Title
Approve and authorize the Emergency Medical Services Director to submit the revised Monterey County Trauma System Care Plan to the California State Emergency Medical Services Authority.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Emergency Medical Services Director to submit the revised Monterey County Trauma System Care Plan to the California State Emergency Medical Services Authority.
SUMMARY:
The purpose of The Monterey County Emergency Medical Services (EMS) Trauma Care System Plan is to identify the process for the designation of Natividad Medical Center (NMC) as an Adult Level II Trauma Center. The initial Trauma Care System Plan was developed in 2007 and revised in 2011 in compliance with the State of California Health and Safety Code, Division 2.5, Sections 1797.257 and 1797.258 (Trauma Statutes) and the California Code of Regulations, Title 22, Social Security Division 9, Pre-hospital Emergency Medical Services Chapter 7, Trauma Care Systems (Trauma Regulations) and the Monterey County Emergency Medical Services Plan.
The Monterey County Trauma Care System Plan outlines the structure and operations of the proposed trauma care system within Monterey County. The new plan incorporates a design change from no Trauma Centers in Monterey County to the designation of an Adult Level II Trauma Center. Specifically, the plan incorporates policies and procedures for system operations, which meet the minimum standards and regulations. In addition, the plan establishes a timeframe for implementation of system changes. Upon your direction, the revised Monterey County Trauma Care System Plan, and applicable policies and protocols will be submitted to the California EMS Authority by the EMS Director.
DISCUSSION:
Currently, the County system of care for trauma patients is to air transport the majority of trauma patients to Santa Clara County Trauma Centers. Mechanism-Anatomic-Physiologic (MAP) triage criteria (algorithm) are used within Monterey County to determine injury severity. When the patient meets MAP criteria, a helicopter is dispatched and patients are transported to a Santa Clara County trauma center.
A Request for Qualifications (RFQ) was sent to the hospitals within the county. This RFQ returned two (2) hospitals who were interested in becoming an Adult Level II Trauma Center. This was a competitive process where a group of outside experts recommended a preferred applicant. The selected hospital was Natividad Medical Center (NMC). Due to NMC being a county safety net hospital and under the guidance and authority of the Monterey County Board of Supervisors, NMC submitted an implementation timeline and acquisition of identified staffing and equipment receiving approval from the Board of Supervisors on January 22, 2014.
Monterey County Emergency Medical Services Agency seeks to improve the care provided to trauma patients in its service area through an inclusive trauma care system. The proposed system design includes:
· The designation of an Adult Level II Trauma Center at Natividad Medical Center (NMC) in Salinas.
· Patients meeting Centers for Disease Control (CDC) field triage criteria will be transported to NMC's Adult Level II Trauma Center whenever possible;
· Appropriate patients will be transported to a designated pediatric Trauma Center in another county;
· Burn patients will be transported to a designated burn center in another county;
· A quality improvement process will be established which includes appropriate stakeholders;
· Training will be provided for pre-hospital and hospital personnel regarding local changes to EMS system policies including field trauma triage and hospital destination;
· Appropriate policies have been adopted for implementation and operation of the system; and,
· Local trauma patients within forty-five (45) minutes (via ground delivery) of the Monterey County Adult Level II Trauma Center will be transported directly to NMC. Any trauma patients greater than 45 minutes away from NMC will be transferred by air (weather permitting). Patients who are in excess of 45 minutes from NMC will be taken to the closest Trauma Center.
This work supports the Monterey County Health Department 2011-2015 Strategic Plan initiatives: empower the community to improve health through programs, policies, and activities; and enhance community health and safety by emphasizing prevention. And, it also supports one or more of the ten essential public health services, specifically: monitor health status to identify and solve community health problems; inform, educate, and empower people about health issues; enforce laws and regulations that protect health and ensure safety; and link people to needed personal health services and assure the provision of health care when otherwise unavailable
OTHER AGENCY INVOLVEMENT:
On October 8, 2014 the revised Monterey County Trauma Care System Plan was reviewed and endorsed by the Emergency Medical Care Committee (EMCC), which was established by the Board of Supervisors to represent the interests of local EMS stakeholders, and to serve in an advisory capacity to both the Board and the Director of Health. The October EMCC meeting also allowed for public comment to the plan.
FINANCING:
Development and revision of the Monterey County Monterey County Trauma Care System Plan was included in Fiscal Year 2014-15 Adopted Budget (4000-8108-HEA010).
Prepared by: Kirk Schmitt, EMS Agency Director, 4964
Approved by: Ray Bullick, Director of Health, 4526
Attachments:
2014 Monterey County Trauma Care System Plan is on file with the Clerk of the Board