DATE: July 9, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director of Public Health
SUBJECT: Retroactive Agreements for Paramedic Ambulance Services with the Cities of Sanger and Selma
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Agreement with the City of Sanger, for paramedic ambulance services, effective July 1, 2024, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $84,375; and
2. Approve and authorize the Chairman to execute a retroactive Agreement with the City of Selma, for paramedic ambulance services, effective July 1, 2024, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $67,500.
REPORT
Approval of the recommended actions will continue paramedic ambulance services in the Fresno County Ambulance Zones G and I. Zone G - Selma Response Area includes the City of Selma and the surrounding area. Zone I - Sanger Response Area includes the City of Sanger and the surrounding area. The recommended agreements satisfy the requirement under Title 22 of the California Code of Regulations (Title 22) for the County to have a written agreement with paramedic provider agencies. The services will be funded with Health Realignment, with no increase in Net County Cost. This item pertains to Districts 4 and 5.
ALTERNATIVE ACTION(S):
Your Board may choose not to approve the agreements. The County would need to identify another ambulance provider through a competitive bid process or allow ambulance coverage by an ambulance provider on a non-exclusive basis. Allowing an ambulance provider to provide paramedic services to the County, without an agreement, would be in violation of State regulations until agreements for paramedic ambulance services are established.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2024 due to the cities of Sanger and Selma needing additional time to review their contracts. Contracts were initially sent to Sanger and Selma in January 2024, but the agreements were not heard before their council until June 2024.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the recommended agreement with the City of Sanger is $84,375, which includes $16,875 for each fiscal year of the term for coverage of the City’s Response Area.
The maximum amount of the recommended agreement with the City of Selma is $67,500, which includes $13,500 for each fiscal year of the term for coverage of the City’s Response Area.
The recommended agreements will be fully offset with Health Realignment funds. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5620 FY 2024-25 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
The County, through the Department, has been designated as the Local EMS Agency of the County pursuant to the California Health and Safety Code, section 1797.200.
Since 1978, the County has provided monthly payments to local rural ambulance service providers to assist with estimated uncompensated care costs. The proposed agreements will continue the reimbursement process. Since 1986, the agreements included the provision of dispatch services by the County through the Fresno County EMS Communications Center. The consolidation of dispatch services benefits the County since all medical 9-1-1 requests for medical assistance are received at one location and allows the closest ambulance to the incident to be dispatched.
Approval of the recommended agreements will provide continued paramedic ambulance service in Fresno County Ambulance Zones G - Selma Response Area and I - Sanger Response Area.
The City of Selma is the only provider of paramedic ambulance services in their respective area on a non-exclusive basis; therefore, the agreement does not restrict the County from contracting with other providers for the same or similar services. The proposed agreements continue the established response and performance requirements.
In 2023, the City of Sanger responded to 3,831 requests for service and performed 2,158 transports and the City of Selma responded to 7,286 requests for service and performed 5,137 transports.
With your Board’s approval, the proposed agreements continue the existing response and performance requirements. The recommended agreements contain a mutual indemnification clause and satisfy the requirement under Title 22 for a written agreement with local paramedic provider agencies.
REFERENCE MATERIAL:
BAI #20 - August 20, 2019
BAI #56 - July 9, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with the City of Sanger
On file with Clerk - Agreement with the City of Selma
CAO ANALYST:
Ronald Alexander