November 5, 2001

State of Vermont
Agency of Transportation
National Life Building
Drawer 33
Montpelier, VT
05633-5001

OFFICE OF THE SECRETARY
Brian R. Searles, Secretary
Phone (802) 825-2657
Fax (802) 828-3522

Federal Highway Administration
Office of Transportation Operations
400 Seventh Street S.W.
HOTO
Washington, D.C. 20590

Re: Manual on Uniformed Traffic Control Devices
Request for Permission to Experiment

Dear Ladies and Gentlemen,

The Vermont General Assembly, in 2001 Vermont Acts No. 64, Section 26 (copy attached), has instructed the Vermont Agency of Transportation to work with the Federal Highway Administration (FHWA) to seek approval for the development and implementation of an experimental sign program for Level I Trauma Centers under Section 1A, 10 of the Manual on Uniform Traffic Control Devices (MUTCD).

This legislation was sought by officials at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and the Fletcher Allen Health Care in Burlington, Vermont, who believe that the existing general service sign for hospitals, the White letter "H" on blue background, is inadequate for directing people to the trauma centers.

At a recent hearing before the Vermont House Transportation Committee, officials from both medical centers argued that patients in need of trauma center level care -were being transported by emergency crews to other nearby hospitals that were not certified as Level I Trauma Centers. They argued that the confusion could be clarified by service signs designating their facilities as Level I Trauma Centers.

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Federal Highway Administration
Page 2

Officials from the Dartmouth-Hitchcock Medical Center said patients in need of Level I Trauma Center care have been mistakenly taken to the U.S. Veterans Hospital in White River Junction, Vermont, or the Alice Peck Day Memorial Hospital in Lebanon, New Hampshire. Neither the Veterans Hospital nor the Alice Peck Day Hospital have Level I Trauma Centers.

Fletcher Allen officials argued that patients needing Level I Trauma Center care were taken to the hospital's Fanny Allen Campus several miles away, which does not have Level I Trauma Center status.

At that hearing, Charles Basner, FHWA Division, Administrator for Vermont, explained to legislators the criteria for hospital signs' under the general service sign provisions of the MUTCD, including the language for continuous emergency care capability spelled out in section 2E.51 (general services signs) of the MUTCD.

Physicians from both hospitals explained to the lawmakers the differences in levels of care between Level I Trauma Centers and ordinary hospital emergency rooms. They argued that existing signage directing emergency vehicles to hospitals with emergency room care were not sufficient for Level I Trauma Centers.

They also said that supplemental guide type signs for Level I Trauma Centers in accordance with the legislative directive already were in use in North Carolina, Pennsylvania, and Illinois.

I request FHWA permission to conduct an experimental program that would replace specific standard general service hospital signs with trauma center signs (see attached) at points along Interstate 89 and U.S. Route 7 in the vicinity of Fletcher Allen Health Care in Burlington, Vermont, and along Interstate 89 and 91 in Vermont in the vicinity of Dartmouth-Hitchcock Medical Center, To my knowledge, the proposed signs are not protected by a patent or copyright.

Specifically, we propose to locate trauma center signs at the appropriate intersections along Interstate 89 northbound and southbound, on Interstate 189 southbound, and along U.S. Route 7 (Shelburne Road) south of Fletcher Allen Health Care.

For Dartmouth-Hitchcock, we propose to install trauma center signs on Interstate 89 southbound on the Vermont side of the Connecticut River, and on Interstate 91 northbound and southbound.

I request permission for the experimental program to run for a three-year period beginning with the date of installation of the trauma center signs.

Federal Highway Administration
Page 3

A detailed evaluation plan for monitoring the experiment `will be developed by the Traffic Operations Unit of the Vermont Agency of Transportation in consultation with the FHWA's Vermont Division Office.

If you have any questions please do not hesitate to call me at 802-828-2657

Sincerely,
Brian R. Searles
Secretary of Transportation

BRS/gc Attachments
cc: Mr. Charles Basner, Division Administrator, FHWA
Mr. Frank McDougall, Dartmouth-Hitchcock Medical Center Mr. William Boettcher, Fletcher Allen Health Care

2001 Vt. Acts No. 64 NO. 64 Page 35

(3) include deterioration rates for infrastructure assets: and

(4) determine, long-term, the annual funds necessary to fund infrastructure maintenance at the recommended performance level,

Sec. 25. INFRASTRUCTURE ASSETS CONSTRUCTED WITHIN THE LAST TEN YEARS; MANAGEMENT PLAN

(a) The agency of transportation shall review all transportation
infrastructure a assets that have been constructed within the last 10 years and
develop an asset management plan for those assets. The plan shall include, but
not be limited to:
(1) the costs associated with implementing the plan;
(2) the activities to be undertaken under the plan; and
(3) the comparative cost differential between maintaining the
infrastructure, utilizing a preventive maintenance program versus deferring those maintenance costs.
(b) The asset management shall be presented to the house and senate
committees on transportation no later than January 15, 2002.

* * * Signing for Level I Trauma Centers * *

Sec. 26. ADDITIONAL SIGNING FOR LEVEL I TRAUMA CENTERS

(a) Subject to obtaining the concurrence of the Federal Highway
Administration, the agency of transportation is directed to develop
and implement an experimental program for providing additional sieving for level I
trauma centers including those at the Medical Center Campus at Fletcher

NO. 64, Page 36

Allen Health Care in Burlington and at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire,

(1) For Fletcher Allen Health Care, the additional signing shall be 1-189 northbound.

(2), For Dartmouth-Hitchcock Medical Center t e additional signing shall be provided on 1-91, northbound and southbound, and pa 1-89 southbound.

(b) The agency of transportation shall coordinate its sign installations-with. affected municipalities and with the New Hampshire Department of Transportation.

Sec. 27. IDENTIFICATION OF BAYLEY-HAZEN ROAD

Notwithstanding any provision of law to the contrary_ the agency of transportation shall, by September l . 2001, install and maintain signs at locations close to where the Bayley-Hazen Road crosses US Route 2 and crosses or passes by Vermont Routes-] 4, 15, 16, and 100. The signs shall substantially state: "Bayley Hazen Road Built 1776-1779".

* * * Transportation Funds for Support of Government * * *

Sec. 28. Sec. 38 of No. 156 of the Acts of 2000 is amended to read:
Sec. 38. TRANSPORTATION FUND APPROPRIATIONS

In fiscal year 2003, the maximum amount of transportation funds that may be
appropriated for the support of government,

Click here to view an image of the "Level I Trauma Center, Next Right" sign. Scroll to the last page of the PDF to view image.