"Medical trauma centers in Texas have fallen victim to a legislative version of bait-and-switch."
Legislators had pushed cameras by saying half of funds would go to emergency rooms, trauma centers
November 12, 2007
By CHRISTY HOPPE
The Dallas Morning News
AUSTIN – Medical trauma centers in Texas have fallen victim to a legislative version of bait-and-switch.
This year lawmakers, who had previously decried the Big Brother and cash cow aspects of red-light cameras, did a U-turn and gave cities permission to use them. The biggest selling point was how the cameras would be used: Half the fine money paid by red-light runners would be dedicated to emergency rooms and trauma care centers.
Except, hospitals are just now learning, the state is keeping the money.
"There was no appropriation made for that fund, so whatever's collected will stay in that fund," said R.J. DeSilva, spokesman for the Comptroller's Office.
Budget writers said the funds were being kept to offset potential, unbudgeted Medicaid costs. And the same pot of money could be used to attract matching federal health care money – building the funds available, although that money wouldn't necessarily benefit trauma centers.
"Obviously, we are disappointed," said Dinah Welsh, the Texas Hospital Association's senior director of public policy. "There is an absolute need for these dollars."
Plus, it's the second time it's happened.
In 2003, lawmakers created a new menu of fees that bad drivers would have to pay on top of their traffic fines. Standing before emergency room entrances at hospitals, Gov. Rick Perry touted the bill as a new way to address medical needs.
Except, lawmakers initially kept the fees to fill state budget holes.
In 2005, they began sending some of the money collected to hospitals, and currently, about 50 cents of every dollar collected is flowing to trauma centers. In fiscal 2007, almost $100 million was raised from the fees and $46 million was sent to medical facilities.
Perry spokeswoman Allison Castle said the governor has pushed for "truth in budgeting" and been prodding lawmakers to spend money for its dedicated purpose. "If we are going to collect the funds to go to trauma centers, they need to go to trauma centers," she said.
But under state budget rules, the money in the red-light fund, which won't build up appreciably until next summer, cannot be spent because it was not appropriated. Legislative leaders could agree to transfer appropriated money to trauma centers instead – in other words, take the money from some state agency.
Or they must wait and make an emergency appropriation at the beginning of the next legislative session in January 2009.
"He's disappointed," Ms. Castle said of the governor. "He's willing to work with the legislative leadership to see what we can do about it."
Ms. Welsh said the solutions are not attractive, and while hospitals are grateful for what money is provided, they have been hoping for the full amount promised.
"We constantly have had these policy decisions by the Legislature that we should give this money to the trauma centers, that there is a need, and then at the end of the day, the funds are not coming," Ms. Welsh said.
"These are two unkind cuts for members of the Legislature," said Public Health Committee chairwoman Dianne White Delisi, who sponsored the driver fees in 2003 and the red-light bill.
She said after money from the Drivers Responsibility Act was sucked into the state treasury, "We just shook the gates of heaven – lots and lots of people from all over the state. This money was being counted on."
When that spigot opened partially, along came the red-light bill. "The thing that pushed people over to support it was that this money was going to be split and that part of it was going to the trauma system," Ms. Delisi said.
Under the bill the cities would keep half the money they collected to be used for community-based safety programs while sending the other half to the state for trauma centers.
Ms. Delisi said she understands budget needs and precautions but said that the state must come to the realization that trauma facilities are overtaxed, and some communities are losing their emergency rooms.
In Dallas, trauma centers were hoping to split $3.5 million a year from the red-light money, said Dr. Ron Anderson, president and CEO of Parkland Memorial Hospital.
Last year, he said, Parkland alone spent $52 million in emergency medical care that was not reimbursed.
"We piece together every dollar we can so that the local taxpayers don't have to pay it all," Dr. Anderson said.
He said the overall bill could help medical centers by cutting down on intersection accidents caused by red-light runners. But he is frustrated by the state budget decision – again – to withhold the money.
"Those of us who helped get these bills passed and worked hard down there, and hoped we would get some relief, it's kind of hard to see these funds not used as intended," he said.
The state might have legitimate concerns about health care costs, but this year lawmakers are sitting on a surplus of several billion dollars, he pointed out.
Dr. Anderson said that when he was pushing for the bill, lawmakers said they were worried that cities might use red-light money to pad their coffers and that's why the bill specified that the funds go for health and safety.
"The state wanted something to watch the cities to make sure they didn't get out of control," Dr. Anderson said.
"Maybe someone needs to watch the state."
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