REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
November 15, 2022
FROM
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency
SUBJECT
Title
Contract with Hi Desert Medical Center for Level IV Trauma Center Designation
End
RECOMMENDATION(S)
Recommendation
Acting as the governing body of the Inland Counties Emergency Medical Agency, approve a Contract, between Hi Desert Medical Center and Inland Counties Emergency Medical Agency for designation as a Level IV Trauma Center, in the amount of $25,000 annually, for the period of November 15, 2022, through June 30, 2024, with an option to extend for one additional three-year period.
(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.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The $25,000 annual fee paid by the Hi Desert Medical Center (HDMC) will cover the costs incurred by the Inland Counties Emergency Medical Agency (ICEMA) related to evaluation and oversight of the hospital’s participation in the trauma system. The cost for the first year will be prorated in the amount of $14,583, for the period of November 15, 2022, through June 30, 2023. Sufficient appropriation and revenue have been included in ICEMA’s 2022-23 recommended budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
ICEMA, as the Local Emergency Medical Services Agency (LEMSA), is responsible for ensuring effective Emergency Medical Services (EMS) for the Counties of San Bernardino, Inyo, and Mono. ICEMA administers State and local regulations governing the provision of emergency medical care at the scene of an emergency and during transport to an acute care hospital. ICEMA ensures an effective system of quality patient care and coordinated emergency medical response by planning, implementing, and evaluating an effective EMS system including pre-hospital providers, specialty care hospitals and hospitals.
ICEMA is responsible for implementing the ICEMA Trauma Care System Plan, which was approved by the ICEMA Board of Directors on December 18, 2001 (Item No. 108). The Trauma Care System Plan provides for a formal basis of implementing, evaluating, and improving the trauma system in the ICEMA region.
California Health and Safety Code, Section 1798.165, provides the authority for ICEMA to designate trauma facilities as part of the trauma care system pursuant to State Regulations. Additionally, the California Code of Regulations, Division 9, Chapter 7, Section 100255 requires ICEMA and designated trauma centers to enter into written agreements outlining the scope of the care to be provided.
The HDMC has been examined by ICEMA and found to possess the performance characteristics, personnel and equipment required in the ICEMA Trauma Standards and California Trauma Regulations. Adding HDMC as a level IV Trauma Center will support the trauma system by providing initial stabilizing trauma care to patients that live in the remote area of Joshua Tree.
HDMC is a licensed general acute care hospital that provided basic emergency services to the community of Joshua tree and has now established standards of care to be designated as a level IV trauma receiving center. The hospital has met the current American College of Surgeons (ACS) for level IV designation and is in compliance with all the requirements listed in the California Code of Regulations Title 22, Division 9, Chapter 7 - Trauma Critical Care System Regulations. HDMC has met the staffing requirements and is staffed with a Trauma Medical Director, Emergency Department Trauma Representative, and Trauma Program Manager. They have implemented a process for the treatment and triage of trauma patients, 24 hours per day, seven days per week.
HDMC has obtained written transfer agreements with ICEMA Level I and II Trauma Receiving Centers, for the immediate transfer of those patients who require additional resources. The hospital has implemented a Continuous Quality Improvement Program, which includes providing outcome data on all trauma patients, and participation in the Trauma Advisory Committee.
The recommendation for designation was determined by an ICEMA verification through an application process. The process included multiple site visits, an official survey, review of staff resumes, and verification of trauma education and certification provided to the staff. Approval of this item will designate HDMC as a Level IV Trauma Center for the period of November 15, 2022, through June 30, 2024, increasing the emergency medical services capacity and resiliency in San Bernardino County.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel,387-5455) on September 13, 2022; Risk Management (Victor Tordesillas, Risk Assessment Director, 386-8623) on September 23, 2022; Finance (Carl Lofton, Administrative Analyst, 387-5404) on October 27, 2022; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on October 28, 2022.