Don't ask Ben Hinson why he serves on the state trauma commission without expecting him to break your heart.

Hinson, a paramedic who owns an EMS company, has seen the hard truths of trauma care in Georgia.

Georgia's system of trauma care is in crisis, said state researchers. The state death rate for trauma victims is 20 percent higher than the national average. If Georgia met the average, 700 lives would be saved yearly, the researchers said.

Hinson, president of Mid Georgia Ambulance Service in Macon, sees it more personally.

"Have you ever had to pull a little girl out of a car wreck? Have you ever had to tell her mother she's dead? I have," he said. "My goal is to help that little girl make it from [age] 10 to 11."

The Georgia Trauma Care Network Commission recently received $58 million in state money to distribute to doctors, hospitals and emergency medical service crews across the state that specialize in emergency trauma care for the most severe injuries.

The funding represents the first major infusion of state cash to support these providers, many of whom lose money — often millions — providing trauma care. That's care primarily for auto accidents, stabbings, shootings and bad household accidents. Trauma care is expensive because it requires advanced medical equipment and specialist surgeons ready around the clock.

Like an EMS crew rushing to save an accident victim before time runs out, the commission is rushing to beat a July 1 deadline to distribute the money. That date marks the new state fiscal year, and if the commission doesn't meet the deadline, it could lose the money.

The tough part for the commission is to fairly calculate how much to give each hospital, EMS and doctor. The difficulty of the task may only be matched by its importance. Considering the sad state of trauma care in Georgia, $58 million is only a stopgap measure, intended more to shore up a fragile system than to expand it.

"We're just trying to tie a knot in the rope, and hang on," Hinson said.

The commission was formed by the Legislature two years ago, but only started meeting late last year.

Gov. Sonny Perdue allocated the millions for trauma care only a few months ago and the commission must gather data on a few hundred providers' costs.

Virtually all 15 Georgia hospitals that specialize in trauma care lose money providing the service. Grady Memorial Hospital, which provides the most trauma care and the most uncompensated care, lost $40 million last year on such care.

Power over the money has thrust the formerly obscure trauma commission to center stage on a issue rife with urgency, a sense of crisis and politics galore.

A frenzy of worries

Some advocates worry politics will worm its way into the commission's work. Some question whether the state funding is a veiled effort to bail out distressed Grady; others that politics will work against the Atlanta hospital that caters largely to minorities and the uninsured.

The nine-member trauma commission — a group of specialists from hospitals and EMS services across Georgia — is promising an objective look at costs and a fair distribution of the money. It is expected to announce the breakdown of funding Monday at its next meeting.

The one-time infusion of $58 million remains the sole state funding for trauma care. Political infighting in this year's legislative session scotched a separate plan to provide $74 million annually for trauma care.

Advocates say the $58 million is a step toward putting trauma care on equal footing with police and fire response.

"We've been trying to design a trauma system for 27 years, and this is the first major step forward we've seen," said Dr. Pat O'Neal, director of the office of preparedness within the state's Division of Public Health.

Hospitals desperate for increased trauma funding are providing piles of paperwork to the commission, hoping to score big money.

Children's Healthcare of Atlanta, trauma care provider for children at Scottish Rite and Egleston, hopes for about $3 million, said Linda Cole, a commission member and vice president of trauma and emergency services for Children's Healthcare.

Cole worries about trauma care as a commissioner and a mother. Across wide swaths of Georgia, particularly in rural areas, a car accident victim could be 90 minutes from a trauma center.

"I worry when my kids head back to college," she said.

The distance between trauma hospitals in metro Atlanta — there are four in addition to the two children's hospitals — along with its traffic problems, frustrate efforts to provide care within the critical first hour after a severe injury.

About half the trauma care in metro Atlanta is performed at hospitals that are not designated trauma centers, meaning many people are not getting the care they need, O'Neal said.

Early in its analysis, the commission realized it could not account for every dollar spent on trauma care in the state of Georgia.

Beyond the 15 trauma hospitals, the commission is charged with calculating costs and providing money to a few hundred EMS firms and doctors who specialize in traumatic injuries. The commission has no executive director or staff.

A California consultant on trauma costs, Bishop and Associates, was brought in to crunch the Georgia data. Defining trauma costs proved daunting.

How does the commission calculate how much of that CT scanner is used for trauma care, vs. standard emergency room work?

"There are tons of gray areas," Cole said.

Going by the numbers

In the end, the commission will depend to a degree on averages and estimates, members said.

The nine commission members were appointed by the governor, lieutenant governor and speaker of the House. All members are professionally involved in medicine, trauma care or emergency response. Four are from metro Atlanta, three from Macon and one each from Rome and Thomasville. Three members — Hinson of Mid Georgia Ambulance, Dr. Joe Sam Robinson of Georgia Neurosurgical Institute in Macon, and Kurt Stuenkel of Floyd Medical Center — have contributed thousands of dollars to political candidates, including the state officials who appointed them to the commission.

Trauma commission members say they are steering clear of politics. Still, commission Chairman Dennis Ashley acknowledged he has briefed the governor's office on the commission's work and received feedback.

"He's the man who put the money in the budget," Ashley said. "We would want the governor to be happy with what we do."

Such talk "heightens my anxiety," said Sen. Vincent Fort (D-Atlanta), a longtime advocate for Grady Hospital. "I didn't see that as one of the criteria — making the governor happy."

Commission member Robinson, president of the Georgia Neurosurgical Institute, said the commission will be even-handed.

"We're going to spend this money appropriately," Robinson said. "We want to minimize the state's trauma death rate."

The commission's work focuses on this one-time funding, but its analysis and funding formulas could form the model for the distribution of any future trauma money.

If they do a good job, members hope the Legislature will be more inclined toward future funding.

Hinson, a commission member, feels the pressure.

"If we don't hit a home run, we may not get any more money," he said.

Staff writer James Salzer contributed to this report.