DATE: August 20, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Amendment to Agreements for Emergency Medical Services Administration with the Counties of Kings and Madera.
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Fourth Amendment to Agreement No. 90-257 with the County of Kings, for Emergency Medical Services Administration to modify compensation terms, effective May 21, 2019 with no change in the unlimited renewals and increasing the annual maximum by $12,452 to $53,875.
2. Approve and authorize the Chairman to execute a retroactive Fourth Amendment to Agreement No. 90-258 with the County of Madera, for Emergency Medical Services Administration to modify compensation terms, effective May 7, 2019 with no change in the unlimited renewals and increasing the annual maximum by $12,452 to $53,875.
REPORT
Approval of the recommended actions will provide for a 30% increase to the annual base rate for the Counties of Kings and Madera for the Department of Public Health’s administration and oversight of emergency medical services (EMS), with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the cost ($41,422) agreed to on May 11, 1999, as part of the Third Amendment, would remain unchanged and the Department would adjust oversight services and corresponding expenditures based on existing revenue.
RETROACTIVE AGREEMENT:
The recommended amendments are retroactive due to the counties consideration of the proposed increase in their budget processes. The Board of Supervisors for the counties of Kings and Madera approved the recommended amendments on May 21, 2019 and May 7, 2019, respectively; however, the funding changes are effective July 1, 2019.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreements will increase the base rate by 30% or $12,452; increasing the annual maximum from $41,422 to $53,875 for both the counties. Sufficient appropriations and revenues were included in the Department’s Org 5620 FY 2019-20 Recommended Budget and will be included in budget requests for the duration of the term.
DISCUSSION:
California Health and Safety Code, section 1797.200 requires that each County designate an EMS Agency to implement, monitor, and evaluate its EMS system. Since 1990, the Counties of Kings and Madera have contracted with the Department for administration and oversight of their EMS system. Contracted oversight responsibilities include development of policies and procedures, certification/licensure of EMS personnel, designation of trauma centers, investigations/background checks, oversight of ambulance contracts, management of disaster medical services, approval of EMS training courses, designation of exclusive operating areas, and oversight of EMS system operations.
On June 19, 1990, the Board approved Agreement Nos. 90-257 and 90-258, which officially designated the County as the Local EMS Agency in accordance with Health and Safety Code, section 1797.200. On November 10, 1992, the Board approved the First Amendments, Agreement Nos. 92-594 and 92-595, which clarified approval of provider agreements and modified the compensation for services. On June 14, 1994, the Board approved the Second Amendments, Agreement Nos. 94-244 and 94-245, which allowed for EMS “on-call” services and added language that would trigger a renegotiation of compensation in the event of reduction in California Emergency Medical Services Authority (EMSA) funding. On May 11, 1999, the Board approved the Third Amendments, Agreement Nos. 99-171 and 99-172, which modified compensation due to increases in State EMSA funding.
In March 2006, the County of Tulare disbanded its County EMS Agency and initiated an agreement to have the County of Fresno as its designated EMS Agency. Tulare County’s annual cost is being adjusted and will be brought to the Board in September 2019.
The Department’s administration and oversight of emergency medical services costs to the Counties of Kings and Madera has remained unchanged due to funding provided by the State EMSA, which has offset the costs to each of the Counties for the provision of services by the County. For the past few years, State EMSA funds have remained unchanged, as County personnel costs have increased requiring an increase in compensation from each of the Counties. The County is designated as the local EMS Agency for four counties: Fresno, Kings, Madera, and Tulare. The State EMSA recognizes the County as a regional EMS Agency known as the Central California EMS Agency. In accordance with Health and Safety Code, section 1797.108, the State EMSA supports the regionalization and inclusion of rural counties and assists the County with regional funding to support and offset the cost of EMS administration for the smaller counties.
With your Board’s approval, the Fourth Amendment to the Agreements with the Counties of Kings and Madera will be amended to include an increase in in costs for EMS administration and oversight.
OTHER REVIEWING AGENCIES:
On May 21, 2019, the County of Kings approved the recommended amendment.
On May 7, 2019, the County of Madera approved the recommended amendment.
REFERENCE MATERIAL:
BAI #41B, May 11, 1999 - Third Amendment - 99-171 (Kings) and 99-172 (Madera)
BAI #32C, June 14, 1994 - Second Amendment - 94-244 (Kings) and 94-245 (Madera)
BAI #18J, November 10, 1992 - First Amendment - 92-594 (Kings) and 92-595 (Madera)
BAI #31L, June 19, 1990 - Agreement No. 90-257 (Kings) and 90-258 (Madera)
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment IV to Agreement No. 90-257 with the County of Kings
On file with Clerk - Amendment IV to Agreement No. 90-258 with the County of Madera
CAO ANALYST:
Sonia M. De La Rosa