Title
Adopt a Resolution to:
a. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (016-4000-8111-HEA009) to increase appropriations by $1,916,307 to reimburse physicians as required by Health and Safety Code Chapter 2.5 Section 1797.98a., financed with available fund balance (4/5ths vote required);
b. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (001-4000-8109-HEA006) to increase appropriations and estimated revenue by $110,000,000 to replace six (6) outdated repeaters and other minor operating expenditures, financed by ($90,000) revenue and a ($20,000) operating transfer in from (092-4000-8108-HEA010) (4/5ths vote required);
c. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (092-4000-8108-HEA010) to increase appropriations by $20,000 to accommodate an operating transfer out to (001-4000-8109-HEA006), funded with available fund balance (4/5ths vote required);
d. Authorize the Auditor-Controller to transfer $20,000 from (092-4000-8108- HEA010), which has sufficient appropriations available to cover the transfer (4/5ths vote required); and
e. Direct the Auditor-Controller and County Administrative Office to incorporate the appropriation changes in the Fiscal Year 2022-23 Health Department Adopted Budgets (016-4000-8111-HEA009), (001-4000-8109-HEA006), and (092-4000-8108-HEA010).
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors adopt a Resolution to:
a. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (016-4000-8111-HEA009) to increase appropriations by $1,916,307 to reimburse physicians as required by Health and Safety Code Chapter 2.5 Section 1797.98a., financed with available fund balance (4/5ths vote required);
b. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (001-4000-8109-HEA006) to increase appropriations and estimated revenue by $110,000,000 to replace six (6) outdated repeaters and other minor operating expenditures, financed by ($90,000) revenue and a ($20,000) operating transfer in from (092-4000-8108-HEA010) (4/5ths vote required);
c. Amend the Health Department Fiscal Year 2022-23 Adopted Budget (092-4000-8108-HEA010) to increase appropriations by $20,000 to accommodate an operating transfer out to (001-4000-8109-HEA006), funded with available fund balance (4/5ths vote required);
d. Authorize the Auditor-Controller to transfer $20,000 from (092-4000-8108- HEA010), which has sufficient appropriations available to cover the transfer (4/5ths vote required); and
e. Direct the Auditor-Controller and County Administrative Office to incorporate the appropriation changes in the Fiscal Year 2022-23 Health Department Adopted Budgets (016-4000-8111-HEA009), (001-4000-8109-HEA006), and (092-4000-8108-HEA010).
SUMMARY/DISCUSSION:
In 1989, the Monterey County Board of Supervisors established the County Emergency Medical Services Fund (EMSF), referred to as the Maddy Fund (001-4000-8111-HEA016) under Section 1797.98 of the Health and Safety Code. The Maddy Fund is administered by the Health Department’s Emergency Medical Services Bureau (EMS). Maddy revenues are generated from court fines, penalties, and forfeitures from various criminal offenses and motor vehicle violations.
Health and Safety Code Section 1797.98d states that all funds remaining at the end of the fiscal year, in excess of any reserve held and rolled over to the next year, shall be distributed proportionally, based on the dollar amount of claims and paid to all physicians and surgeons who submitted qualifying claims during that year.
Partly due to staffing shortages and high turnover at the EMS Agency, the requirement to disburse these funds to physicians was missed. The addition of skilled finance staff allowed the EMS Agency to conduct a thorough review to ensure compliance with all requirements of the fund.
The increase of appropriations in the amount of $1,916,307 is needed to allow the EMS Agency to disburse the funds that have been accumulated over the years. In the future, this disbursement will be included in the EMS Bureau’s annual budget and disbursed annually as mandated by regulation.
In addition, the $110,000 increase of appropriations for Adopted Budget (001-4000-8109-HEA006) is needed to accommodate the cost of the replacing six (6) outdated repeaters and other minor operating expenditures. The repeaters are the critical infrastructure that connects the Med Channels used by the contracted ambulance provider (AMR) to communicate with dispatch. The unanticipated costs will be financed with department revenue and an operating transfer from (092-4000-8108-HEA010), $90,000 and $20,000, respectively.
OTHER AGENCY INVOLVEMENT:
This item was presented to the Budget Committee at the May 24, 2023 meeting.
FINANCING:
There will be no impact to the General Fund from approval of the recommended actions, as the additional expenditures of $2,026,307 ($1,916,307 and $110,00) in FY 2022-23 will be financed with additional estimated revenue ($90,000) and available fund balance ($1,916,307 Fund 016 and $20,000 Fund 092).
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Korina Moreno, Administrative Services Assistant, 755-6344
Approved by:
______________________________Date:_________________________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Board Report
Resolution
Health Safety Code 1797.98a
Distribution Summary