DATE: August 20, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Agreements for Paramedic Ambulance Services with City of Sanger and Sequoia Safety Council, Inc.
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Agreement with City of Sanger for paramedic ambulance services, effective July 1, 2019, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $84,375.
2. Approve and authorize the Chairman to execute a retroactive Agreement with Sequoia Safety Council, Inc. for paramedic ambulance services, effective July 1, 2019, 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.
REPORT
Approval of the recommended actions will continue paramedic ambulance services in Fresno County Ambulance 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 of Title 22 of the California Code of Regulations (Title 22) that the County, as the designated Local Emergency Medical Services (EMS) Agency through the Department of Public Health, have a written agreement with paramedic ambulance providers operating in the County. 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):
There are no viable alternative actions. Should your Board not approve the recommended actions, the existing agreements would expire on June 30, 2019 and the County would be in violation of Title 22 regulations until written agreements with paramedic ambulance providers are established.
RETROACTIVE AGREEMENT:
The recommended agreements are retroactive to July 1, 2019, due to extensive negotiations with the City of Sanger and Sequoia Safety Council related to changes in response areas. The prior agreements expired on June 30, 2019
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the agreement with the City of Sanger is $84,375 or $16,875 each fiscal year. The maximum compensation of the agreement with Sequoia Safety Council is $140,000 or $28,000 each fiscal year. The agreements will be fully offset with Health Realignment funds. Sufficient appropriations and estimated revenues were included in the Department’s Org 5620 FY 2019-20 Recommended Budget and will be included in subsequent budget requests for the term’s duration.
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 paramedic ambulance services in Fresno County Ambulance Zones I - Sanger area and J - Reedley Response Area and this reimbursement process.
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.
In 2018, the City of Sanger responded to 3,485 requests for service and transported 2,290 patients. In the same period, Sequoia Safety Council responded to 5,733 requests for service and performed 4,605 transports.
With your Board’s approval, the proposed agreements continue the existing response and performance requirements and contain a mutual indemnification clause.
REFERENCE MATERIAL:
BAI #57 - July 10, 2018
BAI #71 - June 20, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with the City of Sanger
On file with Clerk - Agreement with Sequoia Safety Council
CAO ANALYST:
Sonia M. De La Rosa