Title:
Consider and take action on a resolution authorizing an agreement between the City of League City and Gulf Coast Regional Blood Center (Fire Chief)
Background:
Approval of this resolution will authorize the Fire Department to provide whole blood to any patients that League City EMS Division responds to that are suffering from traumatic injuries and/or severe blood loss.
Hemorrhagic shock accounts for 40% of preventable deaths due to trauma each year. Administering blood products in the pre-hospital setting gives patients the ability to increase their chances of survival, after suffering from catastrophic incidents and illnesses. Whole blood contains all components necessary to assist in patient stabilization, improving their level of shock, and decreasing hospital mortality.
In FY 23, we had approximately 42 trauma and medical patients who could have benefitted from receiving whole blood, with just over 62% of those patients being transported to HCA Clear Lake. EMS will make the initial purchase of a unit of blood from the blood bank. If the patient who receives the unit of blood is transported to HCA Clear Lake, a level 1 Trauma center, they would provide us with a new unit of blood in return. This would prevent us from incurring an additional cost and ensure another unit of blood is readily available for another patient. If the unit of blood is administered to a patient who is transported to another facility other than HCA Clear Lake that does not have whole blood readily available, we would need to purchase a replacement unit from the blood bank.
EMS estimates that 38% of possible patients will be transported to facilities other than HCA Clear Lake. A new unit of blood would potentially need to be purchased 16 times (estimated), with a total cost being near $6,400.00. The cost of blood would be purchased using the EMS Medical Supplies line item 2950000-51850. To incur the cost, we would remove several medications that are no longer available or beneficial for pre-hospital medicine, such as hespan ($1650 annual savings). The price of Glucagon has decreased by $65.00, saving us $2,600 annually. This gives us approximately $2,150.00 to absorb elsewhere in the medical supply line item.
EMS will add whole blood administration as a treatment charge of $500.00. Blood administration has become common practice in the Hill Country and North Texas but is now being introduced to Southeast Texas as a standard of care. Like other medications and high-acuity skills, this will be treated as an ancillary charge. Medicare and Medicaid disapprove of ancillary charges, unlike private pay insurance, which do. We estimate a return of $8,000.00 on charges billed within 12 months.
League City Fire Department will be the first and only provider in Galveston County to implement this program, which follows best practices in pre-hospital medicine. The blood will be maintained by the on-duty Shift Captain, who will respond and administer the blood to the patients in need. Minimal equipment is needed as the blood will be stored in specialized coolers with electronic monitors and delivered intravenously. Once a unit of blood has been administered, the unit will be replaced by HCA Clear Lake Hospital. If the patient is transported to a non-HCA facility, the Gulf Coast Blood Bank will replenish the unit of blood.
Gulf Coast Blood Bank does charge a flat fee per unit of blood that will be purchased from FY 24 approved medical supply budget and is a recoverable charge through EMS billing. An initial unit of blood will be purchased but can be traded out upon its expiration at no charge with HCA Clear Lake Hospital to ensure utilization and reduce blood waste. The City is also discussing a blood exchange program with UTMB. They currently do not keep blood in their emergency departments, however, have been open to possibly changing their internal policy as more EMS services move to carrying and administering whole blood in the field.
Attachments:
1. Data Sheet
2. Proposed Resolution
3. Exhibit A - Agreement with Gulf Coast Regional Blood Center
CONTRACT ORIGINATION: Fire Department
FUNDING
{X } Funding in the amount of $51,143 is available in EMS Chems, Drugs and Lab Supplies account #2950000-51850
{ } Requires Budget Amendment to transfer from Account #______ to Account #______
{ } NOT APPLICABLE
STRATEGIC PLANNING
{X } Addresses Strategic Planning Critical Success Factor # 3 Safe and Desirable Community
{ } NOT APPLICABLE