.facs.org/trauma/ntdb/pdf/tqipwebregistrars0610.pdf




2/14/11 3:16 PMAmerican College of Surgeons: Trauma Programs: NTDB: TQIP

Page 2 of 2http://www.facs.org/trauma/ntdb/tqip.html

NTDB

Trauma Programs

Revised September 1, 2010

This page and all contents are Copyright © 2008-2010 by the American College of Surgeons, Chicago, IL 60611-3211

http://www.facs.org/trauma/ntdb/index.html

http://www.facs.org/trauma/index.html

Avery Nathens, MD, PhD, FACS Dr. Nathens is currently the Division Head in General Surgery and Director of Trauma at St. Michael's Hospital, in Toronto, Canada and a Professor of Surgery at the University of Toronto. He is a practicing trauma surgeon and epidemiologist with a focus on trauma system design. He is an active member of the Provincial Trauma Network, and the National Trauma Registry Advisory Committee and holds a Canada Research Chair in Systems of Trauma Care. Internationally, he chairs the National Trauma Databank Sub-Committee and directs the Trauma Quality Improvement Program for ACS. Melanie Neal, MS Melanie Neal is the NTDB/TQIP Manager at ACS. Melanie has been with the College for eight years, where she manages the day to day operations of NTDB and TQIP. She also represents these programs at various national meetings, and supports the work of NTDB and TQIP committees.

H://HB 160/Super Speeder Notices and Collections Jan 31.xls

SUPER SPEEDER - $200 FINE

Second Notice - FYInitial Notice Suspension Amount Collection($200 Fine) ($50 Fine) Receivable Total Revenue Collected Outstanding Rate

FY 2010January 2010 142 0 28,400$ 200$ 28,200$ February 2010 1,084 0 216,800 15,200 201,600 March 2,546 0 509,200 73,012 436,188 April 2010 3,659 0 731,800 97,368 634,432 May 2010 4,746 57 952,050 226,095 725,955 June 2010 4,927 505 1,010,650 293,195 717,455

FY 2010 Total 17,104 562 3,448,900$ 705,070$ 2,743,830$ 20.4%

FY 2011July 2010 6,166 927 1,279,550 482,600 796,950 August 2010 5,863 1,536 1,249,400 637,600 611,800 September 2010 6,669 2,157 1,441,650 695,450 746,200 October 2010 5,760 1,980 1,251,000 794,890 456,110 November 2010 5,107 2,471 1,144,950 696,250 448,700 December 2010 4,301 2,688 994,600 787,700 206,900 January 2011 4,498 2,958 1,047,500 847,285 200,215 February 2011 - - March 2011 - - April 2011 - - May 2011 - - June 2011 - -

FY 2011 Total 38,364 14,717 8,408,650$ 4,941,775$ 3,466,875$ 58.8%

OVERALL TOTALS 55,468 15,279 11,857,550 5,646,845 6,210,705 47.6%

HB 160, PART I - REINSTATEMENT FEESFY

Combined No. Amount CollectionNotices Receivable Total Revenue Collected Outstanding Rate

FY 2010July 2010 21,743 -$ -$ August 2010 15,489 - - September 2010 14,435 - - October 2010 12,585 - - November 2010 11,538 - - December 2010 16,697 - - January 2011 16,152 - - February 2011 13,481 - - March 2011 17,882 - - April 2011 14,764 - - May 2011 15,558 - - June 2011 16,846 - -

FY 2010 Total - 187,170 15,988,315$ 1,331,835$ 14,656,480$ 8.3%Average 15,598

FY 2011July 2010 17,940 1,604,035 292,125 1,311,910 August 2010 22,614 1,951,045 253,505 1,697,540 September 2010 16,314 1,535,960 274,585 1,261,375 October 2010 19,805 1,725,135 354,194 1,370,941 November 2010 17,032 1,573,985 208,000 1,365,985 December 2010 17,270 1,525,570 291,530 1,234,040 January 2011 12,649 1,196,620 306,805 889,815 February 2011 - - - March 2011 - - - April 2011 - - - May 2011 - - - June 2011 - - -

FY 2011 Total - 123,624 11,112,350$ 1,980,744$ 9,131,606$ 17.8%

OVERALL TOTALS 310,794 27,100,665 3,312,579 23,788,086 12.2%

Department of Driver ServicesHB 160 Notice and Revenue Tracking

Month and Year

Month and Year

February 4, 2011 RE: Collaborative Systems Inquiry

Introduction to Systems Thinking: Implications for Injury Prevention, Trauma Care and System Development in Georgia March 8-9, 2011

