Loading...
HomeMy WebLinkAboutMINUTES - 07201993 - IO.3 I .O.-3 5 . TO: BOARD OF SUPERVISORS .rContra INTERNAL OPERATIONS COMMITTEE 'J Costa FROM: ;• County July 12, 1993 P DATE: 'Ta=C U. ` SUBJECT: JOHN MUIR MEDICAL CENTER FINANCIAL SUPPORT TO THE COMMUNITY AND FUNDING OF THE REGIONAL POISON CONTROL CENTER SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1 . ACKNOWLEDGE receipt of the attached reports from the Health Services Director and=John :Muir Medical Center on the extent to which John Muir Medical Center has complied with the terms of its contract with the County for designation as a trauma center. 2 . DIRECT the Health Services Director to advise the Regional Poison Control Center that the Board of Supervisors doesn't know how much financial support it can provide to the Regional Poison Control Center beyond what is being paid by John Muir Medical Center until the Board adopts a final budget for the 1993-94 fiscal year and until the Board receives final reports from the County Administrator on the actions of the Legislature, presently scheduled for September 28, 1993 . 3 . AUTHORIZE the Health Services Director, as he feels appropriate, to enter into discussions with Kaiser Foundation Hospitals in Contra Costa County regarding the financial advantages to Kaiser of helping to keep the Regional Poison Control Center operating for the benefit of the residents of Contra Costa County. 4 . DIRECT the Health Services Director to report to our Committee on September 27 , 1993, regarding the level of funding which has been provided to the Regional Poison Control Center on behalf of Contra Costa County, the extent to which the State has made any additional funding available for the Regional Poison Control Centers and what services the• Regional Poison Control Center is providing to the residents of Contra Costa . County. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMI E APPROVE OTHER SIGNATURE S: ACTION OF BOARD ON July 20, 1993 AP ROVED AS RECOMMENDED OTHER The Board APPROVED the above recommendations, and in addition, REFERRED the financial aspects of the report to the Finance Committee. VOTE OF SUPERVISORS �( I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED Contact: PHIL BATCHIL R•C RK OF THE BOARD OF cc: See Page 2 SUPERVISO{ AND COUNTY ADMINISTRATOR BY DEPUTY I.O.-3 BACKGROUND: On June 8, 1993, the Board of Supervisors asked the Health Services Director to report to our Committee July 12 on how the Regional Poison Control Center is being funded and to document the extent to which the John Muir Medical Center is meeting the financial obligations to the community which are a part of its contractual obligation to the County as a part of its designation as the trauma center in this County. On July 12 , 1993, our Committee met with Janiece Nolan, Chief Operating Officer for John Muir Medical Center; Dr. William Walker, County Health Officer; and Art Lathrop, Director, Emergency Medical Services . We received and reviewed the attached report from the _ Health Services Director and the attached- report from John Muir fMedcal -Center. It seems clear to our Committee that the John Muir Medical Center is more than meeting its legal obligation to the County in terms of providing funding for the Regional Poison Control Center and funding for a County injury prevention program. Supervisor McPeak expressed the opinion that there were higher priorities in the community for the use of the funds John Muir Medical Center was willing to provide and that she would prefer to see those funds used in a different manner. Both Supervisor McPeak and Supervisor Smith agreed that they were not interested in providing any County General Funds at this time in support of the Regional Poison Control Center, given the deficit with which the County is faced and the pressing needs in a number of other areas . It was noted that the Kaiser Foundation hospitals have a financial incentive to keep the Regional Poison Control Centers operating since they can refer calls to the Poison Control Center, thereby reducing their reliance on an advice nurse and saving unnecessary visits to the emergency room. Dr. Walker also noted that there is still at least one piece of legislation pending in Sacramento which might provide some funding for Poison Control Centers from the "911" funds which are collected from telephone bills, SB 1016 . Our Committee continues to have a number of questions about the County' s support of the Regional Poison Control Center. The Poison Control Center has asked the County to respond by July 22, 1993, telling the Poison Control Center what level of funding the County is going to make available for the 1993-94 fiscal year and threatening to stop serving residents of any county which does not pay its "fair share" , which for Contra Costa County has been calculated by the Regional Poison Control Center as $121,284 . We are, therefore, asking that the Health Services Director tell the Regional Poison Control Center that we are unable to advise them at this time what level