ANNAPOLIS -- The state agency that provides radio communications and training for medics in Maryland's nationally renowned shock-trauma system must slash its budget by nearly two-thirds by next July.
Known as the Emergency Medical Services System, the agency is the electronic and human support structure for the widely copied Maryland procedure for getting gravely injured people to hospitals within the so-called golden hour -- when their lives can still be saved.
The cuts in the EMS System came to light this week two days after two medevac helicopter bases were closed entirely and all medevac services were suspended between 3 a.m. and 7 a.m. as part of efforts to reduce state spending by $450 million this fiscal year.
Dr. Douglas J. Floccare, the state's aeromedical director, said there was no question that deaths will result if the cuts are not restored. He cited a study of the period between July 1, 1990, and June 30, 1991, showing a total of 254 helicopter patient transports. Most of the victims were picked up at the scenes of highway accidents.
"We found that 82 of the 254 had such severe problems with breathing, blood loss or brain function that they really had only a 'golden few minutes,' " he said yesterday.
The EMS cuts apparently will not directly affect the physicians or surgeons at the trauma centers. But they do threaten the medical training and certification system that is designed to maintain the program quality while providing what physicians say is vital pre-hospital care that begins as soon as a helicopter or ambulance arrives at an accident scene.
"The governor is aware of the cuts [at EMS]," said Raymond C. Feldmann, an assistant press secretary. "Obviously he's concerned, but he recognizes it may have to happen."
Mr. Feldmann said a cut of 63 percent -- far higher than most reported in other agencies -- is a reflection of how little flexibility exists for budget-cutting because of mandated spending in such areas as education and health -- and because the deficit that must be accounted for next fiscal year is $500 million to $700 million.
Meanwhile yesterday, the impact of Gov. William Donald Schaefer's deep spending cuts continued to reverberate. For the third straight day, groups chanted, lobbied and held protest signs on the State House steps.
"We'll Be Safer Without Schaefer," one banner read.
The governor and legislative leaders were to meet today for a discussion of the budget-reduction plan, as various groups come forward with a solution to the troopers' problems and others.
Lt. Gov. Melvin A. Steinberg, who has said he disagrees with the process by which Mr. Schaefer made his budget-balancing cuts, told the troopers yesterday that "rational people" could find a way to save the troopers' jobs without raising taxes or doing further damage to the budget -- and without new taxes.
A spokeswoman for Mr. Schaefer, Daryl C. Plevy, called ideas for solving the trooper problems "a short-term response" to a minuscule part of the problem.
"The governor is more than willing to discuss alternatives, but he feels we still need to look at the big picture -- at what is happening to the economy -- and not take one little piece and solve it and tell them everything will go away, because it won't," she said.
Both houses of the legislature recessed until Tuesday, when they will reconvene to consider the still-unresolved issue of congressional redistricting -- and, perhaps, to address some of the increasingly difficult budget-reduction issues.
Dr. Akeem Ramzy, the EMS director, said he knew nothing of the hit impending in his agency until Thursday.
In fiscal 1991, his budget was $7.3 million. This year's budget was $6.8 million. But that figure was reduced by almost $1 million in the most recent round of cost-cutting at the University of Maryland at Baltimore, under which EMS operates.
And Thursday, Dr. Ramzy was told he must plan a further reduction so that his spending is at the level of $2.5 million a year by next July.
"I acknowledged the information," Dr. Ramzy said, "but I can't accept it because for all practical purposes it may mean the end of the system in the state."
Dr. Ramzy said he was "aghast" at a decision made without his input that would appear to involve important "public policy issues."
The University of Maryland at Baltimore issued a statement yesterday confirming the cuts had been made.
"Every attempt has been made to preserve the essential communication function of the emergency medical system during this difficult process," the university said. "However, the training function will be severely affected. As the situation now stands, layoffs may become unavoidable.
"We hope that somehow resources will become available to turn this situation around."
There are 82 employees on the EMS staff.
The University of Maryland's Shock Trauma Center was started as a two-bed experiment in 1961 by Dr. R Adams Cowley, who was a pioneer in reducing what he considered to be the necessary deaths of accident victims.
The center, which is visited by physicians from throughout the world, built a $44 million, 138-bed facility in downtown Baltimore named after Dr. Cowley in 1989.