To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Emergency Medical Services Level II Trauma Center Redesignation Agreement with Santa Rosa Memorial Hospital
End
Recommended Action:
Recommended action
Authorize the Director of Health Services to execute an agreement with Santa Rosa Memorial Hospital for Level II Trauma Center Redesignation.
end
Executive Summary:
Pursuant to state law, the County of Sonoma Emergency Medical Services (EMS) Agency is responsible for oversight and regulation of the local EMS system. The Board of Supervisors has designated the Sonoma County Department of Health Services as the local EMS Agency for Sonoma County and authorized agreements for EMS administrative services with Mendocino County. This two-county regional organization is formally known as the Coastal Valleys Emergency Medical Services Agency (CVEMSA).
The CVEMSA trauma care program serves to ensure an organized system of medical care for critically injured patients in Sonoma and Mendocino counties. The program includes designation and regulatory oversight of trauma centers that provide high-level definitive medical care and rehabilitation services. This item requests approval of an agreement with Santa Rosa Memorial Hospital for the County to accept revenue for trauma center designation and regulatory oversight for an initial eight-year term from May 1, 2022 through April 30, 2030. CVEMSA has an option to extend the term of the agreement for an additional term of four years through April 30, 2034.
Santa Rosa Memorial Hospital has provided designated Level II trauma services to Sonoma County residents, visitors, and patients for over 30 years. The hospital’s current designation as a Level II Trauma Center expires on April 30, 2022. CVEMSA confirms that Santa Rosa Memorial Hospital meets all state and local trauma center criteria and recommends approval of the proposed agreement to ensure that the life-saving trauma care services continue.
Discussion:
Trauma care is a key component of the regional Emergency Medical Services (EMS) system. The trauma care program’s goal is to ensure an organized system of medical care for critically injured patients and includes the designation of trauma centers that provide high-level definitive medical care and rehabilitation services. Santa Rosa Memorial Hospital was originally selected for designation as a level II trauma center following an extensive multi-year process that began in 1998 and concluded in 2000. This process involved release of a request for proposals (RFP), receipt and evaluation of responses, and the preparation of an Environmental Impact Report. Specifically, the County evaluated qualifications of the hospitals by using an outside team of trauma care experts to review the quality of medical care and trauma services. Upon conclusion of the RFP process and the environmental study, Santa Rosa Memorial Hospital (SRMH or Hospital) was selected and designated as a level II trauma center in 2000. The Hospital was re-designated in March 2010. Its current designation expires at the end of April 2022. The terms of the initial and subsequent designations were contingent upon periodic reviews by the American College of Surgeons (ACS) and maintenance of ACS verification of meeting level II trauma center standards. Santa Rosa Memorial Hospital has consistently maintained the required ACS verification and conditions stipulated in the terms of the Conditions of Designation established by CVEMSA.
In anticipation of the expiration of the current designation at the end of April 2022, CVEMSA staff have met over the past year with representatives of the Hospital and other healthcare/hospital personnel in the region to assess the options for re-designation of SRMH and/or determine if any other hospital was interested in seeking that designation. Throughout those meetings, no hospital other than Santa Rosa Memorial has indicated a desire to provide level II trauma center services. CVEMSA staff have also had outreach to and met with interested citizens, including those who live near the Hospital. Some citizens expressed concerns over existing operational noise associated with some medi-vac helicopter flight paths, but generally supported continuation of the Hospital’s level II trauma center designation to ensure continued availability of critical emergency care and response capabilities for the community. Caltrans regulates helicopter flight paths, which are beyond the scope of the proposed agreement and CVEMSA’s authority. Nevertheless, staff reached out to Santa Rosa Memorial Hospital to invite them to work with and develop a response to neighbors who have expressed complaints and concerns related to existing operation of the hospital, particularly related to noise from helicopter flights, if possible. At the time this staff report was produced, no update was available on the hospital’s progress in this regard.
Overall, uninterrupted continuation of SRMH’s existing services and designation as a level II trauma center will prevent or mitigate the loss of or reduction in existing local emergency response capabilities critical for the public health, safety, and welfare. For these reasons, CVEMSA staff propose a continued agreement with Santa Rosa Memorial Hospital so that the Hospital will maintain its long-standing designation as a level II trauma center in accordance with the terms and provisions of the agreement.
More specifically, the provisions of the proposed agreement include the following: 1) providing the scope of services consistent with state laws and regulations and CVEMSA policies for level II trauma centers; 2) providing appropriately trained and qualified medical professionals and associated critical care/trauma services; 3) continued compliance with the mitigation plan developed through the environmental impact study in 2000; 4) maintaining ACS verification as a level II trauma center; and 5) continued participation in the regional trauma audit oversight program.
The proposed agreement also requires the Hospital to pay fees to cover CVEMSA’s costs associated with re-designation (one-time fee of $55,000) and administering the trauma center program (no more than $173,918 annually, subject to a cost of living adjustment). There is no net county cost associated with the requested action.
Approval of the agreement is a project that is exempt from compliance with the California Environmental Quality Act under 14 CCR 15269(c)) the statutory exemption for emergency projects, as the time that it would take to preform environmental review of the contract extension would extend beyond the term of the exiting contract, causing it to lapse and leaving two counties and the region as a whole without vital trauma service capabilities needed to respond to medical crisis and emergencies; and separately under 14 CCR 15301, the categorical exemption for continued operation of existing facilities where there will be no or negligible expansion of use, and where there no exceptions to the categorical exemption apply. The proposed extension would continue operation of the same hospital, under the same or similar terms, to ensure there is no break in essential trauma services.
Strategic Plan:
N/A
Prior Board Actions:
On March 16, 2010 the Board approved an agreement with Santa Rosa Memorial Hospital for Level II Trauma Center services.
April 21, 1998 - EMS Agency report on trauma center Request For proposals and Designation process.
Fiscal Summary
|
Expenditures |
FY 21-22 Adopted |
FY 22-23 Projected |
FY 23-24 Projected |
|
Budgeted Expenses |
228,918 |
179,136 |
184,510 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
228,918 |
179,136 |
184,510 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
|
|
|
Fees/Other |
228,918 |
179,136 |
184,510 |
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
228,918 |
179,136 |
184,510 |
Narrative Explanation of Fiscal Impacts:
The proposed agreement also requires the Hospital to pay fees to cover CVEMSA’s costs associated with re-designation (one-time fee of $55,000) and administering the trauma center program (no more than $173,918 annually, subject to a cost of living adjustment). There is no net county cost associated with the requested action. There are sufficient appropriations for FY 21-22 and the expenses for FY 22-23 will be included in the recommended budget.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Agreement with Santa Rosa Memorial Hospital
Attachment 2 - Community Meeting Questions and Responses - January 24, 2022
Attachment 3- Presentation
Related Items “On File” with the Clerk of the Board:
None