DATE: November 28, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with the California Emergency Medical Services Authority
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive revenue Agreement with the California Emergency Medical Services Authority for multi-county emergency medical services coordination, effective July 1, 2023 through June 30, 2024 ($959,945).
REPORT
There is no Net County Cost associated with the recommended action. Approval of the recommended action will provide State General Fund revenue for continued emergency medical services coordination of the four-county region: Fresno, Kings, Madera, and Tulare, pursuant to Section 1797.108 of the California Health and Safety (H&S) Code. The funding may only be used to maintain and improve the Emergency Medical Services (EMS) system and continue essential minimum program activities. The recommended Agreement provides State Funds and requires local program funding from the four counties mentioned above. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the Department of Public Health (Department) would be unable to fund personnel and service costs associated with the administration of the EMS system for the four-county region.
RETROACTIVE AGREEMENT:
The recommended Agreement was received from the California Emergency Medical Services Authority (EMSA) on September 7, 2023 and is retroactive to July 1, 2023 and is being brought to your Board in accordance with the agenda item processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended action will provide $959,945 in State General Funds, an increase of $45 from prior year’s award for Central California EMS Agency. The allocation allows for reimbursement of personnel ($443,534), fringe benefits ($164,108), communications ($31,635), and software/software maintenance ($233,402) costs, but limits reimbursement of indirect costs up to 10% ($87,266). The County’s indirect cost rate is 18.314%; the remaining $72,555 will be covered with Health Realignment. Sufficient appropriations and estimated revenues are included in the Department’s Organization 5620 FY 2023-24 Adopted Budget. There are no pending invoices related to this retroactive revenue agreement.
DISCUSSION:
As the designated Local EMS Agency (LEMSA) pursuant to H&S, section 1797.108, the Department’s Emergency Services Division, also referred to as the Central California EMS Agency (CCEMSA), has the responsibility to provide complete oversight and administration of emergency medical services throughout the four-county region: Fresno, Kings, Madera and Tulare. The County is responsible for all H&S Code, Division 2.5 local EMS agency functions. The EMSA identifies the following as potential benefits derived from a regional EMS Agency:
• reducing administrative and program costs;
• standardizing system coordination of emergency response and patient flow;
• focusing of regional EMS concerns;
• providing more effective impacts at the State level; and,
• matching administrative boundaries with natural systems.
The recommended agreement will support existing staffing and services to the entire EMS region and recovers any Fresno County costs that may have been used to support the administration of services in the other counties. The additional funding assists in providing dispatch and technology services in the rural areas of the region.
The recommended agreement for multi-county emergency medical services coordination contains non-standard termination language as it allows the State to terminate the agreement immediately for cause and without cause upon giving the County at least 30-days advanced written notice. The County may submit a written request to terminate the agreement only if the State should substantially fail to perform its responsibilities in the agreement.
The recommended agreement deviates from the County’s standard indemnification and insurance language and requires the County to indemnify the State of California, EMSA, and/or any of their officers, agents and/or employees regardless of the existence or degree of negligence or fault.
OTHER REVIEWING AGENCIES:
The Health Directors and Administrative Officers of Kings, Madera, and Tulare Counties support the continuation of the Central California EMS Agency.
REFERENCE MATERIAL:
BAI #47, November 29, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with California Emergency Medical Services Authority
CAO ANALYST:
Ronald Alexander