DATE: June 20, 2017
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Agreement with Sequoia Safety Council, Inc. for Paramedic Ambulance Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Agreement with Sequoia Safety Council, Inc. for paramedic ambulance services, effective July 1, 2017 through June 30, 2019 ($70,000).
REPORT
Approval of the recommended action will continue paramedic ambulance services in Fresno County Ambulance Zone J, Reedley Response Area, which encompasses much of Southeastern Fresno County including the cities of Orange Cove, Parlier, and Reedley. The recommended agreement satisfies the requirement of Title 22 of the California Code of Regulations (Title 22) that the County have a written agreement with paramedic provider agencies. The services will be funded with Health Realignment, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should the Board not approve the recommended action, the existing agreement would expire and the County would be in violation of State regulations until an agreement for paramedic ambulance services is established.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the agreement is $70,000, which includes $42,000 for FY 2017-18 and $28,000 for FY 2018-19. The agreement will be fully offset with Health Realignment funds. Sufficient appropriations will be included in the Department of Public Health Org 5620 FY 2017-18 Recommended Budget and in subsequent fiscal year budget requests.
DISCUSSION:
Since 1978, the County has provided monthly payments to local rural ambulance service providers for estimated uncompensated care, based upon supporting prior year documentation from the agencies. Due to changes effected by the Patient Protection and Affordable Care Act (Public Law 111-148), the costs of uncompensated care have decreased for ambulance providers. The Department is proposing to gradually decrease the $57,000 provided annually as reimbursement.
Approval of the recommended Agreement would continue paramedic ambulance services in Fresno County Ambulance Zone J (Reedley Response Area). Zone J 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. State regulations require the Department to review contracts with Emergency Medical Service (EMS) providers every two years, except when an exclusive operating area has been designed; however, in this instance, a two-year term agreement is being recommended, as a two-year term is consistent with other rural ambulance agreements. The proposed agreement continues the existing response and performance requirements.
In 2016, Sequoia Safety Council responded to 6,592 requests for service and performed 5,189 transports.
With your Board’s approval, the County will continue to contract with Sequoia Safety Council for paramedic ambulance services in Fresno County Ambulance Zone J, Reedley Response Area. The recommended agreement contains a mutual indemnification clause. In addition, either of the parties can terminate the contract without cause upon 90-day written notice, and parties can terminate for cause with a 10-day advanced notice with an opportunity to cure. In the event of an act of god, act of public enemy, or other extraordinary cause not reasonably within the control of either party, the recommended agreement has a force majeure clause that excuses the parties’ performance under the contract. The recommended agreement satisfies the requirement of Title 22 for a written agreement with local paramedic provider agencies.
REFERENCE MATERIAL:
BAI #59, July 14, 2015 - Agt. No. 15-334
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Sequoia Safety Council
CAO ANALYST:
Sonia De La Rosa