REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF THE SAN BERNARDINO COUNTY FIRE PROTECTION DISTRICT
AND RECORD OF ACTION
July 14, 2020
FROM
GARY McBRIDE, Chief Executive Officer, County Administrative Office
DAN MUNSEY, Fire Chief/Fire Warden, San Bernardino County Fire Protection District
SUBJECT
Title
CARES Act Funding - Fire Dispatch and Emergency Community Nurse System
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of the County of San Bernardino, approve agreement between the County of San Bernardino (County) and the San Bernardino County Fire Protection District (SBCFPD) in the amount of $2,835,862, with a term of July 14, 2020 through June 30, 2021, authorizing the transfer of Coronavirus Aid, Relief, and Economic Security (CARES) Act funds, on a reimbursement basis, to SBCFPD for the following incident management and expanded dispatch capacity costs incurred through December 30, 2020 in support of the COVID-19 preparation, mitigation, response, and recovery efforts:
a. $289,862 for SBCFPD costs associated with the purchase of various equipment to assist the Incident Management Team, as approved by the Board of Supervisors on May 19, 2020 (Item No. 103);
b. $475,000 for SBCFPD staffing costs associated with implementation of the Emergency Community Nurse System (Nurse Triage Program) and the regional dispatch center in Hesperia; and
c. $2,071,000 for Consolidated Fire Agencies (Confire) costs associated with the acquisition of a Regional Computer-Aided Dispatch (CAD) to CAD Program, regional dispatch improvements, and implementation of the Nurse Triage Program.
2. Acting as the governing body of SBCFPD:
a. Approve agreement between the SBCFPD and the County in the amount of $2,835,862, with a term of July 14, 2020 through June 30, 2021, to accept the transfer of CARES Act funds, on a reimbursement basis, from the County for the following incident management and expanded dispatch capacity costs incurred through December 30, 2020 in support of the COVID-19 preparation, mitigation, response, and recovery efforts:
i. $289,862 for SBCFPD costs associated with the purchase of various equipment to assist the Incident Management Team, as approved by the Board of Supervisors on May 19, 2020 (Item No. 103);
ii. $475,000 for SBCFPD staffing costs associated with implementation of the Nurse Triage Program and the regional dispatch center in Hesperia; and
iii. $2,071,000 for Confire costs associated with the acquisition of a Regional CAD to CAD Program, regional dispatch improvements, and implementation of the Nurse Triage Program.
b. Approve agreement between SBCFPD and Confire in the amount of $2,071,000, with a term of July 14, 2020 through June 30, 2021, authorizing the transfer of CARES Act funds, on a reimbursement basis, from SBCFPD to Confire for costs incurred by Confire through December 30, 2020 associated with the acquisition of a Regional CAD to CAD Program, regional dispatch improvements, and implementation of the Nurse Triage Program in support of the COVID-19 preparation, mitigation, response, and recovery efforts.
c. Authorize the Auditor-Controller/Treasurer/Tax Collector to post appropriation and revenue adjustments totaling $2,546,000, as detailed in the Financial Impact section, to SBCFPD’s 2020-21 budget for the following uses of the CARES Act funds (Four votes required):
i. $475,000 for SBCFPD staffing costs to implement the Nurse Triage Program and the regional dispatch center in Hesperia; and
ii. $2,071,000 for Confire costs associated with the acquisition of a Regional CAD to CAD Program, regional dispatch improvements, and implementation of the Nurse Triage Program.
(Presenter: Dan Munsey, Fire Chief/Fire Warden, 387-5779; Mike Bell, Director, Confire JPA, 356-2377)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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.
FINANCIAL IMPACT
Approval of this item will not require the use of additional Discretionary General Funding (Net County Cost) as the costs pertaining to these agreements ($2,835,862) will be funded through a portion of the County’s CARES Act allocation received in April 2020. The estimated cost of each project/program funded by the CARES Act is as follows:
• $1,061,000 for regional dispatch improvements.
• $ 835,000 for the Nurse Triage Program.
• $ 650,000 for the CAD to CAD program
• $ 289,862 for the purchase of equipment to assist the Incident Management Team.
