DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director of Public Health
SUBJECT: Agreements for Paramedic Ambulance Services with Sequoia Safety Council and the Cities of Coalinga and Kingsburg
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with the Sequoia Safety Council 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 $140,000;
2. Approve and authorize the Chairman to execute an Agreement with the City of Coalinga, 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 $225,000; and
3. Approve and authorize the Chairman to execute an Agreement with the City of Kingsburg, 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 $30,000.
REPORT
Approval of the recommended actions will continue paramedic ambulance services in the Fresno County Ambulance Zones C, K, I and J. Zone C - Coalinga Response Area encompasses the City of Coalinga and the surrounding area. Zone K - Kingsburg Response Area includes the City of Kingsburg and the surrounding area. Zones I - Sanger area and J - Reedley response area, which encompass much of the southeastern portion of the County, including the cities of Sanger, Orange Cove, Parlier, Reedley, and the surrounding unincorporated 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.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the recommended agreement with Sequoia Safety Council is $140,000, which includes $28,000 for each fiscal year of the term.
The maximum amount of the recommended agreement with the City of Coalinga is $225,000, which includes $24,000 for each fiscal year of the term for coverage of the City’s response area, and $21,000 for each fiscal year of the term for coverage in the western portion of Zone C, which includes the City of Huron area.
The maximum amount of the recommended agreement with the City of Kingsburg is $30,000, which includes $6,000 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 C - Coalinga Response Area, K - Kingsburg Response Area, and I - Sanger Response Area, and J - Reedley Response Area.
Zone J - Reedley Response Area is a designated exclusive operating area, which designates Sequoia Safety Council as the sole provider of emergency ambulance services and restricts the County from contracting with other providers for the same or similar services. The Zone includes the unincorporated areas of Squaw Valley, Dunlap, and a portion of the Kings Canyon National Park.
The Cities of Coalinga and Kingsburg are the only providers of paramedic ambulance services in each of their respective areas 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, Sequoia Safety Council responded to 8,349 requests for service and performed 5,574 transports, the City of Coalinga responded to 3,294 requests for service and performed 2,133 transports, and the City of Kingsburg responded to 3,118 requests for service and performed 1,760 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 #41 - September 24, 2019
BAI #20 - August 20, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Sequoia Safety Council
On file with Clerk - Agreement with the City of Coalinga
On file with Clerk - Agreement with the City of Kingsburg
CAO ANALYST:
Ronald Alexander