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PA Bulletin, Doc. No. 04-775

NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Additional Class of Disproportionate Share Payments to Hospitals

[34 Pa.B. 2395]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) intent to establish an additional class of inpatient disproportionate share payments to be distributed to hospitals in this Commonwealth accredited as trauma centers by the Pennsylvania Trauma System Foundation (Foundation).

   The Department will distribute annually from funds appropriated for this purpose disproportionate share payments to Commonwealth hospitals with accredited trauma centers to provide financial assistance to improve access to readily available and coordinated trauma care for the citizens of this Commonwealth.

   The Department will allocate 90% of the available funds to hospitals accredited as Level I and Level II trauma centers. Fifty percent of the total amount available for Level I and Level II trauma centers will be allocated equally among Level I and Level II trauma centers. Fifty percent of the total amount available for Level I and Level II centers will be allocated on the basis of each trauma center's percentage of Medical Assistance (MA) and uninsured trauma cases and patient days compared to the Statewide total number of MA and uninsured trauma cases and patient days for Level I and Level II trauma centers. The Department will calculate payment to each qualifying hospital accredited as a Level I or Level II trauma centers using data provided by the Foundation.

   The Department will allocate the remaining 10% of the available funds to hospitals accredited as Level III trauma centers. Until data is available from the Foundation for Level III trauma centers, the available funds will be distributed equally to Level III trauma centers capped at the average payment made to Level II trauma centers. The Foundation will accredit Level III trauma centers in accordance with established standards, which are based upon the current guidelines for trauma centers as defined by the American College of Surgeons for Level III trauma centers. To qualify for these disproportionate share payments as a hospital with an accredited Level III trauma center, a hospital must:  (1) provide comprehensive emergency services; (2) have, on an annual basis, at least 4,000 inpatient admissions from its emergency department; (3) be located in a county without an accredited Level I or Level II trauma center; and (4) not be located within 25 miles travel distance from a Level I or Level II trauma center. A hospital must apply for accreditation as a Level III trauma center to the Foundation to qualify for these disproportionate share payments.

   Effective March 1, 2005, and annually thereafter, the Department will produce a report to the Public Health and Welfare Committee of the Senate and the Health and Human Services Committee of the House of Representatives identifying the trauma centers receiving the disproportionate share payments, the amount of the disproportionate share payments, the number of individuals served by the trauma centers and any recommendations for improvements to further promote the availability of trauma services to the citizens of this Commonwealth.

Fiscal Impact

   This change will result in expenditures of $27.630 million in total funds ($15.130 million in Federal funds, $12.500 million in State funds) for FY 2003-04.

Public Comment

   Interested persons are invited to submit written comments to this notice within 30 days of this publication. Comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention:  Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Persons with a disability may use the AT&T Relay Service, (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note:  14-NOT-388. (1)  General Fund; (2)  Implementing Year 2003-04 is $12,500,000; (3)  1st Succeeding Year 2004-05 is $12,500,000; 2nd Succeeding Year 2005-06 is $12,500,000; 3rd Succeeding Year 2006-07 is $12,500,000; 4th Succeeding Year 2007-08 is $12,500,000; 5th Succeeding Year 2008-09 is $12,500,000; (4)  2002-03 Program--$N/A; 2001-02 Program--$N/A; 2000-01 Program--$N/A; (7)  Trauma Centers; (8)  recommends adoption. Funding for 2003-04, including $15,130,000 in Federal funding, is included in Act 9-A of 2003. State and Federal funding for 2004-05 is recommended in the 2004-05 Executive Budget.

[Pa.B. Doc. No. 04-775. Filed for public inspection April 30, 2004, 9:00 a.m.]

   


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