Greetings, As a recognized leader in Georgia’s trauma care system or a supportive agency, you are invited to participate in an exciting project sponsored by the Georgia Health Policy Center. I am sure you’ve thought about the following: How do we deal with the complex system that impacts health in our society? Russell Ackoff, a renowned organizational theorist, said, “English does not contain a suitable word for a ‘system of problems.’ Therefore I have had to coin one. I choose to call such a system a ‘mess.’ The solution to a mess can seldom be obtained by independently solving each of the problems of which it is composed.” It could also be argued that sometimes the policies we implement to address difficult health care challenges have not only failed to solve our problems but may in fact be making them worse! The health-related challenges in our state – the debilitating impact of injury on the individual and the cost of providing specialty care being great examples – must no longer be viewed independently but rather as part of a much larger and effective trauma system. Trauma is the disease of injury! The Georgia Health Policy Center is interested in examining the issues of injury prevention from a systems thinking/systems mapping approach. We are inviting a diverse group of injury prevention and trauma system stakeholders to meet on a bi-monthly basis over a six month period to learn about systems thinking, explore implications of various system theories, build more comprehensive understanding of how injury prevention is a key component of trauma systems, and identify leverage points for changing performance (see attached timeline). We’d like to develop a community-learning tool that communicates the importance of injury prevention to reduce traumatic injuries and their associated costs.

GEORGIA HEALTH POLICY CENTER 404-413-0314 TEL 14 Marietta Street NW 404-413-0316 FAX Second Floor Atlanta, Georgia 30303 www.andrewyoungschool.org www.gsu.edu/ghpc Mail: Georgia Health Policy Center P.O. Box 3992 Atlanta, Georgia 30302-3992

February 4, 2011 Re: Collaborative Systems Inquiry Page 2 Please consider joining us for a 1.5-day session designed to stimulate your understanding of systems thinking and system dynamics principles as well as introduce you to our project.

WHAT: Introduction to Systems Thinking: Implications for Trauma Care in

Georgia WHEN: March 8th (9:30 a.m. – 4:00 p.m.) and

March 9th (9:30 a.m. – 12:30 p.m.)

WHERE: Andrew Young School of Policy Studies 14 Marietta Street, 7th Floor Atlanta, GA 30303

The entire process has the support of the Georgia Trauma Care Network Commission and will be facilitated by Chris Soderquist, a consultant with Pontifex Consulting, and Rachel Ferencik, a Research Associate with the Georgia Health Policy Center. Chris has used his facilitation and system dynamic modeling skills with Fortune 500 companies, government and nonprofit organizations. Rachel has worked on several system dynamics modeling projects in Georgia, including models on childhood obesity and low birth weight for policymakers in Georgia. Please RSVP and direct any questions to Rachel Ferencik at [email protected]. I look forward to your participation. Sincerely,

Karen J. Minyard, Ph.D. Executive Director Georgia Health Policy Center

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System Dynamics Model on Injury Prevention Context The Georgia Health Policy Center proposes an intensive process for working with a small group of experts to understand effective strategies to improve the trauma system in Georgia and reduce mortality and morbidity associated with the high prevalence of preventable injuries in Georgia. Purpose Develop an experiential learning tool to understand and communicate the systemic issues behind injuries in Georgia in order to determine and promote effective prevention strategies for dramatic reduction and health care costs savings. Process The proposed development process typically occurs over a six-‐month timeframe. Below are details about the major activities during the process Introductory session (1.5 days) – Stakeholders (e.g. from target audience, GHPC, additional content experts) will learn the basics of systems thinking, determine overall project scope, and develop the initial map elements. Additionally, participants will volunteer for project roles – some may wish to participate on the modeling team. Additionally, attendees will determine data needs/availability. Develop map(1 month) –The modeling team will develop the map from the initial map elements. Create model(2 months) –The modeling team will convert the systems map into a simulatable model. Review session 1(1 day)– Participants from the introductory session will review the first model and suggest modifications. Revise(1 month) – The modeling team will implement suggested modifications, including development of an interface for experiencing the learning tool. Final review(1 day)– Stakeholders will have a final opportunity to experience the tool, and suggest next steps for disseminating. Payoff The state of Georgia will have a tool to improve public and legislative understanding about injury prevention and its role in trauma system development, trauma care-‐related costs savings and increase support for systemic programs and policies.

Process Overview • Introductory session • Develop map • Create model • Review session 1 • Revise • Final review

Target Audience • Legislators • Advocacy groups • Service providers

10 State of Georgia’s Budget Report Amended FY 2011

Georgia Revenues: FY 2008 - FY 2010 and Estimated FY 2011

Georgia Revenues: FY 2008 - FY 2010 and Estimated FY 2011 FY 2008Reported

FY 2009Reported

FY 2010Reported

FY 2011Estimated

1. General FundsTaxes: Revenue

Income Tax - Individual $8,829,480,885 $7,814,552,113 $7,016,412,171 $7,432,660,900Income Tax - Corporate 941,966,726 694,718,310 684,700,740 610,853,200Sales and Use Tax-General 5,796,653,340 5,306,490,689 4,864,691,463 5,048,784,031Motor Fuel 994,790,336 884,091,188 854,359,788 848,073,095Tobacco Taxes 239,691,526 230,271,910 227,180,405 219,325,000Alcoholic Beverages Tax 167,397,928 169,668,539 169,019,330 165,787,000Estate Tax 12,325 82,990Property Tax 80,257,696 83,106,994 86,228,331 80,599,400

