DATE: November 5, 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 County of Tulare
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive First Amendment to Agreement No. 04-104 with the County of Tulare, for Emergency Medical Services Administration to modify compensation terms, effective July 1, 2019 with no change in the unlimited renewals and increasing the annual maximum by $12,433 to $53,875.
REPORT
Approval of the recommended action will provide for a 30% increase to the County of Tulare’s annual base rate 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 action, the cost ($41,442) agreed to on March 16, 2004, as part of the First Amendment, would remain unchanged and the Department would adjust oversight services and corresponding expenditures based on existing revenue.
RETROACTIVE AGREEMENT:
The recommended amendment is retroactive due to the counties consideration of the proposed increase in their budget processes. The Tulare County Board of Supervisors approved the recommended amendment on September 17, 2019; however, the funding changes are effective retroactively to July 1, 2019.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended amendment will increase the base rate by 30% or $12,433; increasing the annual maximum from $41,442 to $53,875. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2019-20 Adopted 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 2004, the County of Tulare has 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 March 16, 2004, the Board approved Agreement No. 04-104, which officially designated the County as the Local EMS Agency for Tulare County in accordance with Health and Safety Code, section 1797.200. The Counties of Kings and Madera began contracting with Fresno County for EMS administrative services in 1990. The Board approved amendments to the Kings and Madera agreements on August 20, 2019 which included similar increases in costs.
The Department’s administration and oversight of EMS costs to the County of Tulare has remained unchanged due to funding provided by the State EMSA, which has offset the costs to Tulare County for the services by the County. The County is designated as the local EMS Agency for four counties: Fresno, Kings, Madera, and Tulare. 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 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 First Amendment to the Agreement with the County of Tulare will be amended to include an increase in in costs for EMS administration and oversight. Similar amendments were approved by your Board on August 20, 2019 for the Counties of Kings and Madera.
OTHER REVIEWING AGENCIES:
On September 17, 2019, the County of Tulare approved the recommended amendment.
REFERENCE MATERIAL:
BAI #44, March 16, 2004 - Agreement No. 04-104
BAI #35, August 20, 2019 - Agreements #19-414 and 19-415
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agreement No. 04-104 with the County of Tulare
CAO ANALYST:
Sonia M. De La Rosa