of support Contra Costa County may be able to provide for the current fiscal year. We will review this matter again after the County Budget has been adopted and after the Legislature has recessed for the year in September. cc: County Administrator Health Services Director Dr. William Walker, County Health Officer Art Lathrop, Director, Emergency Medical Services Janiece Nolan, Chief Operating Officer John Muir Medical Center 1601 Ygnacio Valley Blvd. Walnut Creek, CA 94598-3194 Finance Committee via Tony Enea, CAO office -2- Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Tom Powers, 1st District Jeff Smith,2nd District Mark Finucane, Director Gayle Bishop,3rd District ;G ' . _ 20 Allen Street Sunne Wright McPeak,4th District _ _�.,• Martinez,California 94553-3191 Tom Torlakson,5th District en, _--. (510)370-5003 FAX(510)370-5098 County Administrator Phil Batchelor °s County Administrator a coUrA DATE: July 12, 1993 TO: Integial. Operati s Committee FROM: Ma 1 ucaTi '��' Health Services Director SUBJECT: Poison Control Center Funding This report responds to your request for information regarding funding for the Bay Area Poison Control Center and what steps John Muir Medical Center has taken to meet the terms of its community obligation as a condition of being designated as a trauma center. 1. Poison Control Center Poison Control Centers have been in existence since the 1950s and began to be regulated by the EMS Authority in 1988 when seven regional centers were established. Although state funding has never completely covered the costs of the poison control centers, state funding dropped by 40% in 1992 and now represents only 17% of the total. The SF Bay Area Regional Poison Control Center (SFBARPCC) requested that each County provide funds to the Center commensurate with the percentage of calls made by county residents. For FY 1992-93, Contra Costa's share was determined to be $144,944. Approximately $23,660 was credited to Contra Costa from state funds, resulting in a request for $121,284. As part of the agreement developed between John Muir and the County to be designated a trauma center, John Muir Medical Center pledged a total of $61,200 for the PCC -- $31,200 of which was a cash payment and $30,000 of which would be raised. On June 28, John Muir made its final $30,000 payment to the PCC, thereby meeting its obligation. Of the 9 counties (other than San Francisco) that utilize the SFBARPCC, we believe that only San Mateo County has made full payment. Contra Costa, Alameda and Del Norte counties made payments constituting more than half of their "fair share", and Humboldt, Marin, Mendocino and Napa have not paid. Merrithew Memorial Hospital 8 Clinics Public Health • Mental Health • Substance Abuse Environmental Health Contra Costa Health Plan Emergency Medical Services • Home Health Agency Geriatrics A-345 (2/93) -2- The SFBARPCC requested and was granted permission by the State Emergency Medical Services Authority to restrict services of the PCC to only those counties which have made full "fair share" contributions as determined by the PCC, effective next month. We are currently reviewing a number of options for providing access to poison information for the residents of Contra Costa County, in light of this recent decision. We will come back to the IO Committee within one month with a recommendation on how to proceed. Although there were a number of bills pending to identify state funding sources for the PCCs, it's not clear if any will be enacted. AB 2377, one of the Budget Trailer bills, had included $8 - 9 million for PCCs through a new 9-1-1 tax, but that section was deleted. Still pending is SB 1016, which will go before the Assembly Revenue and Taxation Committee this afternoon. This bill would allow PCC services to be funded under the current 9-1-1 emergency telephone phone srutax. As much as $4 to $5 million could be generated from this account, which currently has a surplus. The bill would not increase or establish a new tax. 2. John Muir Medical Center. As stated above, for FY 92-93, Muir agreed to make a cash contribution of $31,200 plus conduct a direct mail fundraising campaign for the Poison Control Center with a guarantee of $30,000. The full contribution of $61,200 has been paid. Muir's obligation to provide Contra Costa County's share of funding for the Poison Control Center was a condition of granting Muir the trauma center designation last year. In addition, Muir pays an annual fee -- $75,000 -- which is the highest in the state. Finally, Muir agreed to pay $30,500 each year to fund a County injury prevention program. Not including the $30,000 fundraising guarantee for the Poison Control Center, Muir's cash payment requirements to be the designated trauma center total $135,000 -- the highest in the state and nearly double the second highest designation fee charged by Sacramento County. Other counties' trauma fees range from zero to $41,560 a year with an average of $17,800 a year. JOHN 1601 Ygnacio Valley Road • Walnut Creek, California 94598-3194 • (510) 939-3000 MUIR MEDICAL CENTER June 3, 1993 Claude Van Marter Assistant County Administrator 651 Pine Street, 11th Floor Martinez, CA 94553 Dear Claude: Enclosed please find the information we discussed: • Board Order (5/18/92) listing specific expanded services to the community (from our Trauma Contract with the County) that John Muir agreed to do. • Section C "Service to the Community" from our proposal to the County for permanent Trauma Center designation. The document discusses our services to the community above and beyond the Trauma Center and expanded services agreement above. In terms of fulfilling the specific expanded services to the community in the Trauma Center contract, we have complied in all four areas: • Poison Control Center: John Muir has been very involved in helping to establish stable funding for. the Poison Control Center. I am on their Oversight Board. We have assumed the County's role in negotiating Contra Costa's share of support. We are guaranteeing $6.1,200 to the Poison Control Center for July 1992 - June 1993, and have paid $30,600 with the rest awaiting a fundraising campaign (copies of letters attached). • Injury Prevention Programs: John Muir provides $30,500 annually to the County Health Services Department for Injury/Violence Prevention programs. A presentation was made at the Childhood Injury Prevention Coalition Open House held at John Muir in May. A not-for-profit medical center sensing the community since 1965 Claude Van Marter Assistant County Administrator June 3, 1993 Page Two • Medical Helicopter Service: Contra Costa County now enjoys a medical helicopter based at Buchanan Field twenty-four hours a day. CALSTAR is funded by John Muir and three other regional medical centers. • "Trauma Team Talks Tough Program:" The John Muir Injury Prevention Program costing $50,000/year is meeting all milestones/goals listed on page 30 of our proposal (attached). We reached over 10,000 children and adults this year with the message of injury prevention. John Muir Medical Center is committed to community service through the Trauma Center and the patients it serves, through the additional commitments we made in the permanent designation contract and through many other programs described in the attachments. Please let me know if you need any further information. Sincerely, \iea S. Nolan Chief Operating Officer JSN/bg Attachments Board Order May 18, 1992 Hospital Agreement #29-325-2 Board order Page 2 A staff review of John Muir's Trauma Center Designation proposal has determined that the proposal meets the requirements of the County's RFP. Muir's proposal includes certain expanded services to the community in the areas of education and injury prevention, poison control, and improved medical helicopter response. These include: (1) Poison Control Center. John Muir will provide the lead agency role in negotiating Contra Costa County's share of support to the Regional Poison Control Center and will provide the level of support negotiated. (2) Injury Prevention Programs. John Muir will provide $30, 500 annually to the County for use in funding programs to decrease violence or prevent injury. (3) Medical Helicopter Service. John Muir will actively promote the basing of a medical helicopter within Contra Costa County, and will commit up to $50, 000 over and above Muir's regular $100, 000 annual contribution to CALSTAR if needed to offset any CALSTAR program deficits that occur because of the Contra Costa County helicopter. (4) Trauma Team Talks Tough Program. John Muir will expand its "Trauma Team Talks Tough" educational program conducted through the schools by committing $50, 000 annual funding. (This represents increased funding of approximately $49, 500 since the existing program .has been conducted on a volunteer basis. ) The John Muir Trauma Center has recently undergone an annual site review conducted by the Health Services Department using an independent review team. John Muir meets the six-year previous designation requirement specified in the RFP for a hospital to be considered for permanent trauma center designation. The Health Services Department recommends permanent Level II Trauma Center designation for John Muir Medical Center. Such designation will be subject to Muir' s continued compliance with standards set forth in their contract. To: BOARD OF SUPERVISORS coPCD FROM: Mark Finucane, Health Services Director Contra By: Elizabeth A. Spooner, Contracts AdministratorCosta DATE: May 18, 1992 County SUBJECT: Approval of Trauma Center Designation and Hospital Agreement #29- 325-2 with John Muir Medical Center SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve permanent designation of John Muir Medical Center as a Level II Trauma Center and authorize the Chair to execute on behalf of the County, Hospital Agreement #29-325-2 with John Muir Medical Center for the term May 22 , 1992 through May 21, 2012 with automatic renewal each year thereafter. II . FINANCIAL IMPACT: Upon execution of the agreement and annually thereafter, John Muir