Taxes: OtherInsurance Premium Tax 348,218,618 314,338,992 274,367,273 347,813,800Motor Vehicle License Tax 296,648,374 283,405,915 282,515,540 310,031,226Total Taxes $17,695,117,754 $15,780,727,640 $14,459,475,041 $15,063,927,652

Interest, Fees and Sales - Dept. of Revenue $150,848,634 $158,916,288 $132,282,145 $274,710,548Interest, Fees and Sales - Treasury

Interest on Motor Fuel Deposits 33,995,473 31,141,764 4,614,422 4,614,422Interest on all Other Deposits 112,819,585 58,016,196 3,543,319 500,000

Regulatory Fees and SalesBanking and Finance 21,485,712 20,728,179 21,428,925 19,230,505Behavioral Health 5,856,093 5,562,555Corrections 16,445,194 15,689,864 13,435,899 16,470,963Human Services 16,587,606 33,609,407 8,955,806 7,612,435Labor Department 32,318,507 30,332,589 28,354,875 29,000,000Natural Resources 51,865,765 47,001,999 49,221,174 47,000,000Public Service Commission 1,051,726 3,031,268 1,499,311 2,200,000Secretary of State 66,970,993 66,794,531 68,244,049 77,089,000Workers' Compensation 17,347,383 18,904,664 18,930,132 19,439,379All Other Departments 99,105,798 101,418,501 117,466,338 158,407,200Sub-Total $323,178,684 $337,511,002 $333,392,602 $382,012,037Driver Services $64,907,591 $64,176,624 $40,600,978 $64,000,000Driver Services Super Speeder Fine 2,046,905 10,543,460Nursing Home Provider Fees 133,973,809 122,623,032 126,449,238 131,321,939Care Management Organization Fees 140,307,653 143,957,013 42,232,458GEFA Monetization 287,900,000Hospital Provider Payment 215,766,054Indigent Defense Fees 45,373,866 43,987,641 44,598,499 44,598,499Peace Officers' and Prosecutors' Training Funds 27,289,574 25,604,604 26,555,179 27,360,606

Total Regulatory Fees and Sales $1,032,694,869 $985,934,164 $756,315,745 $1,443,327,5652. Total General Funds $18,727,812,623 $16,766,661,804 $15,215,790,786 $16,507,255,2173. Lottery Funds $901,286,984 $884,642,058 $886,375,726 $1,158,703,9154. Tobacco Settlement Funds 164,459,961 177,370,078 146,673,654 146,798,8295. Brain and Spinal Injury Trust Fund 1,968,993 1,968,993 2,066,389 1,960,8486. Other

Federal Revenues Collected 2,437 2,808 4,237Guaranteed Revenue Debt Interest 3,603,320 1,719,873 333,632Payments from Georgia Ports Authority 30,576,376Payments from Georgia Technology Authority 49,097,515Payments from State Personnel Administration 2,481,222Payments from Georgia Buidling Authority 2,629,856Payments from Workers' Compensation 1,047,328

7. Supplemental Fund SourcesMid-year Adjustment Reserve 152,157,908

TOTAL REVENUES AVAILABLE $19,799,134,318 $17,832,365,614 $16,251,244,424 $18,052,709,014

* Fiscal Year 2010 reported collections reflect actual cash receipts collected by the Office of the Treasury and Fiscal Services and reported by the StateAccounting Office for the fiscal year ending June 30, 2010. However, motor fuel collections as reported by the Department of Revenue are the basisfor determining the mid-year appropriation of Motor Fuel Funds. For Fiscal Year 2010, this amount is $852,687,517 (see Article III, Section IX,Paragraph VI of the Constitution of Georgia and OCGA 50-17-23 (b)(3)).


Summary of Appropriations: By Policy AreaGovernor's Recommendation for Amended FY 2011

Summary of Appropriations: By Policy Area

Departments/State AgenciesOther State Funds and Attached Agencies

FY 2011Current Budget Changes

AmendedFY 2011

Recommendation

Educated GeorgiaEarly Care and Learning, Bright from the Start: Department of $1,276,823 ($133,765) $1,143,058

Lottery Funds 355,016,656 (597) 355,016,059Education, Department of 6,989,931,274 135,976,826 7,125,908,100Regents, Board of 1,895,507,509 (109,676,948) 1,785,830,561

Tobacco Settlement Funds 11,104,093 (1,405,690) 9,698,403Military College, Payments to Georgia 2,424,555 (129,616) 2,294,939Public Telecommunications Commission, Payments to Georgia 14,125,833 (663,203) 13,462,630

