Title
a. Authorize the Auditor - Controller to amend the FY 2016-17 EMS Operating’s adopted budget 001-4000-HEA006-8109 to increase appropriations by $206,894 (4/5th vote required); and
b. Authorize the Auditor - Controller to amend the FY 2016-17 EMS Operating’s adopted budget 001-4000-HEA006-8109 to increase revenue by $166,417 (4/5th vote required); and
c. Authorize the Auditor - Controller to amend the FY 2016-17 adopted budget 001-4000-HEA005-8117 to decrease appropriations and general fund contribution by $40,477 (4/5th vote required); and
d. Authorize the Auditor - Controller’s office to incorporate, and the County Administrative Office to reflect, these approved modifications in the FY2016-17 adopted budget (4/5th vote required). (ADDED VIA ADDENDA)
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Authorize the Auditor - Controller to amend the FY 2016-17 EMS Operating’s adopted budget 001-4000-HEA006-8109 to increase appropriations by $206,894 (4/5th vote required); and
b. Authorize the Auditor - Controller to amend the FY 2016-17 EMS Operating’s adopted budget 001-4000-HEA006-8109 to increase revenue by $166,417 (4/5th vote required); and
c. Authorize the Auditor - Controller to amend the FY 2016-17 adopted budget 001-4000-HEA005-8117 to decrease appropriations and general fund contribution by $40,477 (4/5th vote required); and
d. Authorize the Auditor - Controller’s office to incorporate, and the County Administrative Office to reflect, these approved modifications in the FY2016-17 adopted budget (4/5th vote required).
SUMMARY/DISCUSSION:
Pursuant to the California Health and Safety Code, Section 1797 et seq., the Monterey County Department of Health’s Emergency Medical Services (EMS) Agency is designated by the Monterey County Board of Supervisors as the local EMS Agency. The EMS Agency is responsible for emergency medical services (EMS) system coordination, medical oversight, and coordination of the delivery of EMS by provider organizations in Monterey County. The EMS Agency is also responsible to establish policies and procedures approved by the Medical Director of the Local EMS Agency to assure medical control of the EMS system as well as 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.
The EMS Agency administers the CSA-74 (Fund 092) fund and the Maddy Fund (Fund 016). These funds provide the primary source of funding for the operation of the EMS Agency. For Fiscal Year 2016-17, given that all EMS expenditures are covered by the CSA-74 and Maddy funds, additional appropriations are needed. However, the EMS Agency recorded approximately $166,417 in revenue from other sources of which $125,000 was the result of reclassification of a fee assessed to Natividad Medical Center intended to cover the EMS Agency’s cost of monitoring the trauma center that had been incorrectly posted to the CSA-74 fund (Fund 092). Additionally, approximately $22,947 is an expenditure offset that represents the Community Hospital of the Monterey Peninsula’s (CHOMP) reimbursement to the EMS Agency for a software subscription, the cost of which is equally shared by the EMS Agency, CHOMP, and Salinas Valley Memorial Hospital (SVMH). The EMS Agency also received more unanticipated revenue in the amount of $18,470 from penalties assessed to the ambulance provider.
The remaining $40,477 in General Fund Contribution (GFC) will be transferred from unit 001-4000-HEA005-8117.This GFC transfer is needed as in FY 2015-16 the EMS budget provided this amount of excess revenues to the General Fund in error using restricted funds which must be returned. Overall, the approval of this action will result in the increase of appropriations in amount of $206,894 in the EMS FY 2016-17 budget, financed by $166,417 in revenues already received and $40,477 in GFC transferred from another Health Department appropriation unit.
While this Board action is not directly in support of a Health Department strategic initiative, it is in support of one or more of the essential public health services, specifically: 4) Mobilize community partnerships and action to identify and solve health problems, and, 6) Enforce laws and regulations that protect health and ensure safety
OTHER AGENCY INVOLVEMENT:
The Auditor-Controller and County Administrative Budget Office have reviewed this report.
Report was presented at August 24, 2017 Special Budget Committee Meeting.
FINANCING:
This action does not impact General Fund contribution as the changes will be contained within the approved Health Department’s FY2016-17 adopted budget.
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: Teresa Rios, Management Analyst III, x7082
Approved by: Ezequiel Vega, Assistant Director of Health, x4622