House Homeland Security and Public Safety Committee
House Bills 104 and 790
April 3, 2013
On behalf of the Texas Medical Association (TMA), thank you for the opportunity to provide comments on House bills 104 and 790, which would repeal the Driver Responsibility Program (DRP). The preservation of this program is essential to the provision of trauma care and emergency services across the state, especially in rural and frontier areas of Texas.
DRP was established in 2003 by House Bill 3588 to support existing trauma centers and provide incentives for other hospitals to become trauma-designated. The program targets repeat offenders and unsafe drivers, such as those who drive under the influence of alcohol or drugs, penalizing those bad drivers with surcharges. These surcharges go into Account 5111— the Designated Trauma Facility and Emergency Medical Services Account — and the General Revenue account. These funds are used to offset the cost of more than $200 million in uncompensated trauma care each year. In 2012, DRP contributed $84 million to the 5111 Account. Since 2004, trauma centers in Texas hospitals have received nearly $504 million from the surcharge, which partially offsets the $2 billion-plus in uncompensated trauma care costs.
A strong trauma care system in Texas is vital to the overall health of the state. Trauma is the leading cause of death for Texans under 44 years of age. Automobile accidents are the leading cause of traumatic injury in Texas children and adults. Texas leads the nation in the number of individuals driving under the influence. DRP penalizes unsafe drivers who cause the majority of traumatic injuries and holds them responsible for their actions. Drivers who obey traffic laws and drive safely receive no penalty; the program is designed to penalize those who put the public at risk. While we acknowledge that the program has caused hardship for low-income drivers who have accrued penalties, eliminating statewide funding would undermine a trauma system on which all Texans depend and shift the financial burden for trauma care to local taxpayers and the privately insured. During the interim, TMA would welcome a robust stakeholder process to address concerns about DRP while maintaining our trauma system’s funding source.
The program not only helps offset uncompensated care but also provides a financial incentive for more hospitals to earn or maintain their trauma center designation. While many of the state’s larger cities have Level I or Level II trauma centers that serve the city’s population, many rural areas do not have any designated trauma centers. This program has encouraged many smaller and rural hospitals to achieve Level III or Level IV trauma designation. Since the program began, an additional 77 Texas hospitals have become designated trauma centers. These additional trauma centers ensure trauma care access to citizens across the state.
We strongly urge the preservation of the Driver Responsibility Program. The funds from this critical program help ensure a strong trauma system exists in the state. During a time of lean state budgets, eliminating a program that produces millions in revenue would be foolish and could put the state’s trauma system in jeopardy.
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