The below table reflects the budget adjustments requested by SBCFPD to proceed with the implementation of these programs/projects.
|
Fund Center |
Commitment Item |
Description |
Increase (Decrease) Amount |
|
1061652410 |
40509198 |
COVID 19 Relief Fund Distribution (Revenue) |
$2,546,000 |
|
1061652410 |
51001010 |
Salary Expense |
$475,000 |
|
1061652410 |
53003305 |
Contributions to Other Agencies |
$2,071,000 |
Although the recommended agreement between the County and SBCFPD is in the amount of $2,835,862, the budget adjustment totals only $2,546,000. The difference is SBCFPD incurred costs of $289,862 in 2019-20 for the purchase of various equipment to assist the Incident Management Team. A transfer of CARES Act funds from the County to SBCFPD for this purpose was approved by the Board of Supervisors/Board of Directors on May 19, 2020 (Item No. 103). This previous allocation is incorporated into the recommended agreement between the County and SBCFPD.
The majority of the CARES Act funds allocated to SBCFPD is for programs/projects that will be implemented by Confire ($2,071,000) with oversight by SBCFPD. SBCFPD will transfer funding to Confire for the cost of these programs/projects on a reimbursable basis.
BACKGROUND INFORMATION
On March 4, 2020, the State of California declared a state of emergency as a result of the COVID-19 outbreak. On March 10, 2020, the County of San Bernardino (County) proclaimed the existence of a local emergency resulting from COVID-19. On March 27, 2020, the United States Congress passed the Federal CARES Act in response to the COVID-19 pandemic. Pursuant to Section 5001 of the CARES Act, the County received a disbursement from the United States Department of the Treasury of money associated with the Coronavirus Relief Fund (Fund) for Local Governments under Section 601(a) of the Social Security Act, some of which may be transferred to other public entities for certain CARES Act purposes.
Confire is the regional provider of fire and emergency medical dispatch and communications services in San Bernardino County. Based in Rialto, Confire provides dispatch services for 13 fire agencies and one private, non-profit ambulance company. Confire is made up of eight member agencies: SBCFPD, Chino Valley Fire, Rancho Cucamonga Fire, Rialto Fire, Colton Fire, Loma Linda Fire, Redlands Fire, and Apple Valley Fire. Confire also provides service to Montclair Fire, San Manuel Fire, Running Springs Fire, Big Bear Fire, Victorville Fire and Needles Ambulance through contractual agreements.
Confire also acts as the Operational Area (OA) Dispatch Center for the region. In this role, it coordinates all mutual aid efforts during wildfire season, dispatches all medical helicopters for the County, and coordinates medical transportation operations during mass casualty incidents.
In addition, Confire is an International Academy of Emergency Medical Dispatch Accredited Center of Excellence (ACE). Confire staff uses an evidence-based, medically directed call-taking protocol that enables each emergency medical call to be triaged for potential severity, with responses to be aligned accordingly. This process also provides for life-saving pre-arrival instructions to be given to the caller by the call-taker before emergency responders arrive at the scene.
SBCFPD, which covers approximately 19,000 square miles and serves more than 60 communities/cities, is the largest Confire member both geographically and as a dispatch system user. SBCFPD, which responded to almost 150,000 calls for service in FY 2018-19, is the largest paramedic provider and second largest ambulance provider in the County.
COVID-19 Response Efforts:
Since the onset of the COVID-19 crisis, Confire and SBCFPD have played a major role in the regional Incident Management Team (IMT). The following initiatives are a partial list of activities Confire and SBCFPD have engaged in and continue to support in response to COVID-19.
• Development of a county-wide situational awareness capability through the unprecedented union of CAD information from numerous dispatch centers.
• County-wide use of Emergency Medical Dispatch (EMD) protocol to screen calls for potential COVID-19 cases and development of appropriate responses.
• Provide responding units with information regarding responses to potential COVID-19 calls, instructing callers to have the person step outside, if possible, to minimize exposure to first responders and others.
• Initiated steps to incorporate nurse triage capability into call-taking process to provide further screening and treatment options for suspected COVID-19 cases.
• Split dispatch operation into two locations (Rialto and Hesperia) to achieve appropriate social distancing for essential staff (dispatchers)
• Developed contingency plans with other dispatch centers to assist each other if agency staffing levels are impacted by COVID-19 cases among staff members.
