Come Nov. 2, Georgians will have to decide if they are willing to tack an additional $10 to their annual car registration fees to support expanding the state's trauma care network.

"The No. 1 cause of trauma in Georgia is car crashes; however, trauma injuries can happen in a variety of ways," said Deb Battle, Northeast Georgia Medical Center Trauma Program manager. "Trauma can occur from situations like falling off a four-wheeler or having a workplace accident."

In 2007, the Georgia General Assembly established the Georgia Trauma Care Network Commission to create a statewide trauma system and to administer trauma funds appropriated annually.

In 2009, the commission came up with a five-year plan to not only increase the number of trauma care centers in the state — currently there are 16, and experts say we need at least 30 — but to also devise potential funding sources.

According to the plan, the best funding source is one that is "trauma-related, sustainable and expands with population growth." Since motor vehicle crashes account for many trauma injuries, an annual $10 fee per vehicle is an ideal funding source, the commission says.

If voters approve the amendment to the state constitution, officials expect the initiative to raise about $80 million annually. The amendment specifies the fee would be deposited monthly into a trauma trust fund and would be used only for the trauma network. Additionally, the money would remain in the account, not roll over to the state's general fund, at the end of each fiscal year.

"This isn't just paying hospitals to take care of trauma patients; it's paying for the additional equipment and education for staff," said Dr. Priscilla Strom, a general surgeon with The Longstreet Clinic and the medical center's trauma services director.

"Part of being a designated trauma care center is having the proper people who are trained to handle trauma cases and the necessary equipment and facilities available 24/7.

"One of the big things that the commission is looking to do is develop an integrated trauma system, so there is consistency from county to county. We need statewide EMS protocols about deciding who needs to go to what hospital, so that we don't overwhelm the trauma facilities we do have."

While the medical center can handle certain trauma cases, it is not a designated trauma care center. There are four different types of trauma centers, from level one to level four - with level one being the highest. In order to be an official trauma care center, facilities must meet specific criteria and be certified by the Georgia Department of Human Resources.

For example, to be considered a level one trauma care center, facilities must be able to handle any time of trauma case and must also be a teaching facility for medical students.

The closest trauma centers to Hall County are the Gwinnett Medical Center and Grady Memorial Hospital in Atlanta.
Six of the state's 16 trauma care centers are found primarily in the metro Atlanta area, which is good news if you get injured near one of them but not so good if you happen to be located in the southern half of the state. Once you travel below Bibb County, there are only three designated trauma care centers: one each in Chatham County, Thomas County and Muscogee County.

"We're a very mobile society. We live, play and work throughout the state," Battle said. "If you're driving towards the mountains, or out towards Hilton Head Island, there are very limited trauma care resources."

Proximity to a trauma care center can make the difference between life and death. For optimal survival outcomes, medical officials say it's important that individuals with a traumatic injury get to a facility within an hour - 30 minutes for children.

"It's important for people statewide to have good access to trauma care," Strom said. "There aren't a lot of trauma care centers in the southwest and southeast portions of the state. That's something people need to think about, especially if they plan on doing any traveling."

Not everyone is in favor of the proposed amendment.

"Last year, (the legislature) passed the super speeder law and added an additional (fee) to speeding fines," said Brett Bittner, operations director for the Libertarian Party of Georgia. "Revenue from that has fallen short of what they expected and this seems to be a second attempt to make it happen.

"Even if the money is used just for trauma care, we haven't seen any plans about how the money will be spent. In terms of raising taxes and additional fees, we're going to oppose them because we feel like (the government) should be able to do what they need to with the money that's already being raised through other forms of taxation and fees. We're already overtaxed at all levels of government as it is."

While the state's Libertarian party opposes raising taxes and fees, medical officials say it's important to find a way to fund improvements to the state's trauma care network.

"Taking care of trauma patients is very expensive. It's like that fire truck parked in a bay at the fire station. You may not need it often, but it has to be ready 24/7 just in case," Battle said.

"It's the same with trauma care. You have to have all those players and all that equipment standing by. An improved trauma care network means better outcomes. It means that no matter where you are hurt in Georgia, you can get access to quality trauma care."