University Hospital, others actively fighting trauma designation for Trinitas

Trinitas Regional Medical Center in Elizabeth. (File photo)

Officials at University Hospital in Newark, as well as more than a dozen elected officials in the Newark/Essex County area, are actively fighting the attempt by Trinitas Regional Medical Center in Elizabeth to become a Level II Trauma designated center by sending six letters of opposition to the Department of Health, ROI-NJ has learned.

Individual letters from Newark Mayor Ras Baraka, Newark Municipal Council President Mildred Crump, Assemblywoman Nancy Muñoz (R-Summit) and U.S. Rep. Donald Payne (D-N.J.), as well as a letter signed by 10 elected officials and one from the hospital itself were sent.

The letter signed by Sens. Teresa Ruiz, Ronald Rice and Nia Gill, Assemblymen Thomas Giblin and Ralph Caputo, and Assemblywomen Eliana Pintor Marin, Mila Jasey, Cleopatra Tucker, Shanique Speight and Britnee Timberlake (all Democrats from the Newark/Essex County area) gave the overall position.

“University Hospital advises that, should Trinitas receive a trauma designation, it would cause financial ruin to the hospital and that the hospital would have no choice but to shutter many, if not all, the vital health services it provides to the local community,” the letter said.

The letters were addressed to John Calabria, the director of the Division of Certificates of Need and Licensing at the state Department of Health.

All of the letters were reviewed by ROI-NJ.

University Hospital CEO and President John Kastanis and board Chairman Robert Johnson asked for the Trinitas Level II Trauma application to be rejected in a six-page letter dated April 12.

Kastanis said 87 percent of University Hospital’s caseload comes from a 10-mile radius surrounding Trinitas.

“As the total number of trauma cases in the greater northern region is largely static, any disruption in the trauma network will necessarily trigger a dramatic decline in cases at University Hospital,” the letter said. “Moreover, because the costs of maintaining a trauma center are fixed, University Hospital cannot decrease its expenses to offset the lost revenue.”

Kastanis and other University Hospital officials were not made available for an interview.

In his letter, Kastanis highlighted four main points:

  1. A new trauma designation in northern New Jersey will jeopardize the trauma system of the whole state;
  2. Trinitas fails to demonstrate a need for the designation, and relies simply on recent renovations to the emergency department as justification;
  3. Trinitas doesn’t use any studies or facts to defend a need to add a new Level II hospital to the region;
  4. The state’s legislatively mandated trauma evaluation committee should be given a chance to study the prevalence of and need for trauma sites in the state before the Department of Health considers Trinitas.

Kastanis cited an American College of Surgeons report that stated the current Level I and Level II trauma centers are “well distributed” and that “no reconfiguration or change in number of trauma centers is needed.”

Baraka also provided a letter to support University Hospital, citing, similarly to the coalition of legislators, the Newark Accords that helped to ensure the continuation of a local hospital and health services in exchange for displacing residents from their homes in 1968.

Baraka also stated that a city of more than 280,000 needs a trauma center in its area.

Muñoz serves outside of the Newark/Essex area, but she has a connection to the hospital. Her late husband, Assemblyman Eric Muñoz, was a trauma surgeon and administrator at University Hospital.

Muñoz said in her own letter of support for University that she has “been advised that designating a new trauma center just eight miles from University Hospital could immediately jeopardize the hospital’s ability to maintain the minimum volume of trauma treatment required by its Level I designation.”

Union County does not have one of the state’s 10 designated trauma centers, seven of which are Level II, including nearby Jersey City Medical Center.

Last August, the Department of Health made a request for applications from hospitals in the county.

Trinitas was the only hospital to apply.

Its application must be ruled upon by May 3.

Trinitas CEO Gary Horan recently told ROI-NJ that Trinitas does not feel gaining a Trauma II designation will hurt University Hospital.

“This is not an issue of taking patients from one hospital for Trinitas to benefit,” he said. “We are already seeing these patients. We want the recognition for what we are already doing. That’s a hard argument to say no to.”

Kastanis and Johnson maintain in their letter that much of the reasoning Trintas uses in its application lacks any substance, and instead appears to be a request to justify significant investments recently made in the emergency department.

Horan said the numbers speak for themselves.

“I think they said 1,200 cases are trauma; that certainly is not the bulk of their activity,” he said. “If 20 percent of their trauma (cases) comes from our area, and they lost it all, it would only be 250 cases.

“The chances of that happening are slim because of the cases we send to them because they are a Level 1 trauma center, and a very good one at that.”

Horan has pointed to the population size of other parts of the country, such as Boston.

Boston has a population of roughly 600,000 residents and seven Trauma I and two Trauma II centers.

Union County has a population of more than 500,000.