Effort aims for upgraded trauma facility

McALLEN — With the legislative session only a few months away, Doctors Hospital at Renaissance and Med-Care Emergency Medical Services are working together to build local support for a Level 1 trauma facility in the Rio Grande Valley.

On Monday, McAllen became the first city to pass a resolution supporting the Edinburg hospital and McAllen-based ambulance service provider’s joint effort to strengthen the state’s network of trauma hospitals by having DHR operate as a Level 1 trauma center in the near future. Level 1 medical facilities provide the highest level of trauma care, complete with surgeons, anesthesiologists, specialists and equipment available 24 hours a day.

As it stands, Region V — which includes Hidalgo, Cameron, Starr and Willacy counties — does not have a Level 1 trauma center.

The closest such facility is in San Antonio, a four-hour drive by ambulance or nearly an hour-long flight by air ambulance, according to Paul Vazaldua Jr., legislative affairs and special projects director for Med-Care EMS. If San Antonio’s two Level 1 facilities, University Hospital and San Antonio Military Medical Center, do not have beds available for patients from the Valley, patients must then be transported to other areas of the state such as Houston, Austin or Dallas.

“Having a Level 1 trauma center could mean that you could expedite the treatment,” Vazaldua said, noting that access to medical care during the first 60 minutes of a traumatic injury, known as the “Golden Hour,” is critical to saving lives.

Hurricane Harvey underscored the need for the state’s network of trauma facilities to be prepared to take in an influx of patients from other areas, said Roberto Haddad, counsel for government affairs and policy at DHR, noting that, “had Harvey hit the Rio Grande Valley, (our medical facilities) would not have had the capacity as Houston did to weather it.”

The region only has a Level 2 trauma center — Valley Baptist Medical Center in Harlingen, which received this designation in February by the Texas Department of State Health Services.

Unlike the Rio Grande Valley, the Houston-The Woodlands-Sugar Land metropolitan statistical area has four Level 1 trauma centers, one of which experienced flooding and was forced to evacuate, while others took in patients from the Corpus Christi and Victoria MSAs, which have no such center.

Given the Valley’s location off the Gulf Coast, it is “at risk of experiencing widespread and catastrophic flooding and damage which may pose significant threats to life and property due to tropical storms, hurricanes and other inclement weather events,” reads the resolution the McAllen City Commission passed, which DHR and Med-Care EMS drafted.

The American College of Surgeons recommends at least one Level 1 trauma center for every 1 million residents. With a combined population of approximately 1.4 million, the McAllen-Edinburg-Mission and Brownsville-Harlingen MSAs are in need of access to higher level care, especially given that the Valley’s population is estimated to exceed 2 million within the next decade, according to information from DHR and Med-Care EMS.

DHR and Med-Care EMS are proposing for lawmakers to allocate money from the Hurricane Harvey Supplemental Funding Package — funds the state received from the federal government — to create a grant program, overseen by the Texas Department of State Health Services, that would provide hospitals with funding to transition from a lower to higher-level trauma verification from the ACS.

DHR, which is currently designated a Level 3 trauma center, is a good candidate to become a Level 1 center given its existing affiliation with the University of Texas Rio Grande School of Medicine, said Dr. Carlos J. Cardenas, the chairman of the board of DHR and former president of the Texas Medical Association.

One requirement of being a Level 1 center is that a facility has a research and teaching component, which is why such centers are frequently affiliated with an academic institution, like Baylor University Medical Center or University Medical Center of El Paso.

“With UTRGV now part of the community, to go to Level 1 would not only be a benefit in the services provided (to the community) but the education and training medical students would receive,” Cardenas said.

DHR currently offers medical residencies to UTRGV students, as well as those from medical schools across the nation, in family medicine; general surgery; internal medicine; obstetrics and gynecology; and preventative medicine. Were it to be designated a top-tier trauma center, it would be able to offer additional residencies in emergency medicine.

The hospital is already taking steps to be designated as a Level 1 trauma center, Cardenas said, describing it as “functioning almost as if (a) Level 2 (center).”

Making the jump to Level 1, however, requires substantial investments in human capital in terms of recruiting physicians, surgeons and specialists, in addition to major financial investments in upgrading facilities and expanding operating room space, Cardenas said, costs that DHR must front.

And the costs don’t stop there — the difference in annual operating expenses between a Level 2 and Level 1 trauma facility is approximately $11.2 million, according to information from DHR and Med-Care EMS.

“I expect all of my legislative colleagues will be working with me in the upcoming legislative session to meet the pressing demand for better healthcare for all South Texans,” State Rep. Terry Canales, D-Edinburg, said in a written statement, adding, “Strengthening our state’s trauma network by providing funding for critical infrastructure and increased capabilities and capacity is needed to save lives.”

In a column published in today’s edition, State Sen. Juan “Chuy” Hinojosa, D-McAllen, a member of The Monitor’s Board of Contributors, also called on fellow lawmakers to “develop a permanent funding mechanism to support current trauma centers and help defray the costs associated with centers leveling up in an effort to address gaps in our trauma system.”

DHR and Med-Care EMS have approached other cities with the resolution, among them Edinburg, Pharr, Mission and San Juan, said DHR’s Haddad, with the hope that they too will adopt it before the session begins in January “to show a unified voice from the Rio Grande Valley that all our communities support” the creation of a Level 1 trauma facility in Region V.

Editor’s note: This story has been updated to reflect that the difference in the annual operating expenses between Level 2 and Level 1 trauma facilities is $11.2 million.