Title
Approve and authorize the Director of Health Services or designee to implement an annual license fee in the amount of $25,000 to Air Ambulance Service Providers providing service in Monterey County, Pursuant to California Code of Regulations, Title 22, Section 100300 (c) (7).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health Services or designee to implement an annual license fee in the amount of $25,000 Air Ambulance Service Providers providing service in Monterey County, Pursuant to California Code of Regulations, Title 22, Section 100300 (c) (7).
SUMMARY/DISCUSSION:
The Emergency Medical Services (EMS) Agency is designated by the County of Monterey as the local Emergency Medical Services Agency responsible for regulating the County of Monterey EMS system pursuant to the California Health and Safety Code, Section 1797 et seq. The EMS Agency (County) is responsible for emergency medical services (EMS) system coordination, medical oversight, and coordination of the delivery of EMS by provider organizations in Monterey County. Furthermore, the EMS Agency is responsible for regulating Advanced Life Support (ALS), Critical Care Transport (CCT), and Basic Life Support (BLS) air ambulance services and EMS service providers within Monterey County, and for authorizing ALS, CCT, and BLS air ambulance response and transport within the county.
Pursuant to California Health and Safety Code, Section 1797.178, no person or organization may provide Advanced Life Support (ALS) unless that person or organization is an authorized part of the emergency medical services system. Further, California Code of Regulations, Title 22, Section 100168 (b)(4), a paramedic service provider must have a written agreement with the local EMS Agency to participate in the EMS system and to comply with all applicable State regulations and local policies and procedures, including participation in the local EMS Agency’s continuous quality improvement (QI) program. In addition, California Code of Regulations, Title 22, Section 100300 (c) (7), the local EMS Agency may charge a fee to cover the costs directly associated with the classification and authorization of EMS aircraft. The annual fee will allow the County to recover costs directly associated with the classification and authorization of EMS aircraft.
The implementation of this fee is critical to the financial stability of the EMS Agency. The EMS Agency is funded primarily through a CSA-74 special tax and Maddy funds. The amount of funding from these sources has remained static for many years while the costs of meeting our regulatory responsibility to provide system coordination and oversight has continued to increase. For example, the CSA-74 special has not changed from $12.00 per parcel since FY 2000-01. A projection using a conservative average inflation rate of 2.50% per year between 2001 and today, indicates that the per parcel rate today should have increased from the current $12.00 to $20.66, or a cumulative 72.15% increase. In addition, the EMS Agency’s share of Maddy funds decreased by approximately $81K (9.89%) between FY21-22 and FY22-23 and by approximately $92K (10.04%) between FY20-21 and FY21-22.
This work supports the County of Monterey Health Department 2018-2024 Strategic Plan Goal(s): 2. Enhance public health and safety through prevention; and 4. Engage Health Department workforce and improve operational functions to meet current and developing population health needs. It also supports the following of the ten essential public health services, specifically: 1. Monitor health status to identify and solve community health problems; 4. Mobilize community partnerships and action to identify and solve health problems; and 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel has approved this Agreement as to form.
FINANCING:
There are no General Fund Impacts resulting from this Board action.
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 Assistant, 755-6344
Approved by:
_________________________Date_______________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report