DATE: July 11, 2017
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Agreement for Paramedic Ambulance Services with the City of Sanger
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive Agreement with the City of Sanger, for paramedic ambulance services, effective July 1, 2017 through June 30, 2018 ($33,750).
REPORT
Approval of the recommended action will continue paramedic ambulance services in the Fresno County Ambulance Zone I, Sanger Response Area, which encompasses the City of Sanger and the surrounding area. The recommended agreement satisfies the requirement of Title 22 of the California Code of Regulations (Title 22) that 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.
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.
RETROACTIVE AGREEMENT:
The agreement is retroactive due to extended negotiations and delays related to the City of Sanger’s approval process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the agreement is $33,750 for FY 2017-18. 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 Adopted Budget.
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 $45,000 provided annually as reimbursement.
California Emergency Medical Services Authority regulations require the Department to review contracts with Emergency Medical Services (EMS) providers every two years, except when an exclusive operating area has been designed. Approval of the recommended agreement will provide continued paramedic ambulance service in Fresno County Ambulance Zone I, Sanger Response Area. The City of Sanger is the only provider of paramedic ambulance services in the area on a non-exclusive basis; therefore, does not restrict the County from contracting with other providers for the same or similar services. The proposed agreement continues the existing response and performance requirements.
In 2016, the City of Sanger responded to 3,771 requests for service and performed 2,630 transports.
With your Board’s approval, the County will continue the contract with the City of Sanger for paramedic ambulance services in Fresno County Ambulance Zone I, Sanger Response Area. The recommended agreement contains a mutual indemnification clause. In addition, either of the parties can terminate contract without cause upon 90-day written notice, and parties can terminate for cause with a 10-day advance 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 proposed agreement has a force majeure clause that excuses the parties’ performance under the contract. The agreement satisfies the requirement of Title 22 for a written agreement with local paramedic provider agencies. The agreement term deviates from the County standard agreement term of a three-year base contract with two optional one-year extensions due to a request for a one-year agreement by the City of Sanger.
REFERENCE MATERIAL:
BAI #67, June 16, 2015 - Agt. No. 15-275
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with City of Sanger
CAO ANALYST:
Sonia De La Rosa