Student Finance Commission, Georgia 32,068,827 (2,674,130) 29,394,697Lottery Funds 772,635,605 31,052,251 803,687,856Non-Public Postsecondary Education Commission 688,007 4,815 692,822

Teachers' Retirement System 965,000 (115,000) 850,000Technical College System of Georgia 319,910,401 (12,639,587) 307,270,814Total $10,395,654,583 $39,595,356 $10,435,249,939

Healthy GeorgiaBehavior Health and Developmental Disabilities, Department of $753,607,824 $24,503,992 $778,111,816

Tobacco Settlement Funds 10,255,138 10,255,138Sexual Offender Review Board 767,059 767,059Developmental Disabilities, Council on 50,607 (4,049) 46,558

Community Health, Department of 1,531,562,236 173,923,720 1,705,485,956Tobacco Settlement Funds 112,361,397 (11,663,968) 100,697,429Nursing Home Provider Fees 131,321,939 131,321,939Hospital Provider Payment 229,007,409 (13,241,355) 215,766,054Brain and Spinal Injury Trust Fund 1,960,848 1,960,848Composite Medical Board, Georgia 1,907,596 (40,006) 1,867,590Physician Workforce, Georgia Board for 41,872,534 (1,593,874) 40,278,660State Medical Education Board 1,134,706 (34,711) 1,099,995Trauma Care Network Commission 22,241,000 (11,697,540) 10,543,460

Human Services, Department of 467,682,810 (13,411,424) 454,271,386Tobacco Settlement Funds 6,191,806 6,191,806Aging, Council on 186,578 (9,190) 177,388Family Connection 8,078,681 (323,147) 7,755,534

Veterans Service, Department of 21,182,680 (221,452) 20,961,228Total $3,341,372,848 $146,186,996 $3,487,559,844

Safe GeorgiaCorrections, Department of $971,895,293 ($7,855,477) $964,039,816Defense, Department of 8,660,548 (329,250) 8,331,298Investigation, Georgia Bureau of 60,041,065 (5,486,411) 54,554,654

Criminal Justice Coordinating Council 370,356 (27,807) 342,549Juvenile Justice, Department of 266,457,146 (10,498,237) 255,958,909Pardon and Paroles, State Board of 50,847,673 301,124 51,148,797Public Safety, Department of 87,527,711 (4,038,773) 83,488,938

Firefighters Standards and Training Council 662,856 (6,494) 656,362Highway Safety, Office of 433,010 (27,510) 405,500Peace Officers Standards and Training Council 1,966,203 (86,276) 1,879,927Public Safety Training Center 10,453,415 (518,324) 9,935,091

Total $1,459,315,276 ($28,573,435) $1,430,741,841

Best Managed StateGeorgia Senate $9,956,175 ($324,279) $9,631,896Georgia House of Representatives 17,317,593 (467,343) 16,850,250

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State of Georgia’s Budget Report Amended FY 2011 77

Department of Community HealthDepartment Financial Summary

Emergency Preparedness/Trauma System ImprovementPurpose: Prepare for natural disasters, bioterrorism, and other emergencies, as well as improving the capacity

of the state's trauma system.Recommended Change:

1. Eliminate trauma registry contracts effective January 1, 2011 and require trauma centers to report tothe registry in order to be eligible for Georgia Trauma Care Network Commission grants.

($377,000)

Total Change ($377,000)

EpidemiologyPurpose: Monitor, investigate, and respond to disease, injury, and other events of public health concern.

Recommended Change:

1. Reduce funds for personal services. ($104,760)

2. Reduce programmatic grant-in-aid to County Boards of Health. (84,121)

3. Reduce funds for the Georgia Poison Control Center. (51,705)

4. Discontinue laboratory testing available through the private sector. (13,946)


Health Care Access and ImprovementPurpose: Provide grants and other support services for programs that seek to improve health access and

outcomes in rural and underserved areas of Georgia through the State Office of Rural Health, thevarious commissions of the Office of Health Improvement, and the Office of Health InformationTechnology and Transparency.

Recommended Change:

1. Reflect an adjustment in the Workers' Compensation premium. $401

2. Reduce funds for Area Health Education Centers (AHEC). (70,950)


Healthcare Facility RegulationPurpose: Inspect and license long term care and health care facilities.

Recommended Change:

1. Reduce state funds for 6 new state licensure positions provided for in the FY 2011 Appropriations Act(HB 948).

($478,181)

2. Eliminate funds for Adult Day Care licensure. (90,921)


ImmunizationPurpose: Provide immunization, consultation, training, assessment, vaccines, and technical assistance.

Recommended Change:

1. Reduce state general funds and use ARRA funds to meet projected expenses. ($1,867,720)

Total Change ($1,867,720)


Department of Community HealthDepartment Financial Summary

Georgia Board for Physician Workforce: Morehouse School of Medicine GrantPurpose: Provide funding for the Morehouse School of Medicine to help ensure an adequate supply of

primary and other needed physician specialists through a public/private partnership with the Stateof Georgia.