Medical Center will pay County a $75, 000 designation fee plus $30, 500 for use by County in funding programs to decrease violence or to prevent injury for a total of $105, 500 annually. III . REASONS FOR RECOMMENDATIONS/BACKGROUND: On January 14 , 1992 , your Board approved a Request for Proposal (RFP) for Level II Trauma Center Designation. The standards and requirements of the RFP were similar to those which have been in effect for the trauma system' s first six years of .operation except for (1) the addition of a "service to the community" requirement, and (2) provision for permanent designation following two three-year contract periods. The deadline for proposal submission was March 30, 1992 , although the RFP contained a provision for extension of the deadline based upon submission of a written request and payment of the application fee. A Bidders ' Conference was held to answer any questions regarding the RFP or application procedure. Copies of the RFP were provided to all hospitals in Contra Costa County. John Muir Medical Center, the County' s existing Level II Trauma Center, was the sole hospital to submit a proposal. There were no requests for extension of the proposal submission deadline, nor were inquiries regarding trauma center designation received from any other hospitals. John Muir was the sole hospital represented at the Bidders ' Conference. Section C Service To The Community Excerpt From: John Muir Medical Center (Trauma Center) Proposal for Permanent Designation submitted to the County of Contra Costa March, 1992 SECTION C SERVICE TO THE COMMUNITY SECTION C SERVICE TO THE COMMUNITY INTRODUCTION This section of the proposal describes the hospital's commitment to medical and health care for the Contra Costa County population, as required by the request for proposal. As further defined during the January 27th bidders' conference conducted by Contra Costa County, the community-service commitment should be directly related to trauma and emergency care. John Muir Medical Center offers the following evidence of its community-service commitments, past, present and future. HISTORICAL COMMITMENT The mission of John,Muir Medical Center is to serve the healthcare needs of the people of Contra Costa County. This means that John Muir provides or supports the delivery of a broad range of health care services throughout the county and surrounding areas. This mission recognizes the special needs of an aging population. John Muir strives to achieve the highest standards of excellence in service and performance,with special emphasis on quality in all operations of the Medical Center; optimizing the skills and experience of our medical and professional staff through advanced technology, education and leadership; preserving personal dignity and individual rights; and promoting a warm, caring and healing environment. In short, John Muir strives to be the preeminent regional health-care organization in its service area. For 26 years., the hospital's services to the community have continued., despite revolutionary changes in the capabilities and complexities of the medical-care field. Through these changes, John. Muir Medical Center has kept in sight its responsibility as a provider of caring and personalized services to the people in the communities it serves. Extensive resources are devoted each year to programs which organize and deliver free and subsidized C, benefits to community residents. These include programs in the following areas: Emergency Services Rehabilitation Center Information and Referral Services Educational Services Support Services Sponsoring of Community Events Other Health Services After a brief review of each program, future plans for community service related to trauma and emergency services are outlined and will be subject to further discussion with the County. EMERGENCY SERVICES John Muir Medical Center has a Iona history of commitment and leadership in the arena of emergency 1:o medical services. In addition to an emergency department serving 26,000 patients a year without regard to ability to pay, five outstanding programs are described below-. John Muir Medical Center Page 23 1. Trauma Center Services The Trauma Center at John Muir Medical Center,serving all of Contra Costa County, has functioned effectively since July, 1986. During that time, the hospital has developed extensive resources for the management and treatment of trauma patients. The hospital has treated 5,500 trauma patients during that time. In response to our commitment to Trauma,we have added a second intensive care nursing unit at a cost of$3.3 million, and this year plan to expand the Emergency/Trauma Department for another $2 million. The original philosophy of applying for, and maintaining the trauma center designation, was as a service to the community, undertaken at a considerable financial risk. Due to the payor mix for trauma., a significant hospital financial contribution continues to be made to this program. Paramedic Base Hospital John Muir Medical Center was the first