2009 California Health and Safety Code - Section 1797.198-1797.199 :: Chapter 3.75. Trauma Care Fund

1797.198.  The Legislature finds and declares all of the following:
   (a) Trauma care is an essential public service. It is as vital to
the safety of the public as the services provided by law enforcement
and fire departments. In communities with access to trauma centers,
mortality and morbidity rates from traumatic injuries are
significantly reduced. For the same reasons that each community in
California needs timely access to the services of skilled police,
paramedics, and fire personnel, each community needs access to the
services provided by certified trauma centers.
   (b) Trauma centers save lives by providing immediate coordination
of highly specialized care for the most life-threatening injuries.
   (c) Trauma centers save lives, and also save money, because access
to trauma care can mean the difference between full recovery from a
traumatic injury, and serious disability necessitating expensive
long-term care.
   (d) Trauma centers do their job most effectively as part of a
system that includes a local plan with a means of immediately
identifying trauma cases and transporting those patients to the
nearest trauma center.
   (e) It is essential for persons in need of trauma care to receive
that care within the 60-minute period immediately following injury.
It is during this period, referred to as the "golden hour," when the
potential for survival is greatest, and the need for treatment for
shock or injury is most critical.
   (f) It is the intent of the Legislature in enacting this act to
promote access to trauma care by ensuring the availability of
services through EMS agency-designated trauma centers.

1797.199.  (a) There is hereby created in the State Treasury, the
Trauma Care Fund, which, notwithstanding Section 13340 of the
Government Code, is hereby continuously appropriated without regard
to fiscal years to the authority for the purposes specified in
subdivision (c).
   (b) The fund shall contain any moneys deposited in the fund
pursuant to appropriation by the Legislature or from any other
source, as well as, notwithstanding Section 16305.7 of the Government
Code, any interest and dividends earned on moneys in the fund.
   (c) Moneys in the fund shall be expended by the authority to
provide for allocations to local EMS agencies, for distribution to
local EMS agency-designated trauma centers provided for by this
chapter.
   (d) Within 30 days of the effective date of the enactment of an
appropriation for purposes of implementing this chapter, the
authority shall request all local EMS agencies with an approved
trauma plan, that includes at least one designated trauma center, to
submit within 45 days of the request the total number of trauma
patients and the number of trauma patients at each facility that were
reported to the local trauma registry for the most recent fiscal
year for which data are available, pursuant to Section 100257 of
Title 22 of the California Code of Regulations. However, the local
EMS agency's report shall not include any registry entry that is in
reference to a patient who is discharged from the trauma center's
emergency department without being admitted to the hospital unless
the nonadmission is due to the patient's death or transfer to another
facility. Any local EMS agency that fails to provide these data
shall not receive funding pursuant to this section.
   (e) Except as provided in subdivision (m), the authority shall
distribute all funds to local EMS agencies with an approved trauma
plan that includes at least one designated trauma center in the local
EMS agency's jurisdiction as of July 1 of the fiscal year in which
funds are to be distributed.
   (1) The amount provided to each local EMS agency shall be in the
same proportion as the total number of trauma patients reported to
the local trauma registry for each local EMS agency's area of
jurisdiction compared to the total number of all trauma patients
statewide as reported under subdivision (d).
   (2) The authority shall send a contract to each local EMS agency
that is to receive funds within 30 days of receiving the required
data and shall distribute the funds to a local EMS agency within 30
days of receiving a signed contract and invoice from the agency.
   (f) Local EMS agencies that receive funding under this chapter
shall distribute all those funds to eligible trauma centers, except
that an agency may expend 1 percent for administration. It is the
intent of the Legislature that the funds distributed to eligible
trauma centers be spent on trauma services. The funds shall not be
used to supplant existing funds designated for trauma services or for
training ordinarily provided by the trauma hospital. The local EMS
agency shall utilize a competitive grant-based system. All grant
proposals shall demonstrate that funding is needed because the trauma
center cares for a high percentage of uninsured patients. Local EMS
agencies shall determine distribution of funds based on whether the
grant proposal satisfies one or more of the following criteria:
   (1) The preservation or restoration of specialty physician and
surgeon oncall coverage that is demonstrated to be essential for
trauma services within a specified hospital.
   (2) The acquisition of equipment that is demonstrated to be
essential for trauma services within a specified hospital.
   (3) The creation of overflow or surge capacity to allow a trauma
hospital to respond to mass casualties resulting from an act of
terrorism or natural disaster.
   (4) The coordination or payment of emergency, nonemergency, and
critical care ambulance transportation that would allow for the
time-urgent movement or transfer of critically injured patients to
trauma centers outside of the originating region so that specialty
services or a higher level of care may be provided as necessary
without undue delay.
   (g) A trauma center shall be eligible for funding under this
section if it is designated as a trauma center by a local EMS agency
pursuant to Section 1798.165 and complies with the requirements of
this section. Both public and private hospitals designated as trauma
centers shall be eligible for funding.
   (h) A trauma center that receives funding under this section shall
agree to remain a trauma center through June 30 of the fiscal year
in which it receives funding. If the trauma center ceases functioning
as a trauma center, it shall pay back to the local EMS agency a pro
rata portion of the funding that has been received. If there are one
or more trauma centers remaining in the local EMS agency's service
area, the local EMS agency shall distribute the funds among the other
trauma centers. If there is no other trauma center within the local
EMS agency's service area, the local EMS agency shall return the
moneys to the authority.
   (i) In order to receive funds pursuant to this section, an
eligible trauma center shall submit, pursuant to a contract between
the trauma center and the local EMS agency, relevant and pertinent
data requested by the local EMS agency. A trauma center shall
demonstrate that it is appropriately submitting data to the local EMS
agency's trauma registry and a local EMS agency shall audit the data
annually within two years of a distribution from the local EMS
agency to a trauma center. Any trauma center receiving funding
pursuant to this section shall report to the local EMS agency how the
funds were used to support trauma services.
   (j) It is the intent of the Legislature that all moneys
appropriated to the fund be distributed to local EMS agencies during
the same year the moneys are appropriated. To the extent that any
moneys are not distributed by the authority during the fiscal year in
which the moneys are appropriated, the moneys shall remain in the
fund and be eligible for distribution pursuant to this section during
subsequent fiscal years.
   (k) By October 31, 2002, the authority shall develop criteria for
the standardized reporting of trauma patients to local trauma
registries. The authority shall seek input from local EMS agencies to
develop the criteria. All local EMS agencies shall utilize the
trauma patient criteria for reporting trauma patients to local trauma
registries by July 1, 2003.
   (l) By December 31 of the fiscal year following any fiscal year in
which funds are distributed pursuant to this section, a local EMS
agency that has received funds from the authority pursuant to this
chapter shall provide a report to the authority that details the
amount of funds distributed to each trauma center, the amount of any
balance remaining, and the amount of any claims pending, if any, and
describes how the respective centers used the funds to support trauma
services. The report shall also describe the local EMS agency's
mechanism for distributing the funds to trauma centers, a description
of their audit process and criteria, and a summary of the most
recent audit results.
   (m) The authority may retain from any appropriation to the fund an
amount sufficient to implement this section, up to two hundred
eighty thousand dollars ($280,000). This amount may be adjusted to
reflect any increases provided for wages or operating expenses as
part of the authority's budget process.