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Featured, from left: Robert D. Martínez, MD, Chief Medical Officer/Chief Physician Executive, DHR Health; Carlos Cárdenas, MD, Chairman, Board of Directors, DHR Health; Raúl Barreda, Jr., MD, Trauma Medical Director, Level III Trauma Center, DHR Health; Joe M. Flores, Precinct 3 Hidalgo County Commissioner; Ramón García, County Judge, Hidalgo County; Eduardo “Eddie” Cantú, Precinct 2 Hidalgo County Commissioner; and David L. Fuentes, Precinct 1 Hidalgo County Commissioner. On Tuesday, September 25, 2018, the Hidalgo County Commissioners Court endorsed efforts by DHR Health leaders, the region’s state legislative delegation, and a growing list of other elected governing bodies and private organizations, for a Level I Comprehensive Trauma Center(s) for the Rio Grande Valley, and for improved statewide trauma preparedness.

Photograph By EVANA VLECK


Valley lawmakers ask Gov. Abbott to endorse push for Level I Comprehensive Trauma Center and improved statewide trauma preparedness


When Gov. Greg Abbott was recently in Pharr for the grand opening of the South Texas College Regional Center for Public Safety Excellence, area state lawmakers formally requested his support for another vital resource to help protect the lives and health of an estimated 1.5 million Rio Grande Valley residents.

In a letter signed by the area’s state legislative delegation, and presented to Abbott by Rep. Terry Canales, D-Edinburg, South Texas legislators urged Abbott to help secure state money for a Level I Comprehensive Trauma Center(s) in the Rio Grande Valley, and for improved statewide trauma preparedness.

In general, a trauma center is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergency department without the presence of specialized services to care for victims of major trauma.

A Level I Comprehensive Trauma Center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Trauma Center is capable of providing total care for every aspect of injury.

“Injuries and traumas are the leading cause of death for Texans from 1 to 44 years old. In fact, approximately 40 Texans, more than 14,600 annually, die every day because of traumatic injuries, and for every Texan who dies from a traumatic injury, at least six more are seriously injured (and saved),” Canales stated. “A robust trauma network is especially important in times of disaster, when existing facilities can be forced offline or quickly overwhelmed.”

In addition to Canales, the other Valley state lawmakers who emphasized in the letter to Abbott the need for a Level I Comprehensive Trauma Center(s) for deep South Texas were (in alphabetical order):

• Rep. Ryan Guillén, D-Rio Grande City;
• Rep. R.D. “Bobby” Guerra, D-McAllen;
• Sen. Juan “Chuy” Hinojosa, D-McAllen;
• Rep. Óscar Longoria, D-La Joya;
• Sen. Eddie Lucio, Jr., D-Brownville;
• Rep. Eddie Lucio III, D-Brownsville;
• Rep. Armando “Mando” Martínez, D-Weslaco
• Rep. René Oliveira; D-Brownsville; and
• Sen. Judith Zaffirini, D-Laredo.

Abbott, who was in Pharr on Tuesday, September 18, 2018, is running for reelection to a second four-year term in office and will face Democrat Lupe Valdéz, the former Sheriff of Dallas County, as well as Libertarian candidate Mark Tippetts, a former member of the Lago Vista City Council, in the Tuesday, November 6, 2018 statewide election.


There is no Level I Comprehensive Trauma Center in the Rio Grande Valley, which is a major metropolitan area, even though much smaller population centers in Texas have such life-saving resources, according to Raúl Barreda, Jr., MD, Trauma Medical Director for the Level III Trauma Center at DHR Health.

“Tyler, with a 300,000 population, has a Level I and Level II trauma center. Killeen-Temple, with a combined population of 400,000, has a Level I and Level II trauma center. Lubbock, with 300,000 residents, has a Level I and Level II trauma center, and an additional Level II center. We (Hidalgo County) have a population of 900,000 people.”

According to the most figures by the U.S. Census Bureau, as of July 2017 – more than one year ago – the estimated population of the Rio Grande Valley was 1,370,424 (Hidalgo County: 860,661; Cameron County: 423,725; Starr County: 64,454; and Willacy County: 21,584).

Like the Houston region, the four-county Rio Grande Valley and the counties along or near the Gulf Coast north of the Valley and north and west of Corpus Christi, each year face the real possibility of significant threats to life and property due to tropical storms, hurricanes, and other inclement weather events.

“Tyler, Killeen-Temple and Lubbock are not along the Texas Gulf Coast,” he continued. “Why do we not have a Level I center in Hidalgo County?”

Barreda’s observations came on Tuesday, September 25, 2018, when he, Robert D. Martínez, MD, Chief Medical Officer/Chief Physician Executive, DHR Health, and Carlos Cárdenas, MD, Chairman, Board of Directors, DHR Health, addressed the Hidalgo County Commissioners Court during its public meeting in Edinburg.

In response to Barreda’s, Martínez’ and Cárdenas’ appearance and presentations, the county judge and county commissioners approved a Hidalgo County resolution endorsing efforts by DHR Health leaders, by the region’s state legislative delegation, and a growing list of other elected governing bodies and private organizations, for a Level I Comprehensive Trauma Center(s) for the Rio Grande Valley, and for improved statewide trauma preparedness.


Cárdenas thanked the county leadership for their united support, noting how deep South Texas over the years has been transformed from a predominantly rural agricultural area into the most populous Texas region along the border with Mexico.

