Trauma Center Recommendation

San Joaquin General HospitalFrench Camp, California

May 31, 2009

San Joaquin General HospitalFrench Camp, California

December 6, 2011

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Trauma Center Background

The San Joaquin County Emergency Medical Services (EMS) Agency has indicated it will draft a Trauma Plan for Board of Supervisors approval in 2012

San Joaquin County currently has no designated Trauma Center

Currently trauma patients are treated at hospitals in San Joaquin County or taken to Level I or II Trauma Centers in Stanislaus or Sacramento Counties

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Trauma Center Background

The EMS Agency’s trauma plan is expected to seek designation of a single Trauma Center in San Joaquin County

If no hospitals apply for or meet criteria designation, the EMS Agency’s Trauma Plan is expected to direct the transport of major trauma patients to designated trauma centers in neighboring counties

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Trauma Center Levels

Overview of Key Attributes of the Levels of Trauma Designation (California)Attribute Level I Level II Level III Level IVTeaching Program XResearch XTrauma Surgeon (inhouse) X XNeurosurgeon (promptly available) X XED Physician (inhouse) X X XTrauma Nurse Coordinator X X X XTrauma Registry X X X XTrauma Prevention Program X X X XSource: CA Code of Regulations

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Trauma Study Background

January 2011: San Joaquin General Hospital commissioned a Trauma Center Level II Study

The study was completed by The Abaris Group in September 2011 Estimated annual volume: 1,247 – 1,525 cases

Based on California average of 2.4 cases per 1,000 residents Initial start-up costs approximately $6 million Estimated annual positive operating margin: $800,000 -

$2.4 million

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Trauma Program Evaluation

Interim Board of Trustees and Executive and Finance Committee Reviewed Report

The EMS Agency’s Trauma Plan is expected to include a phased approach to achieve a Level II Trauma Center in the County by first designating a Level III trauma center with a commitment to achieve Level II at a future time

San Joaquin General Hospital currently meets most Level III criteria Additional requirements can be achieved in 12 – 18

months May be consistent with San Joaquin County Emergency

Medical Services Agency timetable for Trauma Plan implementation

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Trauma Center Level III Designation

New financial analysis completed reflecting Level III Trauma Center status

Recommendation by the Interim Board of Trustees to obtain Level III designation, then proceed to Level II status

Annual Volume: 800 Admissions, 200 Outpatients Start up investment: $2.0 Million Net revenue: $19.3 Million Expenses: $16.8 Million Operating margin: $2.5 Million Estimated start up time: 12 – 18 Months

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Level III Resources Required

Additional Staff: Trauma medical director/surgeon Trauma nurse coordinator Trauma registrar and case managers

Additional Capital: Surgical instrumentation Emergency department equipment ICU beds

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SJGH Trauma Center Recommendations

Recommendations: Start activities at SJGH to prepare to obtain designation

as Level III Trauma Center by June 2013 Report to the Interim Board of Trustees and the Board

of Supervisors a timeline for designation of SJGH as Level II Trauma Center

Provide periodic reports to Interim Board of Trustees and Board of Supervisors about meeting Level III and Level II Trauma Center Designations