REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF THE INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
August 20, 2024
FROM
LUTHER SNOKE, Chief Executive Officer, County Administrative Office
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency
SUBJECT
Title
Ordinance and Policy Relating to Ambulance Service Rate Setting
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of San Bernardino County:
a. Adopt ordinance relating to the establishment and annual adjustment of ambulance service rates through the Local Emergency Medical Services Agency ambulance rate setting policy for San Bernardino County.
2. Acting as the governing body of the Inland Counties Emergency Medical Agency:
a. Approve update to Ambulance Rate Setting Policy No. 3060, effective September 19, 2024.
(Presenter: Daniel Muñoz, Interim EMS Administrator, 388-5807)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
The proposed County ordinance adoption and Inland Counties Emergency Medical Agency policy amendment will not result in the use of Discretionary General Funding (Net County Cost).
It is the responsibility of departments impacted by the adjustment of maximum ambulance service rates to ensure sufficient appropriation is included in their respective budgets for 2024-25 and future recommended budgets.
BACKGROUND INFORMATION
San Bernardino County, in County Code section 31.0820 (County Code), establishes the process for setting and adjusting maximum ambulance rates an ambulance service provider may charge within San Bernardino County. This code section has not been updated in many years and has been previously superseded by action of the Board of Supervisors (Board) by amending the Inland Counties Emergency Medical Agency (ICEMA) policy for ambulance rate adjustments. ICEMA has published annual adjustments to this Board approved ambulance rate policy (ICEMA Policy #No. 3060) since 2012, but the County Code has not been updated to reflect the current Board approved process.
ICEMA is the Local Emergency Medical Services Agency (LEMSA) for the counties of San Bernardino, Inyo, and Mono. ICEMA administers State and local codes and regulations governing the provision of emergency medical care to the sick and injured at the scene of an emergency and during transport to a care facility.
The proposed ordinance will update County Code to properly authorize the establishment of maximum rates and the annual adjustment process through ICEMA policy and identify ICEMA as San Bernardino County’s LEMSA in the County Code Ambulance Chapter 8. This update will align with recent legislation, Assembly Bill 716, which amended California Health and Safety Code Division 2.5, Chapter 3, Article 2 for LEMSA established/approved ground ambulance provider rates and comply with the State reporting requirements.
The proposed ordinance will authorize the schedule of maximum rates that may be charged for ambulance service as established and published by the LEMSA in the ICEMA Ground Based Ambulance Rate Setting Policy No. 3060, for San Bernardino County (as initially approved by the ICEMA Board of Directors on February 23, 2010 [Item No. 69] and on May 8, 2012 [Item No. 46]). The recommended ordinance and ICEMA policy updates will also bring minor updates to the process for calculating the annual rate adjustments.
The proposed policy will update the annual rate adjustments calculation using the federally published consumer price index (CPI) statistics and a local rate comparison of similar jurisdictions. This annual effort will provide ambulance transport providers with equitable maximum rates for transport services, which are adjusted for inflation and comparable to local jurisdictions. Calculation updates include referencing a more accurate geographic region and more appropriate CPI index when calculating rate adjustments. It will also add a process to recommend necessary rate adjustments.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel, 387-5455) on July 24, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) on July 31, 2024; County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on July 31, 2024.