REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF THE SAN BERNARDINO COUNTY FIRE PROTECTION DISTRICT
AND RECORD OF ACTION
February 8, 2022
FROM
LEONARD X. HERNANDEZ, Chief Executive Officer, County Administrative Office
DAN MUNSEY, Fire Chief/Fire Warden, San Bernardino County Fire Protection District
SUBJECT
Title
American Rescue Plan Act of 2021 Coronavirus Local Fiscal Recovery Fund Allocation - Emergency Communication Nurse System
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of San Bernardino County, approve agreement between San Bernardino County and the San Bernardino County Fire Protection District in amount of $2,100,000 with a term from February 8, 2022 through December 31, 2024, authorizing the transfer of American Rescue Plan Act of 2021 funds, on a reimbursement basis, to the San Bernardino County Fire Protection District for costs associated with the Emergency Communication Nurse System (Nurse Triage Program) in response to the public health emergency with respect to COVID-19 or its negative economic impacts.
2. Acting as the governing body of the San Bernardino County Fire Protection District:
a. Approve agreement between San Bernardino County and the San Bernardino County Fire Protection District in amount of $2,100,000 with a term from February 8, 2022 through December 31, 2024, accepting the transfer of American Rescue Plan Act of 2021 funds, on a reimbursement basis, from San Bernardino County for costs associated with the Emergency Communication Nurse System (Nurse Triage Program) in response to the public health emergency with respect to COVID-19 or its negative economic impacts.
b. Approve agreement between the San Bernardino County Fire Protection District and the Consolidated Fire Agencies in the amount of $2,100,000 with a term of February 8, 2022 through December 31, 2024, authorizing the transfer of American Rescue Plan Act of 2021 funds, on a reimbursement basis, from the San Bernardino County Fire Protection District to the Consolidated Fire Agencies for costs incurred by the Consolidated Fire Agencies from February 8, 2022 through December 31, 2024 associated with the Emergency Communication Nurse System (Nurse Triage Program) in response to the public health emergency with respect to COVID-19 or its negative economic impacts.
c. Authorize the Auditor-Controller/Treasurer/Tax Collector to post appropriation and revenue adjustments of $2,100,000, as detailed in the Financial Impact section, to San Bernardino County Fire Protection District’s 2021-22 budget for the Emergency Communication Nurse System (Nurse Triage Program) using American Rescue Plan Act of 2021 funds (Four votes required).
(Presenter: Dan Munsey, Fire Chief/Fire Warden, 387-5779)
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.
Focus on Recovery and Resiliency Following Major Emergency Responses such as the December 2, 2015 Terrorist Attack (SB Strong) and the Global COVID-19 Pandemic.
FINANCIAL IMPACT
Approval of these agreements will not require the use of additional Discretionary General Funding (Net County Cost) as the costs pertaining to these agreements ($2,100,000) will be funded through a portion of the San Bernardino County’s (County) American Rescue Plan Act of 2021 (ARPA) Coronavirus Local Fiscal Recovery Fund (CLFRF) allocation approved by the San Bernardino County Board of Supervisors on June 8, 2021 (Item No. 121).
The table below reflects the budget adjustments requested by San Bernardino County Fire Protection District (SBCFPD) to proceed with the Emergency Communication Nurse System (Nurse Triage Program).
|
Fund Center |
Commitment Item |
Description |
Increase Amount |
|
1061652410 |
40509194 |
ARPA CLFRF Fund Distribution (Revenue) |
$2,100,000 |
|
1061652410 |
53003305 |
Contributions to Other Agencies |
$2,100,000 |
The ARPA CLFRF allocation to SBCFPD will fund ongoing costs on a reimbursement basis, as listed in Exhibit A of these agreements, for the Emergency Communication Nurse System (Nurse Triage Program) in response to the public health emergency with respect to COVID-19 or its negative economic impacts. Such program will be operated by the Consolidated Fire Agencies (CONFIRE) pursuant to an agreement with SBCFPD. SBCFPD will transfer funding to CONFIRE for the cost of this program on a reimbursement basis. CONFIRE will pursue other revenue sources so that the program can continue after this one-time ARPA funding allocation is fully expensed.
