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 for a May 1, 2022 through April 30, 2030 term, with an option to extend for four years through April 30, 2034; and to make non-substantive changes to the agreement prior to execution.
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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. 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.
On March 22, 2022, the agreement was presented to the Board of Supervisors. During that meeting, the Board directed staff to make revisions to the contract and return to address concerns expressed by neighbors of the Santa Rosa Memorial Hospital.
On April 19, 2022, the revised agreement was presented to the Board of Supervisors. During the meeting, the Board directed staff to make further revisions to the contract that would require Santa Rosa Memorial Hospital to “implement all noise attenuation and air quality improvement measures and recommendations identified in and consistent with the studies and to the extent allowable by law.” Unfortunately, the Hospital was not present during the meeting, and later the Hospital notified CVEMSA that they will not sign the agreement with the Board’s revisions.
CVEMSA and Santa Rosa Memorial Hospital met to discuss the hospital’s concerns with the revisions made by the Board. The hospital expressed concern that the revised language exposed the hospital to an unacceptable level of legal and financial responsibility for issues beyond the hospital’s legal, financial, or technical ability to control or mitigate. CVEMSA worked with the hospital to issue a temporary letter of designation for 30 days so that their licensure would not lapse while CVEMSA and the hospital worked together on proposed alternative language to present to the Board of Supervisors.
As proposed in this Board item, the alternative Agreement language would revised the originally proposed agreement to limit the scope of recommended noise and air quality measures to those that are legally, financially, and technically feasible, as well as require the parties to report to the Board of Supervisors at a noticed public meeting within 120 days of receipt of the studies in order to provide the public an opportunity to comment on the studies and proposed measures. Additionally, the proposed alternative language clarifies the agreement’s provision governing options to extend the agreement and ensures that the approval of any extension of the agreement will comply with all applicable laws, and that all reasonable costs associated with such compliance will be borne by the Hospital.
Discussion:
On March 22, 2022, an agreement with Santa Rosa Memorial Hospital for Level II Trauma Center Redesignation was presented to the Board of Supervisors. During that meeting the Board directed staff to make revisions to the contract and return to address concerns expressed by neighbors of the Santa Rosa Memorial Hospital. Board item materials from March 22, 2022 are provided as Attachment 2.
On April 19, 2022, the revised agreement was presented to the Board of Supervisors. During the meeting, the Board directed staff to make further revisions to the contract that would require Santa Rosa Memorial Hospital to “implement all noise attenuation and air quality improvement measures and recommendations identified in and consistent with the studies and to the extent allowable by law.” Unfortunately, the Hospital was not present during the meeting, and later the Hospital notified CVEMSA that they will not sign the agreement with the Board’s revisions. Board item materials from April 19, 2022 are provided as Attachment 3.
Staff is returning to the Board of Supervisors to recommend approval of the Level II Trauma Services agreement with Providence Santa Rosa Memorial Hospital, provided as Attachment 1. A red-lined version of the agreement is provided as Attachment 4. If approved, the agreement will be executed and the residents, neighboring residents and visitors of Sonoma County will continue to be assured that highly trained and specialized medical care professionals will be immediately available to provide life-saving interventions on patients suffering from acute injuries and illness.
Strategic Plan:
N/A
Prior Board Actions:
On April 19, 2022 the Board approved a revised agreement with Santa Rosa Memorial Hospital for Level II Trauma Center Redesignation for a May 1, 2022 through April 30, 2030 term, with an option to extend for four years through April 30, 2034; and to make non-substantive changes to the agreement prior to execution.
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 |
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|
Fees/Other |
$228,918 |
$179,136 |
$184,510 |
|
Use of Fund Balance |
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|
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Contingencies |
|
|
|
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Total Sources |
$228,918 |
$179,136 |
$184,510 |
Narrative Explanation of Fiscal Impacts:
The proposed agreement 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 - March 22, 2022 Board Materials
Attachment 3 - April 19, 2022 Board Materials
Attachment 4 - Agreement with Santa Rosa Memorial Hospital (Red-Lined)
Related Items “On File” with the Clerk of the Board:
None