Testimony on Senate Bill 90
Senate Committee on Transportation
April 5, 2017
Chairman Nichols, my name is Dr. Christopher Ziebell, and I am an emergency physician practicing in Austin. On behalf of the Texas Medical Association, thank you for the opportunity to provide input on Senate Bill 90, relating to the repeal of the Driver Responsibility Program (DRP). Because this bill repeals the DRP, which helps fund the trauma system in Texas, we must oppose it. We understand the criticism surrounding the program, but without another trauma funding source proposed, we must oppose any bill that reduces trauma funding. The preservation of DRP, or the establishment of an alternative trauma funding source, is essential to the provision of trauma care and emergency services across the state.
The Driver Responsibility Program was established in 2003 (House Bill 3588) to support existing trauma centers and offer 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, and penalizes 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. The funds derived from the surcharges are then used to offset the cost of more than $300 million in uncompensated trauma care each year.
A strong trauma system in Texas is vital to the overall health of the state. Trauma is the leading cause of death for Texans under age 44. There are more than 117,000 trauma incidents in Texas each year. These include motor vehicle crashes, falls, assaults, and firearm injuries. Automobile accidents are the leading cause of traumatic injury in Texas for children and adults, and Texas leads the nation in the number of individuals driving under the influence. DRP is an indispensable part of this strong trauma care system. DRP is the leading source of state funding for the Texas trauma system, contributing $75 million-$80 million per year. To maintain Texas’ low trauma mortality rate (2.79 percent, a full percentage point lower than the national average), trauma funding must be preserved.
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. These additional trauma centers ensure trauma care access to citizens across the state.
DRP penalizes unsafe drivers and holds them responsible for their actions. We are fully cognizant that the current structure of the program has the potential to cause hardship for low-income drivers who have accrued penalties. We believe reforms are necessary and support a robust stakeholder process to address any proposed reforms. However, 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.
We strongly urge the preservation of trauma funding in the state. The funds from the Driver Responsibility Program help ensure that a strong trauma system exists in Texas. During a time of lean state budgets, eliminating a program that produces millions in revenue for the state would be short-sighted and could put the state’s trauma system in jeopardy. Thank you for the opportunity to comment today.
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