AUGUSTA — Central Maine Medical Center will continue to receive trauma patient transfers from area hospitals who do not require neurosurgery services, as recommended by the Maine EMS Trauma Advisory Committee on Tuesday.

The committee additionally directed a subcommittee to review the Maine EMS Trauma System Plan and suggest revisions.

The recommendation, which was narrowly approved by a 10-9 vote, was counter to the recommendation of a subcommittee that met last week. It encouraged the Trauma Advisory Committee to discontinue all trauma patient transfers from area hospitals to CMMC in Lewiston.

The subcommittee and Trauma Advisory Committee agreed that the trauma systems plan needed revision.

Officials from Central Maine Healthcare, the parent company of CMMC, hailed the recommendation.

“Now more than ever, as hospitals statewide grapple with capacity constraints, it’s vital that patients receive appropriate and timely trauma care services unburdened by unnecessary additional travel,” said Dr. Steven Littleson, president and CEO of Central Maine Healthcare. “Today’s vote affirms that the experience and expertise of our trauma care team are integral to a robust statewide trauma system.”

Earlier in December, officials from Central Maine Medical Center announced the hospital is ending its neurosurgical trauma program, one of just three in the state. Central Maine Medical Group President Dr. Jason Krupp previously cited the hospital’s inability to hire neurosurgeons as the primary reason.

The other two hospitals with neurosurgical trauma programs are Maine Medical Center in Portland and Eastern Maine Medical Center in Bangor.

Neurosurgical trauma care encompasses brain injuries, spinal cord injuries, skull and spinal fractures, brain bleeds and other conditions.

At the Tuesday meeting, state EMS Director Dr. Sam Hurley cautioned the committee against explicit language which bars transport between hospitals. Such a directive may pose liability concerns for hospitals under the federal Emergency Medical Treatment and Labor Act, which states that hospitals with specialized capabilities must accept transfers from hospitals which do not have the ability to treat patients with unstable emergency medical conditions.

Although CMMC is closing its neurosurgical trauma program, it continues to maintain its general and orthopedic trauma programs.

Hurley said the committee could instead strongly discourage trauma patient transfers to hospitals without neurosurgical trauma services, like CMMC.

Several members of the committee, including Dr. Richard King, a general trauma surgeon at CMMC, expressed concerns that barring all trauma patient transfers was unnecessary and could pose problems for smaller hospitals.

“We still have capacity problems in Maine,” King said, “therefore, I think it behooves everyone on the part of the people in the state to continue to provide robust trauma care at centers that are capable of doing it,” including CMMC.

Chris Costello, a registered nurse from Mount Desert Island Hospital representing the Maine Hospital Association, agreed with King and others who expressed concerns for hospital capacity.

“We are keeping people that we would normally not keep,” she said. “There is definitely a capacity issue where we are having to sit on people for days where we never, ever would ever keep previously.” From a small hospital point of view, she said she is not comfortable limiting the facilities where patients can be transferred.

In a conversation following the meeting, Rick Petrie, Trauma Advisory Committee chairman and chief operations officer for Northeast Mobile Health, said he believes that hospital is capable of providing adequate trauma care for patients who do not require neurosurgical services.

“The reality of it is, when you have a trauma patient, time is everything,” he said. “I’m not talking about someone who has a sprained ankle. I’m talking about the motor vehicle accident where someone is critically ill, or the fall, or the shooting, or the stabbing, something like that where someone is critically injured. The management of the trauma patient is a very complex process, and those patients really need to be cared for by not only physicians, but a team of people at the hospital that know how and have experience with managing those patients.

“They have the resources to care for the patients, other than the neuromeds,” he added.

However, many members did not approve of the Trauma Advisory Committee’s recommendation. Dr. Matthew Sholl, the Maine EMS medical director, said he was concerned that the recommendation did not specify how area hospitals should determine which patients require a neurosurgical consult on hand and those who do not.

A subcommittee will also review the Maine EMS Trauma System Plan and recommend revisions which reflect changes in Maine’s health care system since the document was written in 1996.

Committee members have previously expressed concerns that the plan does not account for the severe strain health care providers face during the COVID-19 pandemic, nor does it address level three trauma certified hospitals.

CMMC is certified as a level two trauma center by the American College of Surgeons, however it will soon be changed to level three to reflect the loss of its neurosurgical trauma program. The American College of Surgeons certifies trauma centers on a scale of one to three, from the highest level of trauma coverage to the lowest. A level two certification, which EMMC also has, requires neurosurgical coverage. Maine Medical Center is a level one trauma center.