paramedic base hospital in the county in 1976, and has continued to provide these services at no charge for the past 16 years. Directing the paramedics in the field requires an additional 1.5 full-time equivalent positions of Mobile Intensive Care Nurses(MICN) in the Emergency Department, as well as providing for MICN training for all registered nurses on all shifts. Substantial numbers of hours each month (estimated at 25 hours) are directed to paramedic- training programs, coordination, and case audits. Since 1985,John Muir Medical Center has undertaken a second zone of coverage as the base hospital for paramedics in Richmond, when the hospital in that zone (Brookside) was unable to continue to serve as a Base Hospital. In November of 1991, John Muir Medical Center took on the-additional resp risibility as a base hospital for all trauma calls, county-wide, as a means of providing continuity of medical direction from the field to the center. This commitment has also meant adding additional MICN resources to the Emergency Department. 3. CALSTAR Helicopter Program John Muir Medical Center is one of the founders and four sustaining members of CALSTAR (California Shock/Trauma Air Rescue). The hospital's contribution to CALSTAR has been in excess of$100,000 per year for the past 8 years. Without that support, CALSTAR would not exist. Through an arrangement with CAI-STAR, the nurses are John Muir Medical Center employees, and the hospital provides the liability insurance coverage for the program. The hospital has made this significant financial commitment to the program because of its belief in the necessity for this service as an adjunct to both emergency and trauma services. John Muir's Vice President of Clinical and Administrative Services is currently a Board member of C,AJ_STAR and helps provide direction to the program. 4. John Muir/Fire Department Partnership In 1985,John Muir joined with the San Ramon Valley Fire Department to provide paramedic services to an area of the county that had not had this service. San Ramon Valley Fire has the Contract for emergency services with the county and, in turn,contracts with John Muir for the paramedics,who are John Muir employees. This service is economical for the public sector, since it avoids the expense of fire-fighter paramedics and provides a consistent not-for-profit approach to emergency medical care. The County is in the process of comparing this model with others in a fire service EMS model assessment by a consultant(who was engaged by the County in response to a request from the mayors in relation to Measure H assessments). This is another example commitment and innovation in the arena of emergency services that was not without financial risk. John Muir Medical Center Page 24 5. Emerpi-Center From 1985 to 1991,John Muir Medical Center maintained a freestanding emergency center in the San Ramon Valley, complete with helipad in response to the communities there stating the need for emergency services. During its last year of operation, an average of 60 patients a day were treated by emergency department physicians. Due to the community need for a 24-hours service, a significant financial contribution had to be made by John Muir to provide this service. When a hospital opened in the valley with emergency services, and the need no longer existed, it was converted into a private practice with extended hours. The Emergi-Center is another example of John Muir's commitment to its various communities in the arena of emergency.services. REHABILITATION CENTER A non-emergency service, but directly related to trauma and emergency services, is rehabilitation. John Muir has had a licensed comprehensive (inpatient and outpatient) Rehabilitation Center since 1985. In 1990 it received CARF (Commission on Accreditation of Rehabilitation Facilities) accreditation. This service is a good example of a medical service directly related to trauma and emergency services. At Contra Costa County's request in 1990, John Muir entered into a contract with Contra Costa County to provide rehabilitation services to county patients at John Muir's Rehabilitation Center.in order to allow the county hospital, Merrithew Memorial Hospital, to close its rehabilitation facilities and utilize the beds for other patients. This agreement has resulted in a substantial increase of MediCal rehabilitation patients at John Muir. Since MediCal payments do not cover costs, care of these patients is provided as a substantial community service. It should be noted that John Muir is the only facility in the county which takes MediCal inpatient rehabilitation patients. INFORMATION AND REFERRAL SERVICES John Muir Medical Center's contribution to the community also comes in the form of information and referral services. Anyone may use these services to determine what type of medical care they need and how to receive it. Sample programs include: Tel-Med Program (a 24-hour recorded health information service) Public Service Articles (in the local newspapers) "Muir Moments" (quarterly