Jack Champlin Consultant Prevention Institute Former Deputy Administrator Region 9 National Highway Traffic Safety Administration California Trauma System Summit September 21, 2009

Trauma System Agenda for the Future Trauma System Agenda for the Future The Vision Trauma systems, when fully implemented throughout the United States, will enhance community health through an organized system of injury prevention, acute care and rehabilitation that is fully integrated with the public health system in a community. 2

Trauma System Agenda for the Future The Vision (continued) Trauma systems will have the ability to identify risk factors and related interventions to prevent injuries in a community and to maximize the integrated delivery of resources for patients who ultimately need acute trauma care. 3

The Challenge How to implement a comprehensive trauma care system in California when faced with the current status of a largely decentralized system? 4

Strategic Highway Safety Plan How it came to be….. ► SAFETEA-LU, 23 U.S.C. § 148, established the Highway Safety Improvement Program (HSIP) as a core federal highway program. ► A Strategic Highway Safety Plan (SHSP) is a major component and requirement of the HSIP. ► SHSP is a statewide-coordinated safety plan that provides a comprehensive framework for reducing highway fatalities and serious injuries on all public roads. 6

Strategic Highway Safety Plan How it came to be….. ► The SHSP is developed by the State DOT in a cooperative process with Local, State, Federal, and private sector safety stakeholders. ► The SHSP is a data-driven, four to five year comprehensive plan that establishes statewide goals, objectives, and key emphasis areas and integrates the four E's 7

Four E's ► ► Engineering ► ► Education ► ► Enforcement ► ► Emergency Medical Services (EMS) 8

SHSP Impact on Trauma and EMS ► Highlights challenges to roadway user safety on California’s streets and highways. ► Uses data to paint the picture of fatalities experienced on California’s roads. ► Proposes high level strategies to reduce fatalities for each challenge area. ► Serves as a guide for the implementation of specific projects and activities through

Impact on Trauma and EMS ► The California SHSP goal is to achieve less than one roadway fatality per 100 million vehicle miles traveled (VMT). ► In the year 2010., if current trends in population growth, vehicle use, and travel patterns hold steady, the number of fatalities and injuries will increase. ► Traffic deaths will grow more than 17 percent to exceed 4,700 per year. ► Injuries and economic losses will grow at a similar pace. 10

Strategic Highway Safety Plan Current Status of California ► EMS is Challenge Area 15 and represents improving crash survivability. SHSP Implementation Challenge ► By 2010, reduce crash-related fatalities in California at least 5 percent from their 2004 level through focused improvements in Emergency Medical Services (EMS) system communications, response, and safety education. 11

CA SHSP Challenge Area 15 Strategies: 1. Improve technology for locating crash sites and for improving EMS access routes and response times. 2. Ensure interoperability of communications systems between all responders to crash sites. 3. Improve patient transportation and destination from crash location. 4. Increase availability of appropriate-level trauma centers, with emphasis on rural areas. 12

CA SHSP Challenge Area 15 Strategies: 5. Improve access to trauma-related training courses for Emergency Medical Technicians and paramedics. 6. Encourage Emergency Medical Dispatch programs to train dispatchers to assist victims awaiting arrival of EMS. 7. Improve data access to meet the needs of EMS. 8. Increase public access to first aid, cardio pulmonary resuscitation (CPR), and automated external defibrillation training. 13

- EMS and Trauma Planning Partners

Click It Or Ticket National Law Enforcement Campaign ► ► The goal is to get more drivers and passengers to always buckle up every trip, every time. ► ► Seat belts save lives:   They are the best defense against injuries and fatalities.   In 2007 alone, seat belts saved an estimated 15,147 lives.   An additional 5,024 lives could have been saved if seat belts were worn at the time of the crashes.   One in five Americans still fail to buckle up regularly. 15

Drunk Driving Over the Limit, Under Arrest ► ► National Law Enforcement Campaign ► ► Designed to crack down on alcohol impaired drivers   August 21 through Labor Day, ► ► Main Points:   Impaired Driving Is a Crime and Will Not Be Tolerated.   Impaired driving is one of America’s most-often- committed and deadliest crimes.   Overall in 2007, nearly 13,000 people were killed in highway crashes involving a driver or motorcycle operator with an illegal blood alcohol concentration (BAC) of 0.08 (80) or higher. 16

Alcohol Impaired Motorcycle Riders are a focus of the “DUI. Over the Limit. Under Arrest” Crackdown 17

Federal Trauma and EMS Funding ► CDC Federal Block Grant fully funds the CA EMS Authority System Division ► In 2009, NHTSA provided grant funds for E- 911 program under the Ensuring Needed Help Arrives Near Callers Employing 911 (Enhance 911) Act  $43.5 Million to states 18

CA Office of Traffic Safety (OTS) Grants - from NHTSA federal funding - ► Imperial County Public Health Department’s Local Emergency Medical Services Communications System Plan  Grant Period 2003 – 2012 ► Emergency Medical Services Authority’s Traffic Records improvement, the California EMS Information System (CEMSIS)  Update Grant - Period 2007 – 2011 ► Fresno County Fire Protection District Regional Vehicle Extrication Equipment Request  Grant Period

Motor Vehicle Trauma The Prevention Challenge “A historic commitment to wellness initiatives will keep millions of Americans from setting foot in the doctor's office in the first place -- because these are preventable diseases and we're going to invest in prevention.” President Obama (February 2009) 20

The Future “One of my goals as Chairman of the Committee on Transportation and Infrastructure is to create a new model for surface transportation, one that invests in alternative modes and promotes active, healthy lifestyles.” James Oberstar, Chairman, Transportation and Infrastructure Committee, United States House of Representatives 21

Transportation Prescription Bold new ideas for healthy, equitable transportation reform in America …….. ► A report commissioned and funded by the Convergence Partnership including:  The California Endowment  Kaiser Permanente Health System  The Kresge Foundation  The Nemours Health System  The Robert Wood Johnson Foundation  W. K. Kellogg Foundation - Technical advisor: The Centers for Disease Control and Prevention 22

Transportation Prescription Developed By ► ► The Prevention Institute   Putting prevention and equitable health outcomes at the center of community well- being. ► ► The Policy Link   A national research and action institute advancing social and economic equity. 23

The Challenge Implementing a comprehensive trauma care system in California – the focus: ► Trauma Registry ► Interoperability of the system ► Federal, state, public, and private partnership - Regionalized approach to care ► Thinking and acting towards prevention 24