DATE: September 12, 2017
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
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, 2017 through June 30, 2018 ($404,842).
REPORT
Approval of the 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. The funding may only be used to maintain the Emergency Medical Services (EMS) system, continue essential minimum program activities, and improve the EMS system. The recommended agreement requires a 100% match, 31% ($124,326) offset with monies from contract funding with the involved counties and 69% ($280,516) 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 action, the Department of Public Health would be unable to fund personnel and service costs associated with the administration of the EMS system in the four-county region.
RETROACTIVE AGREEMENT:
The recommended retroactive revenue agreement was received from the State Emergency Medical Services Agency (EMSA) on June 30, 2017, and is retroactive to July 1, 2017.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended revenue agreement with the State will provide $404,842, an increase of $276 from prior year’s award. The required 100% match will be funded as follows:
• Kings, Madera, and Tulare Counties will provide $41,442 each ($124,326 total)
• Health Realignment ($280,516)
The State allows full reimbursement of direct costs ($368,038), but limits reimbursement of indirect cost to 10% ($36,804) of total direct costs. The Department’s indirect cost rate is 26.19%; the remainder (16.19%) will be covered with Health Realignment funds.
Sufficient appropriations and estimated revenues will be included in the Department Org 5620 FY 2017-18 Recommended Budget.
DISCUSSION:
As the designated EMS Agency pursuant to H&S, 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 emergency medical services throughout the four-county region: Fresno, Kings, Madera and Tulare. The County 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 support existing staffing, medical director support, and services to the entire EMS region.
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 30-days advanced 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 # 34, October 11, 2016 - Agt. No.C16-011
BAI # 34, October 11, 2016 - Resolution No.16-396
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. C17-007
CAO ANALYST
Sonia De La Rosa