Recommended Change:

1. Reflect reduced ARRA federal medical assistance percentage funds and replace with state funds. $690,703

Total Change $690,703

Georgia Board for Physician Workforce: Undergraduate Medical EducationPurpose: Ensure an adequate supply of primary care and other needed physician specialists through a public/

private partnership with medical schools in Georgia.Recommended Change:

1. Reduce funds for medical education for Georgia residents at private, in-state institutions. ($124,260)

2. Reduce funds for undergraduate medical education payments to Morehouse School of Medicine. (493,914)


Georgia Composite Medical BoardPurpose: License qualified applicants as physicians, physician's assistants, respiratory care professionals,

perfusionists, acupuncturists, orthotists, prosthetists, and auricular (ear) detoxification specialists.Also, investigate complaints and discipline those who violate the Medical Practice Act or other lawsgoverning the professional behavior of the Board licensees.

Recommended Change:

1. Reflect an adjustment in telecommunications expenses. $36,928

2. Reduce funds for personal services ($70,007) and regular operating expenses ($6,927). (76,934)


Georgia Trauma Care Network CommissionPurpose: Stabilize and strengthen the state's trauma system, and act as the accountability mechanism for

distribution of funds appropriated for trauma system improvement. Recommended Change:

State General Funds1. Reduce funds for operating expenses and Office of EMS/Trauma allocation. ($281,653)

2. Reduce funds to reflect revised revenue projection. (11,415,887)

Total Change ($11,697,540)

Other Changes3. Require trauma centers to report to the state trauma registry in order to be eligible for grants. Yes

State Medical Education BoardPurpose: Ensure an adequate supply of physicians in rural areas of the state and provide a program of aid to

promising medical students.Recommended Change:

1. Reflect an adjustment in telecommunications expenses. $7,097

FY 2011 Amended Budgets Projections

Allocated by General Assembly (less 3.3% from $23M) 22,241,000$ Amended BudgetGovernor's Amended FY 2011 Budget Requests -53% 10% 8% 6% 4% 0%

Reduction amounts ($11,697,540) ($2,224,100) ($1,779,280) ($1,334,460) ($889,640) -$

New Base 10,543,460$ 20,016,900$ 20,461,720$ 20,906,540$ 21,351,360$ 22,241,000$

FY 2010 Commitments ($1,732,759) ($1,732,759) ($1,732,759) ($1,732,759) ($1,732,759) ($1,732,759)FY2010 DCH Contract Error ($676,889) ($676,889) ($676,889) ($676,889) ($676,889) ($676,889)

Actual Base 8,810,701$ 18,284,141$ 18,728,961$ 19,173,781$ 19,618,601$ 20,508,241$

State OEMS/T Allocation (3% of New Base) 264,321$ 548,524$ 548,524$ 548,524$ 548,524$ 548,524$

Commission Operations 314,755$ 340,405$ 340,405$ 340,405$ 340,405$ 340,405$ ($153,925)

Communication Center 1,439,706$ 1,747,590$ 1,747,590$ 1,747,590$ 1,747,590$ 1,747,590$

System Development and Access 459,711$ 480,450$ 480,450$ 480,450$ 480,450$ 480,450$

Total: OEMS/T, Operations, Communications Center, Dev & Acc. 2,478,493$ 3,116,969$ 3,116,969$ 3,116,969$ 3,116,969$ 3,116,969$

Available for Stakeholder Distribution 5,809,244$ 14,644,208$ 15,089,028$ 15,533,848$ 15,978,668$ 16,868,308$ ($522,964)EMS Allocation 1,161,849$ 2,928,842$ 3,017,806$ 3,106,770$ 3,195,734$ 3,373,662$

Trauma Centers & Physicians Allocation 4,647,395$ 11,715,366$ 12,071,222$ 12,427,078$ 12,782,934$ 13,494,646$ Remaining: -$ -$ -$ -$ -$ -$

($676,889)Total DCH Contract Error Reduction:

FY 2011 Amended Budget DRAFT: Presented 17 February 2011 1

Allocated by General Assembly (less 3.3% from $23M) $22,241,000

Governor's Amended FY 2011 Budget Reduction: New Base Budget ($11,697,540) $10,543,460

FY 2010 Commitments: $1,000,000 New Trauma Center Startup Grants and #10 ($73,275 each) EMS Vehicle Equipment Replacement Grant Awares ($1,732,759)

FY 2010 DCH Contract Error ($676,889)

Actual Base $8,810,701

State OEMS/T Allocation: 3% of Actual Base $264,321

Commission Operations $314,755 ($153,925)

Communication Center $1,439,706

System Development and Access $459,711

OEMS/T, Operations, Communications Center, Dev & Acc. Total: $2,478,493

Available for Stakeholder Distribution $5,809,244 ($522,964)EMS Allocation $1,161,849