To sustain operations and to increase dispatch capacity in support of the regional response to COVID-19, both Confire and SBCFPD will continue to utilize and/or expand these initiatives through the following programs/projects:
CAD to CAD Program
CAD is a system which allows for the coordinated communication, assignment and tracking of resources during calls-for-service. When information for a call is input into CAD, the system recommends what resources are needed for that emergency response. Generally, the software for CAD systems is specialized and does not easily interact with other systems. Because of this, when a call comes in and resources outside the department are needed, a dispatcher must pick up a phone and call another agency to request assistance. A CAD to CAD program is system software that allows different dispatch centers to communicate with each other regardless of which type of program being used. The CAD to CAD system allows sharing information between participating agencies providing immediate intel to field units.
Confire has been leading a two-county effort to implement a regional CAD to CAD program. The COVID-19 pandemic has exacerbated the need to complete this piece of the regional response. Since the onset of the COVID-19 crisis, the IMT established a rudimentary project that allows disparate CAD systems to communicate through a network-based hub that translates information from one CAD to another in real time. The project that will be funded by CARES Act funds will reduce the time required to share information by phone between dispatch centers, the need for which became critically apparent during the response to the COVID-19 pandemic. This expansion and upgrade of this dispatch capacity affords the following benefits:
• Real-time situational awareness and common operating picture between neighboring communications centers.
• Expedites resource requests between agencies, potentially reducing response times across jurisdictional boundaries.
• Improves the transmission and update of incident information to responders.
• Facilitates information flow of real-time information to all San Bernardino County responders regardless of jurisdiction.
Emergency Community Nurse System (Nurse Triage Program)
As an accredited center for EMD, Confire has the ability to expand the EMD program to incorporate a nurse element, which would allow for the further screening of certain calls that can assist in identifying potential COVID-19 cases and directing them to appropriate treatment and transportation options. Utilizing nurses with Confire’s expanded dispatch capabilities, protocols will be implemented to ensure the patient gets to the correct treatment site. This proactive approach of installing nurses in the dispatch center provides for the appropriate care and safety measures for all involved.
Regional Dispatch Improvements
Confire must invest in technological improvements at the Hesperia location to enable seamless operations between its two locations (Rialto and Hesperia). This investment will provide for full redundancy should one location or center become impacted by the COVID-19 pandemic. Staffing necessary to support the Hesperia center includes a command level officer, additional supervision and a computerized mapping analyst. In addition, lessons learned from 9-1-1 centers located in impacted COVID-19 hot spots indicate that the procurement of portable call-taking equipment is vital in increasing the capacity for multiple dispatch centers to work together.
Approval of the recommended agreements will provide funding from the CARES Act to assist Confire and SBCFPD with the following:
• CAD to CAD program application in a manner that would expedite its deployment and increase the capacity of the system to allow more agencies to participate. CAD to CAD will allow multijurisdictional agencies to respond to COVID-19 emergencies quicker, more efficiently, and in a safer manner.
• Immediate implementation of the Nurse Triage Program into Confire’s regional dispatch system.
• Increasing capacity for the Hesperia dispatch center.
These programs/projects will enable Confire and SBCFPD to sustain and expand its capability for response to the COVID-19 pandemic with investment into critical infrastructure of the region.
The use of CARES Act funds for these programs/projects is permissible as the costs for SBCFPD and Confire:
• are necessary expenditures incurred due to the public health emergency with respect to COVID-19;
• were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act); and
• were incurred during the period that begins March 1, 2020 and ends December 30, 2020.
Both agreements require the provision of expenditure reports. The agreements also delegate to the Chief Executive Officer the authority to:
• terminate the agreements with 30 days’ notice; or
• reduce the transfer amount based on Confire’s estimated cash expenditures through December 30, 2020 as identified in the October 31, 2020 and November 30, 2020 reports or a later determination by the United States Department of the Treasury, County, or SBCFPD that the costs are ineligible for CARES Act funding.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Penny Alexander-Kelley, Chief Assistant County Counsel, 387-5455 and Scott Runyan, Deputy County Counsel, 387-5455) on June 19, 2020; Auditor-Controller/Treasurer/Tax Collector (Carmel Manela, Management Services Manager, 382-3191 and Erika Gomez, General Accounting Manager, 382-3196) on June 18, 2020; Finance (Tom Forster, Administrative Analyst, 387-4635 and Joon Cho, Administrative Analyst, 387-5402) on June 18, 2020; and County Finance and Administration (Matthew Erickson, County Chief Finance Officer, 387-5423) on June 18, 2020.