REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 10, 2024
FROM
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency
LUTHER SNOKE, Chief Executive Officer, County Administrative Office
SUBJECT
Title
Ground Ambulance Medical Transportation Services
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of Inland Counties Emergency Medical Agency:
a. Approve an Authorization Agreement with Consolidated Fire Agencies to provide Basic and Advanced Life Support, Interfacility, and Critical Care Transport ambulance services within the Exclusive Operating Areas identified in the County Ground Ambulance Contract No. 23-1282, for a period of five years from the commencement date of Contract No. 23-1282, with one, five-year extension option.
b. Approve the Memorandum of Understanding between the County and the Inland Counties Emergency Medical Agency to provide oversight and monitoring of the County Ground Ambulance Contract No. 23-1282, and receive service charge payments from Consolidated Fire Agencies, for the cost of oversight and monitoring the County Ground Ambulance Contract No. 23-1282, in effect for as long as the County Ground Ambulance Contract No. 23-1282, and any extensions thereof, remain in effect.
2. Acting as the governing body of San Bernardino County, approve the Memorandum of Understanding between the County and the Inland Counties Emergency Medical Agency to provide oversight and monitoring of the County Ground Ambulance Contract No. 23-1282, and assign the contract service charge payments received from Consolidated Fire Agencies directly to the Inland Counties Emergency Medical Agency, for the cost of oversight and monitoring the County Ground Ambulance Contract No. 23-1282, in effect for as long the County Ground Ambulance Contract No. 23-1282, and any extensions thereof, remain in effect.
(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.
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
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
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost).
The Authorization Agreement with Consolidated Fire Agencies (CONFIRE) will authorize CONFIRE to provide ambulance transport services in Exclusive Operating Areas (EOAs) as detailed in the County Ground Ambulance Contract No. 23-1282 (Ground Ambulance Contract). The Ground Ambulance Contract designates Inland Counties Emergency Medical Agency (ICEMA) as the regulatory agency in charge of oversight of ambulance services and contract compliance for an initial estimated annual service fee of $1,800,000. In addition, Recommendations 1.b. and 2 establish a Memorandum of Understanding (MOU) between the County and ICEMA to provide oversight of the Ground Ambulance Contract. Sufficient appropriation and revenue are included in ICEMA’s 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
ICEMA, as the Local Emergency Medical Services Agency (LEMSA), is responsible for ensuring effective emergency medical services (EMS) for San Bernardino, Inyo, and Mono counties. 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 hospital. California Health and Safety Code, Division 2.5, Section 1797.218, gives ICEMA, as the LEMSA, authority to authorize Advanced Life Support (ALS) and Basic Life Support (BLS) EMS programs.
ICEMA has statutory medical control over all EMS providers within its EMS system. ICEMA also reviews provider staffing, drugs, equipment, record keeping, communications, and training to assure compliance with ICEMA standards and requirements. State law requires all providers of ALS services be authorized by the local EMS agency under the terms of a written authorization agreement that outlines the provider’s EMS obligations and responsibilities. In addition, the provider is required to comply with ICEMA requirements for electronic patient care reports and data collection. Data received by virtue of this requirement will be made part of the ICEMA Quality Improvement Program used for the purpose of evaluating and improving the overall EMS system.
On December 5, 2023, the Board of Supervisors approved the County Ground Ambulance Contract No. 23-1282 (Item No. 80) with CONFIRE for ground ambulance transport services in EOAs for an initial term of October 1, 2024 through September 30, 2029. In addition to the Ground Ambulance Contract, ICEMA requires all transport providers to be authorized to provide services within EOAs. The Authorization Agreement identified in Recommendation 1.a will allow CONFIRE to provide the ALS, BLS, Interfacility (IFT), and Critical Care Transport (CCT) services within the EOAs outlined in the Ground Ambulance Contract, for five years from the commencement date of the Ground Ambulance Contract, and any extension thereof, through compliance of ICEMA standards highlighted above.
Approval of the MOU between the County and ICEMA as listed in Recommendations 1.b. and 2 will allow ICEMA to provide performance oversight of the Ground Ambulance Contract and collect service charge payments from CONFIRE.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel, 387-5455) on August 13, 2024; Risk Management (Gregory Ustaszewski, Staff Analyst, 386-9008) on August 13, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) on August 22, 2024; County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on August 23, 2024.