DATE: October 11, 2016
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with State Emergency Medical Services Authority
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue Agreement with the State Emergency Medical Services Authority, for multi-county emergency medical services coordination, effective July 1, 2016 through June 30, 2017 ($404,566).
2. Adopt Resolution identifying the Fresno County Board of Supervisors as the approving authority for the revenue Agreement with the State Emergency Medical Services Authority.
REPORT
Approval of the first recommended action will provide State General Funds 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. Approval of the second recommended action is required to confirm that the local governing body authorizes the execution of the State Emergency Medical Services Authority (EMSA) Agreement No. C16-011 in accordance to the California EMSA Policy for Funding Multi-County EMS Agencies with State General Funds. The funding may only be used to maintain the EMS system, continue essential minimum program activities and improve the EMS system. The recommended agreement requires a 100% match which will be 30% ($124,326) offset with monies from contract funding with the involved counties and the remaining 70% ($280,240) will be covered with Health Realignment funding, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department of Public Health would be unable to fund personnel and service costs associated with the administration of Emergency Medical Services (EMS) in Kings, Madera, and Tulare Counties.
RETROACTIVE AGREEMENT:
The recommended retroactive revenue Agreement was received from the State EMSA on July 19, 2016, and is retroactive to July 1, 2016. Due to internal review timelines the Department was unable to bring this item for consideration prior to this Board date.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreement ($404,566) with the State EMSA is an increase of $197 from the prior year. The required 100% match will be offset with contract funding from Kings, Madera, and Tulare Counties ($124,326) and Health Realignment funding ($280,240). Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2016-17 Adopted Budget. The State allows full reimbursement of direct cost, but limits reimbursement of indirect cost to 10% of total direct costs. The current indirect cost rate is 15.873 percent; the remainder will be covered by funds received from Kings, Madera, and Tulare Counties.
DISCUSSION:
As the designated Central California EMS Agency pursuant to H&S Code, section 1797.108, the Department’s EMS Division, also referred to as the Central California EMS Agency, has the responsibility to provide complete oversight and administration of consistent standardized emergency medical services throughout the four-county region: Fresno, Kings, Madera and Tulare. Fresno County was designated the lead by its member counties and is responsible for all H&S Code, Division 2.5 local EMS agency functions. The State 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 a more effective impact at the state level; and,
• matching administrative boundaries with natural systems.
The recommended Agreement will be used to support existing staffing, medical director support, and supplies to provide services to the entire EMS region. The recommended Resolution is required by the State to confirm that the local governing body authorizes the execution of the recommended Agreement.
The recommended retroactive 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 thirty (30) days advance 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.
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 # 55, September 22, 2015 - Agt. No.C15-003
BAI # 55, September 22, 2015 - Resolution No.15-480
BAI # 44, March 16, 2004 - Agt. No. 04-104
BAI # 31L, June 19, 1990 - Agt. Nos. 90-257 & 90-258
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - State EMSA Agreement No. C16-011
On file with Clerk - Resolution - State EMSA Agreement No. C16-011
CAO ANALYST:
Sonia De La Rosa