Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: James C. Porter, Director of Public Works
Louise F. Rodgers, Chief, San Mateo County Health
Subject: Appropriation Transfer Requests for San Mateo Medical Center Ligature Projects
RECOMMENDATION:
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Approve the following Appropriation Transfer Requests (ATRs):
A) Recognizing $750,000 in unanticipated revenue from the San Mateo Medical Center Enterprise Fund and corresponding expenditures to the Capital Projects Budget Unit (8500B) for the execution of the San Mateo Medical Center Prevention Self Harm and Ligature Project; and
B) Transferring $750,000 from the Medical Center Capital Expense - Software Budget to the Capital Expenditures - DPW to fund the above project.
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BACKGROUND:
San Mateo Medical Center (SMMC) was cited for existing ligature risks during their triannual Joint Commission accreditation survey that occurred December 19-21, 2018. A ligature risk (point) is defined as anything which could be used to attach a cord, rope, or other material for the purpose of hanging or strangulation. Some common ligature points include shower rails, ceiling fittings, and door handles and hinges. Centers for Medicare & Medicaid Services (CMS) state the presence of ligature risks in the physical environment of a psychiatric patient pose a risk to the patient's safety. This is particularly an issue for a patient with suicidal ideation. The SMMC’s Patient's Rights under the Conditions of Participation (CoP) provides all patients with the right to care in a safe setting.
This is a serious finding that must be addressed immediately for safety as well as continued compliance with Joint Commission requirements. The Joint Commission will return to SMMC within 21 to 45 days of the survey date to resurvey the areas of noncompliance.
DISCUSSION:
The Department of Public Work’s Capital Projects Unit is working collaboratively with SMMC to quickly address ligature risk points and to address regulatory compliance deficiencies under the Office of State Health Planning Department (OSHPD).
Funding for this project will allow the Capital Projects team to expedite the execution of contracts necessary and take corrective action in order to meet the Joint Commission’s timeline.
County Counsel has approved this resolution as to form.
This resolution contributes to the Shared Vision 2025 outcome of a Healthy Community by improving facilities and protecting the safety of our patients.
FISCAL IMPACT:
Initial funding of $750,000 will allow Public Work’s staff to immediately begin corrective measures to address the ligature risk. Funding to start this project will be absorbed within SMMC’s FY 2018-19 Adopted Budget. Total Project cost is estimated at $2,000,000 and additional funds to complete this project will be included in the Recommended FY 2019-20 Capital Budget. There is no additional impact to the General Fund this fiscal year.