Trauma Centers & Physicians Allocation $4,647,395Remaining: $0

($676,889)

FY 2011 Amended: General Budget

Total DCH Contract Error Reduction:


Allocation 548,524$

Position: Salary Fringe Travel

Trauma Nurse Coordinator $ 100,000 temp $ 12,000 1.0 FTE

EMS Region 10 Program Director 68,000$ 27,200$ 12,000$ 1.0 FTE

EMS Region 5 Program Director 68,000$ 27,200$ 12,000$ 1.0 FTE

EMS Medical Director 70,000$ 28,000$ 4,924$ 0.5 FTE

EMS Training Coordinator 68,000$ 27,200$ 12,000$ 1.0 FTE

Travel for OEMS/T staff 12,000$

Sub Totals: 374,000$ 109,600$ 64,924$ Overall Total 548,524$

3% of Actual Base - New Total: 264,321$

EMS Education oversight

Region 5 & 6 regional directors, and other OEMS/T personnel whose travel is for the purpose of administering or monitoring an adequate system of statewide trauma care.

Position Description

Office of EMS and Trauma Allocation: FY 2011 Amended

Recommend keeping $12,000 dedicated to Staff travel (Region 5 and 6 directors) for Pilot Project-related activities

Assist in TC designations and Comm Ctr pilot

EMS Regulatory oversight for Region

EMS Regulatory oversight for Region

Deputy State EMS Medical Director


Original Cut New Amount

Executive Director $ 145,950

Administrative Assistant 57,000$

Contracted Accounting/Auditing Services 100,000$ ($48,925) 51,075$

Procurement Officer 55,000$ ($55,000)

Commission Per Diem 11,300$ ($8,150) 3,150$

Fed EX and postage 900$

Travel 7,500$ Additional travel funds added to ED contract 7,500$ Office Telephone and Internet Service 4,800$ Staff Cell phones Wireless Service 1,680$

Conference Call and Commission Printing 10,200$

Contingency Planning 100,000$ ($75,000) 25,000$ Total: 494,330$

314,755$

Trauma Commission Operations: FY 2011 Amended

Via Personal Employment Contract: Salary, benefits, travel, office space, website maintenance

Administrative Assistant 2 telephone lines and DSL internet service ($400.00 per month)

Administrative Assistant and Procurement Officer

Contingency Planning

Exempt Contract

Via Temp Services Contract: salary, temp service expenses, no benefits

$75 per month

$105.00 per diem per member (5) per month (6)

Conference account @$600.00 per month, printing @$250 per month

Via Contract Amendment to increase ED FY 2011 travel budget

New Total:


Original Cut New AmountOne Time Capital Expenditures:

Communications Center Software 960,000$ Hardware 100,000$ Backup generator 5,000$ Call recorder 8,000$ Workstations 20,000$

Capital Expenditures: 1,093,000$ Operations:

Communication Center Staff (24/7 Operators) 288,750$ (192,500)$ 96,250$

Communications Center Lead position 100,000$

Travel 15,000$ Cell Telephone 840$

Building Lease and Utilities 25,000$ (15,384)$ 9,616$ Contingency 225,000$ (100,000)$ 125,000$

Operations: 654,590$

Total: 1,747,590$ New Total: 1,439,706$

Hardware - is a catchall category to include the cost of antennas and other outside infrastructure, as well as cost of setting up an office (furniture, office equipment, supplies, etc and labor associated with setting up the office). The one time labor cost of setup will be significant.

Backup generator - may cover generator, probably won't cover associated labor and definitely won't cover cooling, if needed for the server room.

Call recorder, no longer necessary, but the $8K is roughly the needed supplement for the backup generator budget.

Workstations - think of this as non TCC PC supplies, If we treat TCC work stations as dedicated, we need a least a couple of PCs for doing basic office work - word processing, Internet, email, etc. Similarly, we need a couple of phones not tied into the TCC for normal office conversations, a quality printer/scanner/copier and possibly a large screen TV/monitor (for visualizing AVLS functionality - if determined to be placed in TCC)

Building lease and utilities - covers rent and utilities, but there will be a monthly charge for a couple of months for phone lines/Internet, as well as probably a one time charge for setup and installation of same. Recommend having at least one dedicated cell phone at the TCC as part of COO. In the event landlines are down, having a cell line gives one more option for remaining functional

Lead position

Unexpected costs or expenses

Estimated Costs Only.