publication to 100,000, providing health information on subjects such as cancer, rehabilitation and birthing) "Muircare 65" Newsletter (distributed to 13,000 homes, three times a year) providing information to those with Medicare coverage Physician Referral Service Senior Information and Referral provided in conjunctionwith the Contra Costa County Office on Aging EDUCATIONAL SERVICES Another community service commitment at John Muir Medical Center is provided in the form of educational programs. Employees, patients, their families, and the community at large are all beneficiaries of John Muir Medical Center's educational programs. These programs encompass such activities as: John Muir Medicai Center Page 25 Bereavement Counseling Pre-Conception Planning Effort Teen Trauma Prevention Program (i.e. "Heads Up" program, "Trauma Team Talks Tough") Monthly educational programs targeted at older adults and their care givers Numerous other programs., such as: Continuing education for health care professionals Student education for allied health professionals in training Community speaker's bureau Adoption counseling Adult and pediatric oncology education groups Special cancer education seminars Education for high-risk mothers Rehabilitation education and support services for families of patients SUPPORT SERVICES Support Services are also a substantial statement of the hospital's community service. John Muir Medical Center's support services are aimed at helping people to help themselves in a variety of ways. "I-Can-Cope" Classes Elsa U. Pardee Foundation Grant Administrator for Contra Costa Countv Wellness Community (oncology support group) Grant Parents, Kids, and Drugs Classes Medical Equipment Support Programs for Care Givers to the Frail Elderly Other Services Initial assessment of adolescents Financial and insurance counseling Prenatal care and support to incarcerated women Drug Hotline 24-hour pastoral care OB home visits SPONSORSHIP OF COMMUNITY' EVENTS Another source of John Muir Medical Center's community service is acknowledged through sponsorship of community events. Reaching out to its public,John Muir Medical Center has a growing reputation for its sponsorship of community events. Such programs include: Bi-Annual Medical Film Festival (recently reorganized) Halloween Candy Screening Program Making Available Meeting Facilities to Community Groups (i.e., stroke support., Alzheimer training, other support groups). John Muir Medical Center Page 26 OTHER HEALTH SERVICES High-risk Obstetrics Case Management for Frail Elders Community Service Fund Chemotherapy Health Fairs and Screening FUTURE PLANS FOR ADDITIONAL COMMUNITY SERVICE (Related to Trauma and Emergency Services) John Muir Medical Center, in addition to the historical hospital and trauma center commitment to community services,described above has the following plans for additional community service related to trauma and emergency services. 1. Expand the "Trauma Team Talks Tough" Program John Muir Medical Center and its volunteer trauma-team members began this program six months ago to initiate a change in injury patterns among school-age children county-wide. The program detailed elsewhere in this proposal (please see Section E.17., Outreach Programs), was originally organized around a group of volunteers (hospital and non-hospital staff) with hospital support. John Muir',Nledical Center plans to expand this commitment, and plans to increase annual funding to$50,000. Please see Table 9 for the proposed budget and Table 10, first-year's milestones. 2. CALSTAR Relocation Due to John Muir Medical Center's own desire to better serve Contra Costa Countv. arrangements are being made to secure a second CALSTAR helicopter and locate it in Contra Costa County. As discussed above.John Muir is a major sponsor of CALSTAR ($100,000 per year). By mid-April 1992, CALSTAR will endeavor to add a second helicopter, with both helicopters initially based at the Hayward Airport. This addition will provide expanded coverage to Contra Costa County and to the greater CALSTAR area. Unless there are substantial factors to the contrary, 12 hours a day service of a second medical helicopter,based in Contra Costa County,should begin as early as June, 1992, and remain so long as there is the demand and financial ability to do so, 3. Poison Control Center Assistance The 9-County Regional Poison Control Center is located at San Francisco General Hospital and requires considerable financial support from the areas it serves. John Muir has supported the Poison Control Center for about 10 years with a current assessment of$3)200 per year. We understand that county governments have been asked to provide additional subsidy in proportion to the number of calls coming from each county. As this county's trauma center, John Muir Medical Center would be willing to take a leadership role and become Contra Costa County's link with the Regional Poison Control Center. John Muir Medical Center would negotiate directly with the Regional Poison Control