TO: Board of Supervisors
FROM: Jennifer Yasumoto, Director Health and Human Services Agency
REPORT BY: Gaby Angeles, Staff Services Analyst II
SUBJECT: Revenue Agreements with St. Helena Hospital, Inc. dba Adventist Health St. Helena for Emergency Medical System (EMS) Receiving Hospital Designation and ST-Segment Elevation Myocardial Infarction (STEMI) Receiving Center
RECOMMENDATION
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Director of Health and Human Services Agency (HHSA) requests approval of and authorization for the Chair to sign the following with St. Helena Hospital, Inc. dba Adventist Health St. Helena for an annual maximum of $15,000 per fiscal year per agreement for the term of July 1, 2022, through June 30, 2025:
1. Revenue Agreement No. 230041B for the continued designation as a Receiving Hospital; and
2. Revenue Agreement No. 230042B for the continued designation as a ST-Segment Elevation Myocardial Infarction (STEMI) Receiving Center.
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EXECUTIVE SUMMARY
Approval of today’s actions will allow the continued designation of St. Helena Hospital, Inc. dba Adventist Health St. Helena as a Receiving Hospital to receive ambulance patients and provide medical care in accordance with Section 1798.101 of the Health and Safety Code, and Local EMS Agency (LEMSA) policies and procedures, and will ensure the continued designation of St. Helena Hospital as a STEMI Receiving Center pursuant to Section 1797.204 of the Health and Safety Code and the EMS System Plan approved by the California EMS Authority.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Health & Human Services Agency, Public Health Division |
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Is it Mandatory or Discretionary? |
Mandatory |
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Is the general fund affected? |
No |
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Future fiscal impact: |
These Agreements terminate on June 30, 2025. Appropriations have been included in the requested Fiscal Year 2022-2023 budget and future fiscal years will be budgeted accordingly. |
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Consequences if not approved: |
If these Agreements are not approved, upper valley emergency patients would not be transported to St. Helena Hospital directly, which would delay patient care and potentially worsen patient outcomes. Additionally, patients in the northern half of Napa County who require the specialized care and treatment provided by a STEMI center would have to be transported to Queen of the Valley Medical Center or out of Napa County to receive lifesaving services. Delay in reaching the services of a STEMI center could be fatal. |
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County Strategic Plan pillar addressed: |
Healthy, Safe, and Welcoming Place to Live, Work, and Visit |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.
BACKGROUND AND DISCUSSION
EMS RECEIVING HOSPITAL DESIGNATION
The County has established an Emergency Medical Services (EMS) system pursuant to Division 2.5 of the California Health and Safety Code. The Napa County Department of Health and Human Services Agency's Public Health Division (HHSA-PH) has been designated as the local Emergency Medical Services Agency (EMS Agency). The EMS Agency is responsible for oversight of Receiving Hospitals for the County's EMS system. Approval of the recommended revenue agreement will continue the designation of Adventist Health St. Helena as a Receiving Hospital. As a designated Receiving Hospital, Adventist Health St. Helena will receive ambulance patients, in accordance with the Health and Safety Code and local EMS policies and procedures. The Receiving Hospital's responsibilities include maintaining a basic or standby, emergency department and staffing its emergency department in conformance with state law. The Receiving Hospital additionally will maintain radio communications systems and participate in system-wide committees to improve the quality of emergency care delivered in Napa County.
The County's EMS Agency is responsible for the following in relation to the Receiving Hospital:
- Compliance monitoring, program oversight, investigations, and medical review of the facility's operations related to emergency services.
- Providing support, training and education for the facility's Internal Tactical Communications Resource (ReddiNet).
- Gathering information and statistics from the facility to provide continuous monitoring and evaluation of the region's ambulance programs and for establishing local medical control policies.
The EMS Agency's responsibility and authority is established in state law (Health & Safety Code Section 1797.204) and is predicated on the establishment of written agreements between the EMS Agency and the facility serving as a Receiving Hospital. Approval of the recommended agreement will also reimburse the County for the provision of oversight and other services to keep Adventist Health St. Helena in compliance with all pertinent regulations and statutes.
This multi-year agreement from July 1, 2022, to June 30, 2025, will provide the EMS Agency with funding of $15,000 per year for functions related to the designation of Adventist Health St. Helena as an EMS Receiving Center.
STEMI
The County has established an Emergency Medical Services (EMS) system, pursuant to Division 2.5 of the California Health and Safety Code. The Napa County Department of Health and Human Services Agency's Public Health Division (HHSA-PH) has been designated as the local Emergency Medical Services Agency (EMS Agency). The EMS Agency is responsible for oversight of ST-Segment Elevation Myocardial Infarction (STEMI) Receiving Hospitals for the County's EMS system.
Approval of the recommended revenue agreement will continue the designation of Adventist Health St. Helena as a STEMI Receiving Hospital. As a designated STEMI Receiving Hospital, Adventist Health St. Helena will receive STEMI (heart attack) ambulance patients, in accordance with the Health and Safety Code and local EMS policies and procedures. The STEMI Receiving Hospital's responsibilities include maintaining a basic or standby emergency department and staffing its emergency department and Cardiac Catheterization facilities in conformance with state law and local policy.
This multi-year agreement from July 1, 2022, to June 30, 2025, will provide the LEMSA with funding of $15,000 per year to offset some of the costs associated with the provision of ongoing oversight for the STEMI program.