$7616 for GPSTC pro rated rent for FY 2011 plus $2000 for telephones

Trauma Communications Center: FY 2011 Amended

5.5 FTE ($70,000 per) Estimate Only includes salary plus fringe (down from 9 months to 3 months)

1.0 FTE state contract via state contracted temp services include

Lead position (Coverage of EMS Region 5 and 6 and statewide travel)


Original Cut New

Trauma System Regionalization $ 150,000

Georgia Tech Research Institute $ 125,000 $ (20,739) $ 104,261

Bishop+Associates $ 103,950

Trauma Center Association of America $ 1,500

TeleMedicine TeleTrauma Direct Grant Award $ 50,000

Broselow Lutin Solutions System $ 50,000

Total: $ 480,450

Total $ 459,711

System Development and Access: FY 2011 Amended Budget

Technical Assistance: Trauma Communications Center startup

Provide Counsel To GTCNC In Preparing FY 2012 Budget, Conduct CY 2009 Georgia Trauma Center Economic Survey, Work With Commission And Staff To Assess And Update GTCNC Five Year Strategic Plan, Provide Technical Assistance For The Preparation Of Research/White Papers On The Work Of The GTCNC

Annual membership

Georgia Partnership for Telehealth: Continuation of pilot project TeleTrauma capabilities in Georgia

Continuation of activities: The system provides rapid access to standardized dosing information, treatment methods, and clinical support algorithms in the care of children

Grants for Trauma System Regionalization Activities (two EMS regions) To be added to Trauma Center Readiness funding contracts


Available EMS Budget $ 1,161,848.80

EMS Subcommittee on Trauma Support: $4200 for Subcommittee support (minutes) $600 conference call and $600 printing support.

$ 5,400.00

AVLS Anticipated Expenses 01 January 2011 - 30 June 2011 $ 72,843.00

Total for existing programs distribution 1,083,605.80$

EMS Uncompensated Care Program 26.3% 284,988.33$ EMS Vehicle Equipment Replacement Grants 60.2% 652,500.00$

First Responder Training 13.5% 146,117.47$

Total : 100% 1,083,605.80$

EMS Stakeholder Allocation: FY 2011 Amended Budget


GEORGIA TRAUMA CARE NETWORK COMMISSION FY 2011 BUDGETTRAUMA CENTER/PHYSICIAN ALLOCATION 21 January 2011 DRAFT

AmountNew Trauma Center Startup Grants1 0

Trauma Center Readiness Payments3 1,626,588Performance Based Payment4 697,109

Sub Total Readiness Payments 2,323,698

Uninsured Patient Care Payments5 2,323,698Total Trauma Center Allocation6 4,647,395

Hospital/Physician Fund Division7 75% Hospital 25% Physician TotalTrauma Center Readiness Payments % $1,742,773 $580,924 $2,323,698Uninsured Patient Care Payments $1,742,773 $580,924 $2,323,698

Total $3,485,546 $1,161,849 $4,647,395New Trauma Centers Startup Grants $0

Total $4,647,395

Notes:

3Trauma Center readiness payments are described on page 2.

5Uninsured trauma patient care payments are described on page 3.6Amount allocated to Trauma Centers by the GTCNC.

Gov's Amended $4,647,3954% $12,659,7946% $12,303,9488% $11,948,082

10% $11,592,226

1Grant program to foster the development of new trauma centers in regions of Georgia with the greatest need.

4A performance based payment (PBP) program will reward trauma centers that meet defined standards. For 2011, 30% of trauma center funding will be set aside for PBP.

7Payments for readiness and uninsured patient care received by Trauma Centers are to be proportionally distributed between the hospital and physicians on a 75%/25% basis.

Replace green number above with new dollar amount to see resulting trauma center distribution changes throughout EXCEL workbook


GEORGIA TRAUMA CARE NETWORK COMMISSION FY 2011 BUDGETTRAUMA CENTER READINESS & PAY FOR PERFORMANCE PAYMENTS 21 January 2011 DRAFT

Trauma Center Funding Level % of Fund

Readiness Payments1

Potential P4P Payments2

Total Readiness Payments

CY 2008 Readiness

Costs %Level IV Morgan 5% 0.49% 8,012.75 3,434.04 11,446.79 $52,003 22.0%Level III Walton 10% 0.99% 16,025.50 6,868.07 22,893.57 $95,316 24.0%

Level II 60%Athens 60% 5.91% 96,153.00 41,208.43 137,361.43

Archbold 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,202,973 11.4%Atlanta 60% 5.91% 96,153.00 41,208.43 137,361.43 $4,615,992 3.0%

Columbus 60% 5.91% 96,153.00 41,208.43 137,361.43 $2,405,756 5.7%Floyd 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,846,100 7.4%

Gwinnett 60% 5.91% 96,153.00 41,208.43 137,361.43 $2,963,726 4.6%Hamilton 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,687,888 8.1%

North Fulton 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,867,551 7.4%Egleston 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,882,197 7.3%

Scottish Rite 60% 5.91% 96,153.00 41,208.43 137,361.43 $1,425,068 9.6%Level I 100%

Grady 100% 9.85% 160,255.00 68,680.71 228,935.71 $7,555,497 3.0%MCCG 100% 9.85% 160,255.00 68,680.71 228,935.71 $4,577,839 5.0%MCG 100% 9.85% 160,255.00 68,680.71 228,935.71 $5,008,878 4.6%

Memorial 100% 9.85% 160,255.00 68,680.71 228,935.71 $5,259,273 4.4% Totals 1015% 100.00% 1,626,588.25 697,109.25 2,323,697.50 $42,446,057 5.5%

Notes:

2Pay for performance (P4P) payments, if fully earned, will be distributed to trauma centers based upon the readiness payment formula.

