Upload
francis-franklin
View
214
Download
0
Embed Size (px)
Citation preview
California Trauma System Summit II
Improving Trauma Care through State Trauma System Development
September 21, 2009
Measure B – Support for Trauma Services
Cathy Chidester, DirectorLos Angeles County,
Emergency Medical Services AgencyTrauma Summit
LOS ANGELES COUNTY
4,082 Square Miles Population > 10 Million 73 9-1-1 Receiving Centers 13 Trauma Centers 30 Public EMS 9-1-1 Providers 19,500 Trauma Patients Annually
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
WHY OUR TRAUMA SYSTEM WAS VERGING ON COLLAPSE:
Increase in Trauma Patient Volumes Poor Payor Mix Drastic Cuts in Proposition 99 Tobacco
Tax Funds
INCREASE IN TRAUMA PATIENT VOLUMES:
YEAR TRAUMA PATIENT VOLUME
1992 12,718
1993 12,423
1994 12,151
1995 12,619
1996 12,596
1997 14,303
1998 15,252
1999 15,653
2000 16,912
2001 18,837
2002 19,196
PRIVATE TRAUMA CENTERS PAYOR MIX:
Medi-Cal15%
Medicare5%
Group11%
Worker's Comp5%
CASH32%
O ther *5%
HMO27%
County Funds Paid 71% of CASH
In Collection 15% of CASH
Self Pay1%
Charity Write-O ff14% of CASH
Fiscal Year 1997/98 (n = 6,745)
COUNTY TRAUMA CENTERS PAYOR MIX:
Worker's Comp1%
Medicare3%
Group9%
Medi-Cal32% CASH
38%
O ther *7%
HMO9%
County Funds Paid 52 o CASH In Collection
14% of CASH
Self Pay2%
Charity Write-O ff35% of CASH
Fiscal Year 1997/98 (n = 7,293)
DRASTIC CUTS IN TOBACCO TAX FUNDS:
1990/91
PHYSICIAN SERVICES
$7,711,000
HOSPITAL SERVICES
$9,209,000
2000/01 $596,000 $1,075,000
2001/02 $394,000 $998,000
Declined by 88%, while the indigent population for Los Angeles County steadily increased.
AS IF THAT WASN’T 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 County’s entire Medical Delivery System was verging on collapse due to the loss of Federal Medicaid "waiver" funding in two years.
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 County’s 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.”
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 improvements…would 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 County’s health funding crisis. However, it would go a long way toward the preservation of the most critically needed services provided by the County”
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.
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 3:2
CAMPAIGN
Short time frame Educate Voters (history of passing Prop 13) Utilized Labor Union (SEIU) Board of Supervisor’s Support Retained Political Consultant –
Dakota Communication
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
PROS versus CONS
Argument in Favor of Measure BPreservation of our most critically needed services!
Rebuttal to Argument for Measure BStop your taxes from rising out of control!
Virginia Price Hastings, Director, EMS Agency
Michael Metro, Chief, Paramedic Services, LA Co Fire
League of Women VotersStephen J. Ryan, MD, Dean, Keck
School of Medicine of USC
Michael D. Antonovich, Supervisor Triso Del Junco, MD, Chief
Medical Staff, ELA Star Community Hospital
Gary G. Hill, Chairman, Board of Directors, Antelope Valley Hospital
Jon Coupal, President, Howard Jarvis Taxpayers Association
TIMING IS EVERYTHING!
November 3, 2002
(Approximately 190 vehicles were involved. Roughly forty people were hospitalized, nine reportedly in critical condition.)
VIRGINIA TRIUMPHS!
MEASURE B WAS PASSED BY THE
VOTERS ON NOVEMBER 5, 2002
AT AN UNBELIEVABLE RATE OF 73%
MEASURE B FUNDS FY 2007/08
County Hospitals - County Departments - Trauma Hospitals / physicians -Grand Total -
140 million
9.8 million
44.6 million
197 million
DOWNFALLS OF MEASURE B
The passage of Measure B was no easy task Measure B has not resulted in a complete fixNot meeting expectations of:
EMS Providers All hospitals Underserved areas
REALITY OF MEASURE B
Saved our Trauma System Protects the emergency departments Makes a significant difference for
bio-terrorism preparedness
CREATIVE FUNDING
Thank you for listening to
Los Angeles County’s
creative solution to improving our
Trauma System funding.