Trauma center faces opposition

Dan Kulin

Friday, July 23, 2004 | 11:08 a.m.

The Clark County Health District Board on Thursday asked its lawyer to find a way to block or overturn a state decision to give Sunrise Hospital and Medical Center permission to open a trauma center in January on a 12-month trial basis.

Board members said they want to create a trauma system to oversee trauma care and deal with issues such as which hospitals should have trauma centers, before deciding what hospitals should be allowed to open new trauma centers.

By approving Sunrise's request, board members said the state has potentially crippled the county's only existing trauma center at University Medical Center.

UMC bosses and other county officials say opening a trauma center at Sunrise will take too many patients from UMC, exacerbating financial problems at the county-run hospital and possibly hurting the quality of care because the doctors and other trauma staff would have less cases to work on.

Board members also echoed comments some of them made last week about how upset they were about the Sunrise decision handed down by state Health Division Administrator Alex Haartz. Some said they believe political pressure, possibly from the governor's office, pushed Haartz to OK Sunrise's application.

"We weren't treated with respect. There's a lot of work that went down the drain," Board Chairman Gary Reese, a Las Vegas City Councilman, said, referring to the citizens task force and independent reports that reviewed the issue.

County Commissioner Chip Maxfield, who is also on the Health Board, said he was "beyond disappointed" with the state's decision to move ahead before receiving a county recommendation.

Maxfield asked board attorney Stephen Minagil, "What can we do ... to try and counteract what's occurred?"

Reese asked: "Is there any way we can stay this action? An injustice has been done."

Minagil said their ability to take action might be limited because state law assigns power over trauma centers to the state.

Board member Stephanie Smith, a North Las Vegas councilwoman, likened the state's decision on this matter to promises that "sound science" would be the basis for whether Yucca Mountain would be made a nuclear waste dump.

"Here we're bring overridden again," Smith said. "This demonstrates that we need local control over this."

Board member Andrea Anderson, a Boulder City councilwoman, said she was "very disappointed" by the state's decision, adding that it doesn't address the two main points of the independent reports and task force discussions.

"The two main threads have been: Don't do anything until there is a trauma system and the need is in the south of the valley," Anderson said.

"The experts say we have to develop a system first," she said. "Sunrise may very well be a part of that, but we want the process in place first."

Sherry Colquitt, a nurse and board member, said: "I'm embarrassed and outraged but I'm not surprised. ... This is not the first time politics has overridden good judgment and planning."

County Chief Health Officer Dr. Donald Kwalick said Haartz "wouldn't have done this unless he was told, pressured, or talked to by his boss ... and the governor's office. He wouldn't have done this, he isn't stupid."

Smith said Haartz "obviously" wasn't the ultimate decision maker.

"He was just the name on the letter," she said.

Gov. Kenny Guinn spokesman Greg Bortolin said Haartz was not lobbied or pressured from above.

"That's absurd," he said.

Haartz also said the decision was his.

Haartz said he approved Sunrise's request because the reports, county task force, and other officials have said there is a need for more trauma centers, and Sunrise is the only hospital that has asked the state for permission to open a trauma center.

St. Rose Dominican Hospital has offered to open a low-level trauma center at its Siena campus in Henderson, but the hospital has not applied to the state, Haartz said.

Haartz said he was particularly concerned that a "mass casualty" event could overwhelm the county's one trauma system.

The decision "wasn't intended as a slap in the face," Haartz said, adding that he is still waiting to hear the county board's recommendations.

The county Health Board on Thursday voted to recommend that a trauma system be developed before any new trauma centers are allowed to open, and to have staff review possible actions the county board could take in response to the state decision.

The votes were both 9-0. Board members Dr. Jim Christensen, Mary Jo Mattocks, and Rory Reid, a county commissioner, did not attend the meeting. Joe Hardy, a Republican assemblyman from Boulder City, abstained from the vote because Sunrise is part owner of the company he works for.

Haartz also said that his decision does not guarantee Sunrise will receive a permanent trauma center designation.

The permission to temporarily open a trauma center is contingent on Sunrise's ability to bring together the necessary trauma doctors and other staff, and on UMC, Sunrise and the County Health District agreeing on which trauma patients would be brought to a Sunrise trauma center.

To qualify for a full trauma center designation, Sunrise will have to show the state that it can handle trauma patients, and the American College of Surgeons will have to review and recommend Sunrise's operation.

Cheryl Smith, a spokeswoman for Sunrise, declined to comment, except to say that Sunrise officials have always "followed the law."

UMC Chief Executive Lacy Thomas said Thursday that until they know how large an area Sunrise will draw patients from, it's difficult to say how much UMC will be affected by the state's decision.

UMC officials have said that opening a second high-level trauma center near UMC -- Sunrise is about 3 1/2 miles away -- would drain too many patients from UMC, and possibly cost UMC more than $2 million a year.

Sunrise wants to become a Level II trauma center, which hospital officials have said would increase the overall level of care at Sunrise and enable the hospital to launch more care-intensive specialty programs.

UMC operates a Level I trauma center, which is similar to a Level II except that a Level I centers also do teaching and research.

St. Rose is offering to open a Level III trauma center. At a Level III trauma center the trauma doctors are required to be on call, whereas trauma doctors are always in the hospital at Level I and II trauma centers.

UMC has supported St. Rose's offer.