Riverside County Regional Medical Center Trauma and Security Services

On July 21, 2004, the Riverside County Community Health Agency, which serves as the local Emergency Medical Services Agency for Riverside County, conducted a focused survey of the RCRMC Trauma Center, and noted that the “Trauma Bay was extremely small.” The Office of Statewide Health Planning and Development* confirmed that there are no California State standards for Trauma Bay size or design and that each healthcare institution determines its own size and design. Therefore, the Grand Jury obtained comparative data from other hospitals in Riverside and San Bernardino counties (see Table I) *A state agency that approves all new hospital construction and remodeling in California TABLE I RIVERSIDE AND SAN BERNARDINO COUNTIES TRAUMA CENTER COMPARISON FACILITY TRAUMA ROOM ANNUAL BAY SIZE VOLUME RIVERSIDE COUNTY REGIONAL MEDICAL CENTER 1 12’ X 14’ 9” 2,160 RIVERSIDE COMMUNITY HOSPITAL 2 14’ 5” X 18’ 5” 1,842 ARROWHEAD REGIONAL MEDICAL CENTER 8 14’ 6” X 11’ 2” 2.068 SAN BERNARDINO COUNTY LOMA LINDA UNIVERSITY MEDICAL CENTER 10 9’ X 18’ 2,700 SAN BERNARDINO COUNTY

In November 2004, the RCRMC received a $250,000 Federal Planning Grant to design the expansion of the Trauma Center. As of June 28, 2005, there has been no public release of a plan design or timeline for a Trauma Center Expansion project. 3

The 2004 Annual Security Assessment for RCRMC prepared by a Security Officer with the Riverside County Sheriff’s Department and a RCRMC Safety Officer stated the following: • Although terrorist attacks can occur anywhere in the country, the threat of a possible terrorist attack occurring at RCRMC is rated medium. This is based on the Rapid Response Profile** of the Riverside County Sheriff’s Department. However, the Medical Center would be expected to deal with other Mass Casualty Incidents (MCIs) occurring within the county. In order for RCRMC to effectively respond to MCIs, perimeter security of the facility is vital. Currently, RCRMC has over thirty (30) perimeter doors that are accessible from the street. • The electronic monitoring system that attaches to newborn, Neonatal Intensive Care Unit and pediatric patients to prevent infant abduction is “…becoming antiquated and parts are becoming harder to find. Additionally, with the current system it takes an extended amount of time to validate if an actual abduction has occurred. This allows an abductor to exit the Medical Center before a perimeter is established, and this was proved during a recently staged abduction drill.” .

Although RCRMC is committed to providing a safe and secure environment for patients, staff and visitors, the RCRMC 2004 Annual Security Assessment identifies additional strategies to enhance security at the Medical Center. The estimated cost of implementation of these safety and security strategies is summarized in Table II. **The Rapid Response Profile is designed to respond to previously identified critical infrastructure within the county. This is a pre-plan for law enforcement operations in the event of a terrorist attack or natural emergency. TABLE II RCRMC PROPOSED SECURITY AND SAFETY STRATEGIES a. Install perimeter fence around the Medical $130,000 Center and Tank Farm. b. Upgrade the Infant Abduction Monitoring 200,000 System. c. Install barrier doors that require the use of key 15,000 card to control access to the Operating Room. d. Install doors in the hallway that require the use 30,000 of key card to control access to the Diagnostic Imaging Department. e. Install an alarm system around the perimeter of 4,000 the Tank Farm. f. Install a gate at the top of driveway leading to 30,000 the Loading Dock. g. Implement a screening system for patients and 15,000 visitors with the use of color-coded passes. h. Install a stationary metal detector at the four 35,000 main entrances (Nason Street, Cactus Avenue, and Security and Emergency Departments) to the Medical Center. TOTAL $459,000