Center with regard to any subsidy requests of Contra Costa. John Muir Medical Center would expect to contribute over and above our assessment as a hospital, but reserve the right to negotiate directly with the Regional Poison Control Center. John Muir Medical Center Page 27 4. Designation Fees/Fundinp, Iniury Prevention The Trauma Center annual designation fee in Contra Costa County (currently $100,000 per year, and now proposed at $115,000 per year) are among the highest in the State (see Table 11). The County's Injury Prevention program (Health Service Injury Prevention Program, Department of Public Health)has made a substantial contribution toward injury prevention, but there are still unmet needs. John Muir Medical Center proposes to work cooperatively with the Contra Costa County EMS Agency to reduce their costs of monitoring, the trauma, program and,therefore, the designation fees. The hospital would offer these fee savings to the County's injury-prevention program. Funds could be designated for specific prevention programs or specific areas of the County (i.e., North Richmond). 5. Other Emergency and Trauma-Related Services to be Discussed with the County It should be noted that the above community services commitments align with the mission of John Muir Medical Center and reflect the maturing of trauma center commitments at John Muir Medical Center. John Muir Medical Center is open to discuss other services that might be of mutual benefit to the community and the hospital. Z� John Muir Medical Center wishes to work with Contra Costa County to meet the community service needs of the County,particularly in the trauma and emergency care area. Our historical commitments and future plans are a direct validation of our resolution. John Muir Medical Center Page 28 Table 9 John Muir Medical Center Injury Prevention Program "Trauma Team Talks Tough" BUDGET: Program Coordination $31,400 Printing/Graphics $12,100 Miscellaneous (i.e. telephone, travel, office supplies, audio visual materials, j conferences) $6,500 Total 12—month budget: $50,000 John Muir Medica!Center Page 29 Table 10 From JMMC's Permanent Trauma Center Designation John Muir Medical Center Proposal "Trauma Team Talks Tough" MILESTONES / GOALS 1. Further develop program a. Define mission and goals b. Develop program plan c. Develop/define target market 12. Develop campaign materials a. Brochures b. Slides c. Audiovisual enhancements 3. Coordinate with other community injury—prevention programs (i.e. Childhood Injury Prevention Project — Contra Costa County) 4. Develop/enhance volunteer network for conducting classes 15. Conduct programs as follows: a. Provide age appropriate injury prevention programs reaching 10,000 school children throughout the county. b. Provide injury prevention programs as part of the driver education programs offered through the public schools in the county. c. Provide injury prevention programs reaching 1,000 adults,especially young parents throughout the county. d. Serve as a resource for providing injury prevention programs to any other interested agencies and/or organizations throughout the county. e. Coordinate efforts with related projects and programs locally and throughout the state and nation. 6. At the conclusion of one "Trauma Teams Talk Tough" presentation, learners will be able to: a. Describe one or more behaviors that will reduce their chances of a major injury. I b. Discuss injury prevention behaviors associated with the following activities (based on learners'ages): Driving Diving Other water safety Bicycling Skateboarding/roller skating Walking Winter/wilderness activities iC. Discuss appropriate first aid procedures(age appropriate)should they witness or become involved in an injury situation. 7. Participate in other injury—prevention projects as needs and data,based on John Muir Medical Center's trauma registry,define. John Muir Medical Center Page 30 Poison Control Center Copies of Letters 9-i 'MOUHIN1� 1'00i Y�nacio Vailev Road - 11%'Fim Cr--e4. Calir'OMIFI 5qS-3i94 - '5)'Lol 9139-3000 MEDICAL CENTER December 10, 1992 Thomas E. Kearney, Pharm.D. Managing, Director San Francisco Bay Area Regional Poison Control Center San Francisco General Hospital 1001 Potrero Avenue San Francisco, CA 94110 Dear Dr. Kearney: Enclosed is a check for $30,600 representing six monthly payments of $5,100 from July 1, 1992 through December 31, 1992. This payment is made pursuant to my letter of October 15, 1992 (attached). We are still waiting to have a seat on a new regional oversight advisory body to the PCC. Sincerely, Janiec\e .Zl;ola�n, Ph.D. Chief Operating Officer JSNL /bg cc: J. Kendall Anderson. Mark Finucane Dan Smiley A not-for-profit medical center serving the community since 1966 U l� October 15, 1992 Thomas E. Kearney, Pharm.D. Managing Director San Francisco Bay Area Regional Poison Control Center San Francisco General Hospital 1001 Potrero Avenue San Francisco, CA 94110 Dear Dr. Kearney: John Muir Medical Center, in its role as the Regional Trauma Center for Contra Costa