“I stand before you – the three of us, local physicians born and raised here – and can remember a time when you could see spots between communities because of lack of lights when I was growing up,” Cárdenas recalled. “Today, we are a sea of lights from Brownsville all the way to Rio Grande City. We are 1.5 (one point five) million people. We are 240 miles away from the nearest Level I trauma center in San Antonio. The next one after that is in Houston – 350 miles away to a Level I trauma center. One and a half million people (in the Rio Grande Valley) deserve a Level I trauma center, and we thank you for passing the resolution today.”

DHR Health’s push for state funding also would benefit the Trauma Network in the State of Texas, which is made up of 288 designated trauma hospitals, first responders, and emergency medical service providers.

The Trauma Network in the State of Texas is comprised of 22 regions and includes 18 Level I Comprehensive Trauma Centers, 21 Level II Major Trauma Centers, 56 Level III Advanced Trauma Centers, and 193 Level IV Basic Trauma Centers.

Barreda noted that the need for a Level I Comprehensive Trauma Center(s) for the Rio Grande Valley is based on high and unbiased standards set by the American College of Surgeons, a prestigious nationwide institution that, among its many duties, verifies the resources available at a hospital trauma center.

“The American College of Surgeons recommends a Level I and Level II trauma center for every million people in population. Trauma centers become verified by the American College of Surgeons to make sure they are filling out criteria, protocol, and that they save lives,” Barreda explained. “Nothing there is political, everything is merit-based. If you are good and you do a good enough job, and you have the facilities, then you earn it.”


Money is proposed to come from the Hurricane Harvey Supplemental Funding Package to create a grant program, administered by the Texas Department of State Health Services, that would provide trauma centers with the needed resources to invest in strengthening the trauma network statewide.

Last year, on Friday, September 8, 2018, President Trump signed federal legislation to provide billions of dollars to help communities, including those in Texas hard-hit in late August 2017 by Hurricane Harvey, which narrowly missed the Rio Grande Valley.

“With that (near-strike by Hurricane Harvey), we must be more aggressive in obtaining our funds,” Barreda said. “These funds are to make the trauma centers in Texas unified and equal. That way, if one goes down, the other ones can pick up the slack, and it is like fingers acting on a hand. We need that so they all work together.”

It is the threat of weather disasters such as Hurricane Harvey that also justifies the need for a Level I Comprehensive Trauma Center(s), and not just for the benefit of the Rio Grande Valley.

“The Trauma Network identified glaring holes after Hurricane Ike (in September 2008) hit the Houston area. They said, ‘You need to do this, you need to do this, you need to do this.’ They shored everything up,” Barreda reported. “When (Hurricane) Harvey hit (in 2017), there were four Level I trauma centers between Galveston and Houston, and two of those went down. The Level I trauma center at The University of Texas Medical Branch in Galveston and at Ben Taub Hospital in Houston were flooded. The other two were overwhelmed and they could not care for the people that needed it done.”

The University of Texas Health Science Center at Houston and Texas Children’s Hospital in Houston are the two other Level I Comprehensive Trauma Centers in Houston.

“For those reasons, the American College of Surgeons and the Trauma Network is recommending these actions take place preventively before the next disaster hits, especially shoring up the Gulf Coast – the Rio Grande Valley and the Corpus Christi area,” Barreda said. “If we are hit in these areas, we are cut off from everything else, with no help.”


DHR Health’s Martínez praised the growing list of elected governing bodies in deep South Texas which already have thrown their support behind the legislative effort that would lead to a Level I Comprehensive Trauma Center(s) in the Rio Grande Valley.

“The Cameron County Commissioners Court, the Starr County Commissioners Court, and the Willacy County Commissioners Court, in addition to the Hidalgo County Commissioners Court, have approved respective resolutions in support of this undertaking, which has become one of the major state priorities for deep South Texas for the upcoming regular session of the 86th Texas Legislature,” said Martínez.

Also – as of late October 2018 – the cities of Alamo, Edinburg, Elsa, McAllen, Mission, Pharr, San Juan, and Weslaco have publicly endorsed the call for a Level I Comprehensive Center(s) for the Rio Grande Valley.

“We are in an excellent position to succeed, not only because we have an outstanding state legislative delegation and because all of Texas stands to benefit, but because our cause is right and just,” Martínez said.

Martínez said the region’s state lawmakers understand the importance of upgrading the state’s trauma center capabilities.

“This issue is especially of interest to the Rio Grande Valley delegation given our location along the Gulf Coast. Of the top nine most populated regions in the state, only the Rio Grande Valley lacks a Level I trauma center,” Martínez quoted the lawmakers’ letter to the governor. “While the Rio Grande Valley was spared the worst of Hurricane Harvey, the next big storm could hit our area. We owe it to our constituents to be ready and make the necessary investments in our trauma system before disaster strikes. Strengthening our network by providing funding for critical infrastructure and increased capacity would save many additional lives.”

Cárdenas and Barreda shared Martínez’ determination for bringing a Level I Comprehensive Trauma Center(s) to deep South Texas.

“Will a local hospital become Level I? Yes. We will move forward for Level I with or without funding from the state,” Barreda predicted. “But if the Rio Grande Valley can have a voice and obtain funding to become EMS (Emergency Medical Services) and trauma centers equal to the rest of the state, then that is what we are asking for you to aggressively support.”


For more information, please contact Roberto Haddad, Vice President and Counsel for Government Affairs and Policy at DHR Health, or Jesse Ozuna, Government Affairs Officer at DHR Health, at 956/362-7165.  For more on this and other Texas legislative news stories which affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature.

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