California Trauma System Summit II

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California Trauma System Summit II

• Improving Trauma Care through
• State Trauma System Development
• September 21, 2009

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Measure B Support for Trauma Services

• Cathy Chidester, Director
• Los Angeles County,
• Emergency Medical Services Agency
• Trauma Summit

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LOS ANGELES COUNTY

• 4,082 Square Miles
• Population gt 10 Million
• 73 9-1-1 Receiving Centers
• 13 Trauma Centers
• 30 Public EMS 9-1-1 Providers
• 19,500 Trauma Patients Annually

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GOVERNANCE

• Board of Supervisors (BOS) - 5 Members
• Department of Health Services -
• EMS Agency - 2002
• Virginia Price Hastings, Director
• EMS Commission 17 Members
• Various constituent groups 12 Members
• Appointed by the BOS 5 Members

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WHY OUR TRAUMA SYSTEM WAS VERGING ON COLLAPSE

• Increase in Trauma Patient Volumes
• Poor Payor Mix
• Drastic Cuts in Proposition 99 Tobacco Tax Funds

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INCREASE IN TRAUMA PATIENT VOLUMES
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PRIVATE TRAUMA CENTERS PAYOR MIX
Fiscal Year 1997/98 (n 6,745)
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COUNTY TRAUMA CENTERS PAYOR MIX
Fiscal Year 1997/98 (n 7,293)
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DRASTIC CUTS IN TOBACCO TAX FUNDS
Declined by 88, while the indigent population
for Los Angeles County steadily increased.
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AS IF THAT WASNT ENOUGH

• Not only was LA facing the collapse of our Trauma
  System due to the Increase in Trauma Patient
  Volumes, Poor Payor Mix, and Drastic Cuts in
  Proposition 99 Tobacco Tax Funds
• In addition, the Countys entire Medical Delivery
  System was verging on collapse due to the loss of
  Federal Medicaid "waiver" funding in two years.

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BOARD OF SUPERVISORS HEARING JULY 30, 2002

• Hearing to consider adoption of a resolution
  calling for voter approved special assessment
• Supervisor Yaroslavsky In less than 3 yrs, the
  Countys Section 1115 Medicaid Waiver will
  expire. In FY 05/06, we anticipate that the
  County will face a deficit of 710 million in the
  DHS budget
• The projected decline in health funding will
  hurt County residents in many ways, but none so
  widespread as in the impact on trauma centers,
  EMS, and bioterrorism response.

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Board resolution providing for and giving notice
of a special tax election

• While the County continues to press the State
  and Federal governments for relief, it should
  attempt to help itself by authorizing the raising
  of local revenues
• A charge of only 3 cents per sq foot of
  structural improvementswould raise approximately
  168 million a year.
• Preservation of Trauma Centers and EMS,
  Bioterrorism Response measure before the voters,
  does not come close to solving the Countys
  health funding crisis. However, it would go a
  long way toward the preservation of the most
  critically needed services provided by the
  County

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PURPOSE of MEASURE B

• To avoid the life-threatening shutdown of Los
  Angeles County's trauma network,
• To maintain and expand the trauma network
  Countywide, while ensuring more timely response
  to critical and urgent medical emergencies, and
• To respond effectively to biological and chemical
  terrorism.

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MEASURE B November 5, 2002, Special Tax Election

• Would Authorize the County of Los Angeles to levy
  a 3 cents per sq. ft. special tax on structural
  improvements to provide funding for the
  Countywide System of Trauma Centers, Emergency
  Medical Services and Bioterrorism Response.
• Would require a 2/3 majority approval for passage
  from the voters.
• Supervisors in favor of the measure 32

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CAMPAIGN

• Short time frame
• Educate Voters (history of passing Prop 13)
• Utilized Labor Union (SEIU)
• Board of Supervisors Support
• Retained Political Consultant
• Dakota Communication

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CAMPAIGN (continued)

• Tenet Healthcare
• Hospital Association
• Endorsement by LA Times and Daily News
• EMS providers
• Free news coverage from local media
• Funding through Labor Union and coalition of
  supporters

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PROS versus CONS
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TIMING IS EVERYTHING! November 3, 2002
(Approximately 190 vehicles were involved.
Roughly forty people were hospitalized, nine
reportedly in critical condition.)
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VIRGINIA TRIUMPHS!

• MEASURE B
• WAS PASSED BY THE VOTERS ON
• NOVEMBER 5, 2002
• AT AN UNBELIEVABLE RATE OF 73

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MEASURE B FUNDS FY 2007/08
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DOWNFALLS OF MEASURE B

• The passage of Measure B was no easy task
• Measure B has not resulted in a complete fix
• Not meeting expectations of
• EMS Providers
• All hospitals
• Underserved areas

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REALITY OF MEASURE B

• Saved our Trauma System
• Protects the emergency departments
• Makes a significant difference for bio-terrorism
  preparedness

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CREATIVE FUNDING

• Thank you for listening to
• Los Angeles Countys
• creative solution to improving our
• Trauma System funding.