County, has accepted the lead agency role in negotiating Contra Costa County's contribution to our Regional Poison Control Center (PCC). Your September 11 letter to Contra Costa County's Director of Health Services was forwarded to me for response. We are supportive of the PCC and wish to voluntarily contribute to its operation in 1992-93 in behalf of Contra Costa County. I think you realize that the threat of selectively discontinuing services was not a good approach and I believe we can put those thoughts behind us and work with you in developing a firm financial base for the PCC. John Muir is prepared to provide: 1. $31,200 voluntary contribution in behalf of Contra Costa County which is at the level of last year's funding plus a 4% increase for cost of living. 2. $30,000 through a direct mail fund raising campaign in Contra Costa County undertaken by the John Muir Foundation, at its own expense, in the spring of 1993. In the professional opinion of our Foundation Director, at least $30,000 can be raised from a direct mailing to Contra Costa residents, provided you do not duplicate this effort centrally and cooperate with us in developing information for the mailer. There is a distinct possibility that a great deal more could be raised, but we are willing to guarantee only $30,000 at this time. 3. Possible $30,000 in increased Contra Costa County hospital contributions. We will utilize our relationship with the East Bay Hospital Conference to attempt to increase the individual hospital contributions by $5000 per hospital times six hospitals. 4. We also believe that a Health Maintenance Organization (HMO) such as Kaiser covering 30-40% of the population, should be considered far a higher level of funding rather than as a sum of 15 member hospitals at $3000 each. Other HMO's and insurance agencies should also provide a share of funding related to savings derived from reduced emergency department use. The total of$61,200 from items 1 and 2 that we are willing to guarantee can be paid to the PCC in monthly payments of$5100, retroactive to July 1. If you accept this proposal, we will send you a check for four months for $20,400, on or about the first of November, and continue with $5400 monthly payments through June, 1993. If we raise more money in fund raising for the PCC we will forward it to you. Contingent upon this funding is the following: • John Muir Medical Center, as a voluntary participant in yourfunding program, will have a seat on a new regional oversight advisory body to the PCC. We want to help you look at ways of reducing cost, improving service, and developing stable funding. • John Muir Medical Center's name is to appear along with other major supporters on the letterhead of the PCC. We are prepared to assist in payment for the cost of stationary changes. • You will to send us on a routine basis detailed reports on the types of calls from our county. Again, let me state that we are supportive of the PCC and the work that it does, and trust that our relationship will be cooperative and productive. We look forward to your response. Sincerely, Janiece S. Nolan, Ph.D. Chief Operating Officer JSNlbg cc: J. Kendall Anderson Mark Finucane Dan Smiley "Trauma Team Talks Tough" Table 10 From RM1\IC's Permanent Trauma Center Designation John Muir Medical Center Proposal "Trauma Team Talks Tough" MILESTONES / GOALS I 1. Further develop program a. Define mission and goals b. Develop program plan c. Develooidefine target market Develoo campaign materials a. Brochures b. Slides c. Audio visual enhancements 3. Coordinate with ocher community inju;i—prevention programs (i.e. Childhood Injury Prevention Project — Contra Costa County) : 4. Develop enhance volunteer network for conducting classes Conduct programs as foUows: a. Provide age appropriate injury prevention programs reaching 10,000 school children throughout the county. b. Provide injury prevention programs as part of the driver education programs offered through the puolic schools in the county. c. Provide injurti prevention proQr=ns reaching 1.000 adults, especially young parents throughout :he county. d. Serve as a resource for providing injury prevention programs to any ocher interested i agencies andior organizations throughout the county. e. Coordinate efforts with related :rojects and programs locally and throughout the state and nation. 6. At the conclusion of one "Trauma Teams Talk Tough" presentation, learners will be able to: I a. Describe one or more behaviors :hat will reduce their chances of a major injury. b. Discuss injury prevention behaviors associated with the following activities (based on learners' ages): D rivin g DivingV Other water safety B icvclin g Skateboardingiroller skating Walking Winter�wdderness activities c. Discuss appropriate first aid procedures (age appropriate)should they witness or become involved in an injury situation. i. Particioate in ocher injury—preventioa projects as needs and data, based on John Muir Medical Center's trauma registry,define. I john Muir Medical Center Page 30