DATE: June 12, 2018
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Valley Children’s Hospital Designation as a Level II Pediatric Trauma Center
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Agreement with Valley Children’s Hospital, for designation as a Level II Pediatric Trauma Center, effective July 1, 2018, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions. ($0)
REPORT
Approval of the recommended action will designate Valley Children’s Hospital (VCH) as a Level II Pediatric Trauma Center. The recommended agreement is required by the California Code of Regulations for trauma centers and outlines the responsibilities of both the County and VCH. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, VCH would lose its designation as a Level II Pediatric Trauma Center.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. There are no costs associated with the recommended agreement.
DISCUSSION:
The Department of Public Health is the designated Local Emergency Medical Services (EMS) Agency for Fresno, Kings, Madera, and Tulare counties, pursuant to Health and Safety Code, section 1797.200. The Local EMS Agency is responsible to planning, implementation, and evaluation of the emergency medical services system, which includes the designation of trauma centers.
The recommended actions will approve an agreement with VCH continuing its designation as a Level II Pediatric Trauma Center. VCH is the only children’s trauma center between the San Francisco Bay Area and Los Angeles. VCH has been designated Level II since 2016. Two other trauma centers have been previously approved in the four-county EMS region, which include Community Regional Medical Center as a Level I Trauma Center and Kaweah Delta Medical Center as a Level III Trauma Center.
As a Level II, VCH is authorized by the EMS agency to receive critically injured pediatric patients transported directly from the field by ambulance or helicopter. The Level II designation requires VCH to maintain a preparedness level to receive and respond to trauma that is significantly higher than non-trauma hospitals. As a designated trauma center, the State regulations set a minimum requirement of hospital services that must be immediately available, which include surgical and anesthesiology services and response performance to critical trauma in the emergency department. A significant amount of training and education is also required for hospital staff.
The recommended agreement will be effective July 1, 2018 through June 30, 2021, and may be extended for two optional one-year renewals, unless a 30-day advanced written notice of non-renewal is given by either of the parties. The proposed agreement may be terminated without cause by either party upon the giving of a 30-day advance written notice of an intention to terminate or the County may immediately terminate the agreement due to breach of contract.
County Risk Management has recommended that VCH obtain molestation and abuse insurance coverage. VCH lacks this specific policy and has determined that their current coverage is adequate for their business model. The Department of Public Health agrees with VCH’s assessment.
Section 12 of the agreement contains the insurance coverage and language currently approved for use in the County’s model contract. Risk Management has recently proposed that the insurance coverage and language in the County’s model contract be revised. County Counsel and Risk Management are currently reviewing those proposed changes, but it is anticipated that the language will not be finalized for another couple of months. The Department of Public Health has a need to move forward with this contract now, and cannot wait an additional month or two for the model contract language to be approved. Additionally, the Department of Public Health believes the insurance coverage required in Section 12 of the agreement adequately protects the interests of the County in this contract and County Counsel is comfortable signing the agreement as to legal form.
REFERENCE MATERIAL:
BAI #24, February 2, 2016 - Agt. No. 16-063
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Valley Children’s Hospital
CAO ANALYST:
Sonia M. De La Rosa