Title
Receive the EMS System Assessment Report prepared by Fitch & Associates, LLC for the Emergency Medical Services (EMS) Agency.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Receive the EMS System Assessment Report prepared by Fitch & Associates, LLC for the Emergency Medical Services (EMS) Agency.
SUMMARY:
The EMS 20/30 System Redesign is a three-phase process that will culminate with the selection of a new 911 Exclusive Operating Area (EOA) ambulance service provider for Monterey County. Phase One-System Assessment consists of assessing the status of the current Monterey County EMS System. Phase Two-Strategic Planning includes the development of an EMS System Strategic Plan, which will serve as a roadmap to guide the strategic adaptation of the EMS System during 2020 to 2030. Phase Three-RFP Development, Issuance/Award involves the development of detailed procurement specifications, releasing an RFP, and selecting a successful contractor by February 2019.
This EMS Assessment Report is the key deliverable for Phase One of Monterey County EMS 20/30: EMS System Redesign. The resulting EMS System Assessment Report describes Fitch & Associates findings and recommendations for the Monterey County EMS System. The information in this EMS System Assessment Report will inform Phase Two of the EMS 20/30: EMS System Redesign.
DISCUSSION:
The Monterey County Department of Health’s EMS Agency is designated by the Monterey County Board of Supervisors, pursuant to California Health and Safety Code, Section 1797.200, as the Local EMS Agency. Consistent with California Health and Safety Code, Section 1797.224, the Local EMS Agency has designated the whole of Monterey County as an EOA except for: (1) certain areas served by the Carmel Fire Department and the Monterey County Regional Fire Protection District; and (2) the area within US Army Garrison Fort Hunter Liggett. Within the Monterey County EOA, the contracted ambulance provider is the sole and exclusive provider of ambulance transport services including interfacility transports, except for transports of certain County mental health patients and authorized mutual aid responses.
The Monterey County EMS 911 ambulance EOA has been served by a single contracted ambulance provider since January 30, 2010. This contract expires on January 31, 2020. The Monterey County EMS Agency must select, through a competitive process, an ambulance service provider by early 2019 to allow ample time to the selected provider to begin services on February 1, 2020.
The next EOA contract and paramedic service provider agreement must address the unprecedented changes that will occur in EMS systems throughout California during the next ten (10) years, including changes in EMS system financing and reimbursement, alterations in clinical scopes of practice based on research and outcomes, and modifications in call volume, call type, and types of transport. To this end in July 2017, the EMS Agency entered in to an agreement with Fitch & Associates to assist the EMS Agency.
The EMS System Assessment Report includes several recommendations, some of which the EMS Agency is already working to implement or is planning to implement prior to the release of the 911 Ambulance Provider RFP. For example:
• Use of Emergency Medical Dispatch on all calls to reduce response risk to patients, caregivers, and citizens.
• Require IAED Accreditation and enhanced QI for medical dispatch and communication functions.
• Measure and report medical first responders’ response times on a fractile basis, adjusted for call density.
• Determine whether the California EMS Authority will allow contract modifications to improve EMS system efficiency and reduce costs, which may include:
o Considering using BLS services for low acuity interfacility transfers
o Evaluating new options for the more humane and lower cost transport of non-medical mental health patients and those being held, pursuant to California Welfare and Institutions Code, Section 5150.
• Improve medical accountability throughout the EMS System.
• Review Contractor’s local leadership team throughout the remainder of the term of the contract.
The information included in the EMS System Assessment Report prepared by Fitch & Associates will be used in Phase Two to develop an EMS System Strategic Plan and in Phase Three to inform the preparation of detailed procurement specifications.
This work is not directly in support of a Health Department strategic initiative, it is in support of one or more of the ten essential public health services, specifically: 7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Board Report 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: Teresa Rios, Management Analyst III, 7082
Approved by: Elsa Jimenez, Director of Health, 4526
Attachments:
EMS System Assessment Report is on file with the Clerk of the Board
PowerPoint presentation is on file with the Clerk of the Board