REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
June 10, 2025
FROM
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency
SUBJECT
Title
Mono County Ambulance Rates Adjustment
End
RECOMMENDATION(S)
Recommendation
Acting as the governing body of the Inland Counties Emergency Medical Agency, approve ambulance rate adjustment to Mono County’s ambulance rates, effective July 1, 2025.
(Presenter: Daniel Muñoz, Interim EMS Administrator, 388-5807)
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 and Stakeholders.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost), nor will it affect the budget of the Inland Counties Emergency Medical Agency (ICEMA).
BACKGROUND INFORMATION
ICEMA is the Local Emergency Medical Services Agency (LEMSA) 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 facility. One of the duties that ICEMA oversees is that of ground based ambulance rate setting.
Historically, ICEMA set ground based ambulance rates for San Bernardino County in compliance with San Bernardino County Code section 31.0820. On February 23, 2010 (Item No. 69), ICEMA’s Board of Directors (Board) approved ICEMA Ground Based Ambulance Rate Setting Policy No. 5080 (Policy), establishing an annual procedure for adjusting ambulance rates based on consumer price index (CPI) and local jurisdictions’ rate comparison calculations. Although this Policy applied to only San Bernardino County, ICEMA annually applied the same process to both Inyo and Mono Counties and published those rates as a guideline to transport providers in the respective counties.
On October 8, 2023, California State Assembly Bill No. 716 (AB 716) was approved as a consumer protection bill regarding ground medical transportation. AB 716, codified in Health & Safety Code section 1797.124, included requirements of the state EMS Agency (EMSA) to report ground based ambulance maximum rates by county from each LEMSA.
Most recently, on August 20, 2024 (Item No. 102), ICEMA Policy (renumbered to 3060) was updated to allow for necessary rate adjustments, subject to ICEMA Board of Directors approval, in the event that the annual adjustment process is insufficient to address rate increases. This update also formally included the continued application of ICEMA’s rate setting Policy to Inyo and Mono Counties to formally comply with AB 716. Under the current ICEMA Policy, the EMS Administrator may at any time recommend necessary rate adjustments due to cost increases or decreases to the ICEMA Governing Board based on the needs of emergency medical services, transportation, or other contractual factors affecting ground ambulance services within ICEMA’s jurisdiction.
ICEMA has historically published rates for Inyo and Mono counties and continues to do so following the approval of AB 716. Mono County commissioned a consultant, Willdan Financial Services (Willdan), to perform a comprehensive study of all Mono County fees, including EMS rates charged by the Mono County affiliated transport provider, Mono County EMS. Willdan recommended EMS rates based on cost recovery methodology, applicable local subsidy, and CPI calculations. Mono County officially adopted the recommended rates on May 2, 2023.
Mono County EMS has billed the adopted rates since they became effective on July 1, 2023. To comply with AB 716, ICEMA and Mono County find it necessary to adopt Mono County’s approved rates, effective July 1, 2025 and apply ICEMA’s regular rate adjustment process in subsequent years.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel, 387-5455) on May 13, 2025; Finance (Carl Lofton, Administrative Analyst, 387-5404) on May 22, 2025; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on May 23, 2025.