1. Trauma Center Recommendation San Joaquin General Hospital French Camp, California May 31, 2009 San Joaquin General Hospital French Camp, California December 6, 2011

2. 1 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

3. 2 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

4. 3 Trauma Center Levels

5. 4 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

6. 5 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

7. 6 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

8. 7 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

9. 8 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