Level II trauma center received 60% of the payments for Level I trauma centers. Level III trauma centers receive 10% and Level IV trauma centers receive 5%.


GEORGIA TRAUMA CARE NETWORK COMMISSION FY 2011 BUDGETTRAUMA CENTER UNINSURED PATIENT CARE PAYMENTS21 January 2011 DRAFT

Cost Norm Based Allocation of Funds2

Trauma Center ISS 0-8

ISS 9-15

ISS 16-24

ISS >24 Total

Severity Adjusted

Cost Norms

Total Based Upon Cost

NormsLevel IV MorganLevel III Walton 4 2 6 $6,987 $41,924 0.11% $2,642.79

Level IIAthens

Archbold 27 21 5 5 58 $10,846 $629,052 1.71% $39,653.92Atlanta 143 110 47 21 321 $13,327 $4,277,961 11.61% $269,672.31

Columbus 9 18 9 0 36 $11,437 $411,741 1.12% $25,955.16Floyd 25 25 5 1 56 $9,365 $524,450 1.42% $33,060.06

Gwinnett 36 41 21 9 107 $12,475 $1,334,811 3.62% $84,143.25Hamilton 12 9 2 1 24 $9,594 $230,253 0.62% $14,514.59

North Fulton 33 21 22 10 86 $13,535 $1,164,021 3.16% $73,377.07Egleston 38 11 5 1 55 $9,832 $540,780 1.47% $34,089.46

Scottish Rite 47 12 1 1 61 $6,988 $426,256 1.16% $26,870.15Level I

Grady 468 395 122 65 1,050 $12,889 $13,533,553 36.71% $853,122.42MCCG 83 59 32 11 185 $13,433 $2,485,128 6.74% $156,656.45MCG 93 127 50 21 291 $14,588 $4,245,058 11.52% $267,598.18

Memorial 66 111 96 71 344 $20,399 $7,017,111 19.04% $442,341.69Total LI/LII 1080 960 417 217 2,674 $36,862,099 100.00% $2,323,697.50Notes: Patient Treatment Cost Norms3

ISS Community Academic0-8 $5,267 $6,373

9-15 $10,428 $12,61816-24 $19,626 $23,747>24 $33,945 $41,073

Allocation Based On % of Norm Cost Total

Self Pay Patients Meeting SB 60 Requirements1 in CY 2008

1Trauma Centers report number of uninsured trauma patients meeting SB 60 requirements by Injury Severity Score (ISS) category.

3To develop a fair and consistent approach to estimating costs, national trauma center patient treatment cost norms by injury severity were used, for both community and academic hospitals.

2Allocation is based upon the number and severity of patients meeting SB 60 requirements times cost norms. This derives a percent of total costs which is then applied to the total amount available.


GEORGIA TRAUMA CARE NETWORK COMMISSION FY 2011 BUDGETTOTAL TRAUMA CENTER ALLOCATIONS 21 January 2011 DRAFT

Trauma Center Readiness Payment

Potential P4P Payments2

Total Readiness Payments

Uninsured Patient

PaymentTotal %

Level IV Morgan $8,013 $3,434 $11,447 $11,447 0.2%Level III Walton $16,026 $6,868 $22,894 $2,643 $25,536 0.5%

Level IIAthens $96,153 $41,208 $137,361 $137,361 3.0%

Archbold $96,153 $41,208 $137,361 $39,654 $177,015 3.8%Atlanta $96,153 $41,208 $137,361 $269,672 $407,034 8.8%

Columbus $96,153 $41,208 $137,361 $25,955 $163,317 3.5%Floyd $96,153 $41,208 $137,361 $33,060 $170,421 3.7%

Gwinnett $96,153 $41,208 $137,361 $84,143 $221,505 4.8%Hamilton $96,153 $41,208 $137,361 $14,515 $151,876 3.3%

North Fulton $96,153 $41,208 $137,361 $73,377 $210,738 4.5%Egleston $96,153 $41,208 $137,361 $34,089 $171,451 3.7%

Scottish Rite $96,153 $41,208 $137,361 $26,870 $164,232 3.5%Level I

Grady $160,255 $68,681 $228,936 $853,122 $1,082,058 23.3%MCCG $160,255 $68,681 $228,936 $156,656 $385,592 8.3%MCG $160,255 $68,681 $228,936 $267,598 $496,534 10.7%

Memorial $160,255 $68,681 $228,936 $442,342 $671,277 14.4%Total 1,626,588 697,109 2,323,698 2,323,698 4,647,395 100.0%


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