The County in its capacity as the local emergency medical services (EMS) agency, is soliciting proposals from general acute care hospitals, hereinafter referred to as "PROPOSER", to be considered for designation acceptance as an adult level II trauma center. Authority for designation is provided for by Division 2.5 of the Health and Safety Code of the State of California. Therefore the COUNTY shall accept formal written proposals from general acute care hospitals seeking the designation of a Level II Trauma Center.
The County of Monterey Department of Health, hereinafter referred to as COUNTY, in its capacity as the local emergency medical services (EMS) agency, has been authorized by the Monterey County Board of Supervisors to identify a hospital and medical staff who desire to be designated as an adult level II trauma center, and who complies with, or materially exceeds, COUNTY criteria for designation. The Board of Supervisors shall approve the final Memorandum of Understanding (MOU) or Memorandum of Agreement (MOA), if appropriate. The MOU for this RFQ will be continuous.
The qualified PROPOSER offering the highest overall quality of service, and meeting or exceeding COUNTY minimum requirements, as specified in this Request for Qualifications (RFQ), may be recommended for designation.
The purpose of this Request for Qualifications is to assure high quality trauma care to all residents of and visitors to the County of Monterey. To this end, a Level II trauma center will be designated and patients meeting trauma triage criteria will be transported directly to the trauma center from the field. Air medical dispatch procedures will be evaluated as part of the Trauma Plan Implementation Process to ensure consistency with established treatment guidelines. The trauma system will be implemented and monitored by the Monterey County EMS Agency with assistance from a designated Trauma Advisory Committee.
The 1966, National Academy of Sciences "White Paper" entitled "Accidental Death and Disability: The Neglected Disease of Modern Society", identified deficiencies in providing emergency medical care in the country. This paper was the catalyst prompting federal leadership toward an organized approach to EMS and trauma care. The authority of states to set standards, regulate EMS, and implement programs designed to reduce injury were further reinforced and encouraged by the enactment of the 1966 Highway Safety Act. Various subsequent federal and state initiatives were responsible for improving and refining pre-hospital systems of care during the two decades which followed the landmark 1966 paper.
The development of EMS systems began in 1981 with the establishment of state law and the California EMS Authority. After considerable debate, the California State Legislature enacted the "Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act." (Health and Safety Code 1797, et seq.). This law specifically authorized local EMS agencies to "...plan, implement, and evaluate an emergency medical services system...consisting of an organized pattern of readiness and response services..." (Health and Safety Code 1797.204). The Act further authorized local EMS agencies to plan, implement and monitor limited advanced life support and advanced life support programs.
The California EMS Authority promulgated the document Emergency Medical Services System Standards and Guidelines in 1985, revised in 1993, pursuant to 1797.103 of the California Health and Safety Code.
County of Monterey has been evaluating its trauma care practices since 2004, when it began to identify and solicit community support for the planning process. To meet this objective, the COUNTY has conducted numerous meetings with representatives from hospitals, advance life support providers, and conducted retrospective trauma patient flow and outcome studies. This process has allowed the COUNTY to assess pre-hospital care resources and needs, identify hospital services and resources and begin to develop and revise trauma-specific policies, protocols and system standards. A Trauma Advisory Committee will be established to provide broad EMS community input and support throughout this process. In September 2011, Monterey County EMS Agency received approval from the California EMS Authority for its trauma system plan.