REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 11, 2025
FROM
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency
ANDREW GOLDFRACH, Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Emergency Medical Services Pediatric Trauma Fund Disbursements
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of the Inland Counties Emergency Medical Agency:
a. Approve Memorandum of Understanding with San Bernardino County for distribution of the Emergency Medical Services Pediatric Trauma Fund to Arrowhead Regional Medical Center in the amount of $300,000, for the period of July 1, 2025 through June 30, 2028.
b. Approve Contract with Loma Linda University Children's Hospital for distribution of the Emergency Medical Services Pediatric Trauma Fund in the amount of $500,000, for the period of July 1, 2025 through June 30, 2028.
c. Approve Contract with Hi-Desert Medical Center for distribution of the Emergency Medical Services Pediatric Trauma Fund in the amount of $100,000, for the period of July 1, 2025 through June 30, 2028.
d. Approve Contract with Providence St. Mary Medical Center for distribution of the Emergency Medical Services Pediatric Trauma Fund in the amount of $100,000, for the period of July 1, 2025 through June 30, 2028.
2. Acting as the governing body of San Bernardino County, approve revenue Memorandum of Understanding with the Inland Counties Emergency Medical Agency for distribution of the Emergency Medical Services Pediatric Trauma Fund to Arrowhead Regional Medical Center in the amount of $300,000, for the period of July 1, 2025 through June 30, 2028.
(Presenter: Daniel Muñoz, Interim EMS Administrator, 388-5807)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). It will allow the Inland Counties Emergency Medical Agency (ICEMA) to distribute the Emergency Medical Services (EMS) Pediatric Trauma Fund balance, on a reimbursement basis, to Loma Linda University Children's Hospital (LLUCH), Arrowhead Regional Medical Center (ARMC), Hi-Desert Medical Center (HDMC) and Providence St. Mary Medical Center (SMMC) in the amounts listed below.
|
Hospital |
Trauma Designation |
Amount |
|
LLUCH* |
Level I |
$500,000 |
|
ARMC |
Level I |
$300,000 |
|
HDMC |
Level IV |
$100,000 |
|
SMMC |
Level IV |
$100,000 |
* Pediatric specialty hospital
Allocations were based on patient volume, Trauma designation level, and pediatric capabilities.
Sufficient appropriation and revenue will be included in ICEMA and ARMC’s 2025-26 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
ICEMA is requesting to enter into a Memorandum of Understanding with ARMC and contracts with LLUCH, HDMC, and SMMC, designated Trauma Centers in the County, to allow for the distribution of the EMS Pediatric Trauma funds.
On January 9, 2007 (Item No. 69), the Board of Supervisors (Board) adopted Resolution 2007-02, which implemented Senate Bill (SB) 1773, allowing the County of San Bernardino to collect an additional $2 for every $10 or fraction thereof, upon various fines, penalties, and forfeitures for primary moving violations. This additional fine levied is designated for purposes of supporting EMS. A portion of the additional fine is more specifically to be used to support pediatric trauma services. SB-1773 sunset on January 1, 2009, but was reauthorized through SB-1236.
On January 6, 2009 (Item No. 46), the Board adopted Resolution 2009-01, which implemented SB-1236, which extended the authority of SB-1773. SB-1236 legislation sunset on January 1, 2014, but was reauthorized through SB-191.
On December 17, 2013 (Item No. 36) the Board adopted Resolution 2013-250, which implemented SB-191, which extended the authority of SB-1236, extending the sunset date to January 1, 2017.
On June 11, 2019, (Item No. 25) the Board adopted Resolution 2019-83, which implemented SB-867, which extended the authority of SB-191, extending the sunset date to January 1, 2027.
The funds collected are held in trust in the EMS Pediatric Trauma Fund and were last approved for distribution to ARMC and LLUMC by the Board on July 9, 2019 (Item No. 52). ICEMA will transfer the designated funds from the EMS Pediatric Trauma Fund to the ICEMA operating budget for 2025-26.
On May 7, 2024 (Item No. 60), the Board approved extensions of trauma designation agreements with LLUCH, ARMC, and HDMC and a new trauma designation agreement with SMMC, all with terms through June 30, 2027, with one three-year extension option, to provide trauma services within the County. As designated Trauma Centers, LLUCH, ARMC, HDMC, and SMMC provide data to ICEMA regarding the treatment of trauma patients, including pediatric trauma. Although LLUCH is the designated pediatric trauma center, all trauma centers are required to be capable of providing pediatric trauma care.
The expenditure of the pediatric trauma funds is limited to the reimbursement to physicians, surgeons, and hospitals for patients who do not make payment for pediatric emergency care services in hospitals up to the point of stabilization; to hospitals for expanding the services provided to pediatric trauma patients at trauma centers; to hospitals providing care to pediatric trauma patients; and for the purchase of equipment to assist in the treatment of pediatric trauma patients.
The contract with LLUCH includes non-standard insurance terms that differ from the County’s and ICEMA’s standard contract. The non-standard term includes the following:
The contract does not require LLUCH to meet the County and ICEMA’s insurance standards as required pursuant to County Policy 11-07, including naming the County and ICEMA as additional insured.
• The County and ICEMA Policy requires contractors to carry appropriate at limits and under conditions determined by the County’s Risk Management Department and set forth in the County and ICEMA standard contract.
• Potential Impact: The contract does not include County standard insurance requirements. This means that the County and ICEMA have no assurance that LLUCH will be financially responsible for claims that may arise from ICEMA’s distribution of funds to LLUCH, which could result in expenses to ICEMA.
ICEMA recommends approval of the contract with LLUCH, including the non-standard term, because the benefits of providing hospitals with EMS Pediatric Trauma Funds better support county residents and serve a public health benefit.
As a requirement for receiving the EMS Pediatric Trauma funds, each trauma center is required to submit written plans to ICEMA detailing how the allocated funds will be spent. ICEMA will determine that the utilization of these funds complies with the statutory requirements outlined in SB 867 and is compliant with Health and Safety Code 1797.98a.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel, 387-3203) on January 14, 2025; County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5465) on January 17, 2025; Risk Management (Gregory Ustaszewski, Staff Analyst II, 386-9008) on December 6, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) February 24, 2025; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on February 24, 2025.