Ross Valley Neighborhood Association

Re: Proposed Level II Trauma Center with Helipad at MGH

(For Informational purposes)

Neighbors, once again we are confronted with the issue to construct a helipad at Marin General Hospital (MGH). In 1998, a similar proposal was defeated. Although a formal proposal has not been submitted, all indications point to a submission occurring within the near future to convert MGH to a Level II Trauma Center with a helipad. Therefore, we hope to provide our community with the latest information available so we may collaborate and arrive at a timely and informed decision.
 

Background

In 1998, the Ross Valley Neighborhood Association (RVNA) was established to support improved trauma care in the county but to oppose the construction of a helipad at or near MGH. Shortly thereafter, the helipad notion was tabled due to questions about necessity and environmental impact. We do continue to support improved trauma and health care in our county but are opposed to the construction of a helipad at MGH.
 

Current Proposal

MGH, managed by Sutter Health, clearly would like to become Marin County's Level II Trauma Center with a helipad. The estimated cost to convert MGH to a Level II Trauma Center is in the range of $500,000 to $1,500,000. Thereafter, the Level II would cost approximately $2,000,000 per year to maintain.

  • Funding - Currently, a hospital is allowed to charge $20,000 per patient for opening the trauma center to that patient. This is simply an activation fee, not including medical services then provided. This amount is then added to the patient's insurance and billed out.
     
    • Some questions remain: What effect will this have on insurance premiums? Will more county funds be diverted to MGH to provide a subsidy for increased costs? Will the taxes of Marin residents increase? What other medical services in the County will suffer as a result? What will happen to trauma care services at Kaiser in San Rafael and Novato Community Hospital. (The proposal is to extinguish them.)
       
    • Although HMO's could treat their own patients, they would end up paying cash because the patients were shipped to a Level II.
       
  • Helicopter Evacuations in Marin County - There were 143 flights in 2002:
     
    • 104 were trauma and 39 were medical
       
      • Flight breakdown follows:
        • 48 went to Santa Rosa
        • 38 went to Walnut Creek (John Muir)
        • 20 went to Doctor's Hospital in San Pablo (burns & cardiac catheter lab)
        • 19 went to Oakland Children's Hospital
        • 12 went to Petaluma Valley Hospital
        • 6 went to other facilities (Stanford, UC Davis, Eden, all special care situations)

The rampant increase in flights in the last five years shows that the "triage tool" is broken, leading to "over-triaging" by paramedics. The massive increase in flights is not attributable to increased trauma cases.

  • State of California requirements for a Level II Trauma Center:
     
    • Available immediately - 24/7 - A General surgeon, Emergency room doctor, Anesthesiologist, Neurosurgeon, Orthopedic surgeon and Radiologist
    • 24/7 Critical Care Coverage
    • Minimum county population: 350,000
       
  • State requirements not satisfied / considerations and impacts:
     
    • Marin County does not have the population to support a Level II Trauma Center.
       
    • MGH is currently struggling to maintain 24/7 neurosurgical coverage
       
      • Additional considerations:
        • MGH will probably file for an exemption with the state to have the population criteria overlooked.
        • MGH struggling to maintain 24/7 neurosurgical coverage but will be expected to leapfrog to Level II status.
        • San Francisco General Hospital is a Level I (the highest designation) Trauma Center that is nationally renowned for its trauma care... they don't have and/or need a helipad.
        • Currently, helicopters are allowed to land at Creekside Park - directly across from MGH. We believe this practice should continue to ensure life-threatening events are treated in an expeditious manner.
        • Impacts / more unanswered questions:
          • Compliance with Land Use laws?
          • Environmental concerns?
            • Noise levels, vibration, extreme disturbance
            • Weather issues: fog, severe wind, rains in a narrow valley
            • Impact on Schools and Park
            • High population density near and around MGH
            • Sensitive habitats and endangered wildlife in Corte Madera Creek and surrounding environs
            • Safety hazards:
              • Helicopter crashes - Mechanical problems are the number one cause of helicopter accidents.
                 

Some Pertinent Quotes

  • Margaret Sabin, MGH's CEO, was recently quoted as saying, "I know there's not another Level II in the country servicing a community of 250,000 (Marin pop. estimate) and the reason is the cost is prohibitive."
     
  • A member of the Marin Healthcare District, at the open forum on 3/25/03 at the Civic Center, suggested that a proposition be put on the ballot to raise the necessary funds by taxing Marin residents.
     
  • San Rafael Fire Chief, Bob Marcucci, has consistently stated that we don't need a Level II Trauma Center in Marin, with a helipad. (IJ articles of March 13, 2003 and November 24, 2002).
     

Santa Rosa Memorial - A Case Study

Santa Rosa is currently dealing with how to limit the number of helipad landings at their hospital. Here's a perspective of possible coming attractions should MGH become a Level II with helipad.

  • Santa Rosa initially promised their residents only 50 helicopter flights per year. Santa Rosa now has about 500 flights per year.
     
  • Of 419 landings in 2002, only 242 were actual trauma cases delivered from the scene... the rest were transfers from other hospitals.
     
  • Most Marin patients delivered to Santa Rosa were from our coastal areas as well as the Marin/Sonoma county line, following the principal rule: always transport to the nearest trauma center. These patients would continue being delivered to Santa Rosa (regardless of MGH's status) simply because it is the closest trauma center to these areas. Santa Rosa is not diverting patients from its care. While Santa Rosa's emergency room occasionally goes on "divert" or by-pass (due to the high volume of patients relying on the ER as their primary source of care), its trauma center has only been on divert four times in the past year... each time for no longer than an hour.
     
  • Santa Rosa residents and leadership just went through an extensive "battle" to limit the number of flights into Santa Rosa Memorial. They were overruled. Once a helipad is established, the FAA governs it and it cannot be restricted.

If you would like further information on this issue, or copies of supporting documents, please contact us at: rossvalleyna@msn.com