BACKGROUND INFORMATION
On March 4, 2020, the State of California declared a state of emergency as a result of the Coronavirus Disease 2019 (COVID-19) outbreak and on March 13, 2020, by Proclamation 9994, the President declared a national emergency concerning the COVID-19 pandemic. The COVID-19 pandemic continues to cause significant risk to the public health and safety of the Nation and the County. On March 11, 2021, the American Rescue Plan Act was signed into law by the President. The law is intended to combat the COVID-19 pandemic, including the public health and economic impacts.
Pursuant to Section 9901 of the ARPA, the County received a disbursement from the United States Department of the Treasury of money associated with the Coronavirus Local Fiscal Recovery Fund (CLFRF) for Local Governments under Section 603(a), some of which may be transferred to other public entities for certain ARPA 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.
In addition, CONFIRE is an International Academy of Emergency Medical Dispatch Accredited Center of Excellence. 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.
Approval of the recommended agreements will provide funding from the ARPA CLFRF to assist CONFIRE and SBCFPD with the Nurse Triage Program in CONFIRE’s regional dispatch system in response to the public health emergency with respect to COVID-19 or its negative economic impacts. CONFIRE’s Nurse Triage Program incorporates a nurse element to emergency response calls that allows for the further screening of certain calls. The Nurse Triage Program includes over 200 protocols and assists in identifying potential COVID-19 cases and directing them to appropriate treatment and transportation options. Utilizing nurses with CONFIRE’s expanded dispatch capabilities ensures that patients get to the correct treatment site. This proactive approach of installing nurses in a dispatch center provides for the appropriate care and safety measures for all involved.
This program will enable CONFIRE and SBCFPD to sustain its capability for response to the COVID-19 pandemic by providing the following benefits:
• Decreased hospital Emergency Department volume to enable hospitals to accommodate the COVID-19 surge as healthcare experts have warned the impact of a “twindemic” during the 2021-22 flu season.
• Effective standardized clinical nursing assessments that lead the most appropriate care for each low-acuity patient as well as establishing safe, efficient and effective uses of other EMS and community health resources.
• Decreased ambulance transports per year.
• Decreased hospital ambulance visits.
Funding for the developmental phase of the program was provided under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The initial operational phase of the program (Phase 1) will use funding from ARPA CLFRF. The use of ARPA CLFRF for this program is permissible as the costs for SBCFPD and CONFIRE are to respond to the COVID-19 public health emergency and will be incurred for the period from February 8, 2022 through December 31, 2024, as required by the United States Department of the Treasury.
Both agreements require the provision of expenditure reports in order to process reimbursement. The agreements also delegate to the Chief Executive Officer the authority to:
• terminate the agreements with 30 days’ notice; and
• reduce the transfer amount based on CONFIRE’s estimated cash expenditures through December 31 of each calendar year starting with December 31, 2022 through December 31, 2024, and as identified in the quarterly reports or a later determination by the United States Department of the Treasury, County, or SBCFPD that the costs are ineligible for ARPA funding.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Julie Surber, Principal Assistant County Counsel, 387-5455 and Scott Runyan, Supervising Deputy County Counsel, 387-5455) on January 14, 2022; Auditor-Controller/Treasurer/Tax Collector (Vanessa Doyle, Chief Deputy Controller, 382-3193) on January 12, 2022; Finance (Tom Forster, Administrative Analyst, 387-4635; Guy Martinez, ARPA Compliance Analyst, 387-5428; and Joon Cho, Administrative Analyst, 387-5402) on January 12, 2022; and County Finance and Administration (Diana Atkeson, Deputy Executive Officer, 387-5423) on January 14, 2022.