Title
a. Approve and authorize the Director of Health or Assistant Director of Health, and the Emergency Medical Services (EMS) Agency Director to execute the County of Monterey, Department of Health, Emergency Medical services Agency Agreement with ESO and Providers for Reporting to California Emergency Medical Services Authority between the County and those EMS provider agencies intending to participate in the County’s Unified Electronic Patient Care Reporting (ePCR) and Data System for first responders, ambulance transport providers, hospitals, and communications centers, for a period from the date of approval and execution by the participating parties through March 30, 2020; and
b. Approve and authorize the Director of Health or Assistant Director of Health, and the Emergency Medical Services (EMS) Agency Director to execute the County of Monterey Emergency Services Agency Agreement with EMS Providers (CALFIRE, Cachagua FPD, City of Carmel FD, Gonzales Rural FPD, Greenfield Fire, Monterey City Fire, Presidio of Monterey Fire, Seaside Fire, Salinas, Fire, Big Sur VFB, Mid Coast FB, American Medical Response) intending to participate in the County’s Data System for Quality Assurance/Quality Improvement (QA/QI) Oversight and Data Collection/Aggregation. See Exhibit A for a list of participating agencies.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health or Assistant Director of Health, and the Emergency Medical Services (EMS) Agency Director to execute the County of Monterey, Department of Health, Emergency Medical services Agency Agreement with ESO and Providers for Reporting to California Emergency Medical Services Authority between the County and those EMS provider agencies intending to participate in the County’s Unified Electronic Patient Care Reporting (ePCR) and Data System for first responders, ambulance transport providers, hospitals, and communications centers, for a period from the date of approval and execution by the participating parties through March 30, 2020; and
b. Approve and authorize the Director of Health or Assistant Director of Health, and the Emergency Medical Services (EMS) Agency Director to execute the County of Monterey Emergency Services Agency Agreement with EMS Providers (CALFIRE, Cachagua FPD, City of Carmel FD, Gonzales Rural FPD, Greenfield Fire, Monterey City Fire, Presidio of Monterey Fire, Seaside Fire, Salinas, Fire, Big Sur VFB, Mid Coast FB, American Medical Response) intending to participate in the County’s Data System for Quality Assurance/Quality Improvement (QA/QI) Oversight and Data Collection/Aggregation. See Exhibit A for a list of participating agencies.
SUMMARY:
The Health Department seeks authorization to execute two Agreements:
a. EMS Data Collection/Reporting Agreement
b. EMS QA/QI Oversight Agreement
Both Agreements are between the County EMS and those EMS provider agencies intending to participate in the County’s Unified Electronic Patient Care Reporting (ePCR) and Data System. It should be noted that four EMS provider agencies have chosen not to participate in the County-funded ePCR/Data system. They are: North County Fire Protection District, Monterey County Regional Fire District, Marina Fire and King City Fire. Those provider agencies currently use another electronic data system and have chosen to remain with that system. They will be responsible for providing electronic data through their vendor to the County data system.
DISCUSSION:
On September 30, 2015, the Governor Approved Assembly Bill 1129. This bill revised California Health and Safety Code, Section 1797.227, which sets standards for the documentation of EMS patient encounters and participation in a local EMS data system. The relatively new state law now requires local emergency medical care providers to submit electronic data following the National EMS Information System (NEMSIS) or national standard. California’s standard (CEMSIS) follows that national standard for tracking and reporting data. Currently, the various EMS providers in Monterey County use several different ePCR (electronic Patient Care Report) systems which do not meaningfully integrate with each other. Some providers still use handwritten PCRs. This makes the collection and analysis of system-wide data very difficult. In many cases, it is impossible. A single integrated ePCR system will help the EMS System to provide better patient care, which is the primary aim of all system quality improvement efforts.
ESO Solutions, Inc. was awarded a contract in the amount of $450,000 in April of 2017 as the ePCR vendor for Monterey County Emergency Medical Services by way of a formal Request for Proposal (RFP #10588) process conducted in late 2016. Given that the implementation of a single integrated ePCR system county-wide is important for the Monterey County EMS system and to ensure compliance with the requirement of the new state law, the EMS Agency is using CSA-74 monies to pay for the ESO contract which provides initial and continuing costs of ESO software, licensing, and database integration with communication centers, hospital systems, and health information exchanges for those organizations that become part of the EMS Agency-provided ePCR data system at least until March 30, 2020, based on the needs of the EMS system and available CSA-74 funding.
To implement the ePCR data system agreement with ESO, two new agreements are necessary. The two Agreements were developed by a writing team consisting of EMS Agency staff, the Health Department Privacy Compliance Officer, and County legal staff. The two Agreements are designed to protect private health information, to ensure adherence to all applicable local policies, and state and federal law, and to document the responsibilities of the County and EMS provider agencies/stakeholders regarding the county-wide EMS data system. The agreements’ purposes are as follows:
County of Monterey, Department of Health, Emergency Medical services Agency Agreement with ESO and Providers for Reporting to California Emergency Medical Services Authority Agreement
• Establishes terms regarding the use of ESO Software to be utilized by agencies and allow County to access the information needed to prepare reports required by the State. This agreement incorporates the ESO Solutions agreement awarded under RFP #10588 as an Exhibit.
County’s Data System for Quality Assurance/Quality Improvement (QA/QI) Oversight and Data Collection/Aggregation Agreement
• Establishes obligations of the County, who shall be acting on behalf of the agencies as a business associate. The agreement will allow quality assurance and quality improvement activities to take place while ensuring that the Federal and State laws are being followed regarding Protected Health Information (PHI).
This work supports the following Board Strategic Initiatives: Administration - Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency. Health and 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. This work supports the MCHD 2018-2022 Strategic Plan Objectives: 1. Empower the community to improve health, 2. Enhance public health and safety through prevention, and 3. Ensure access to culturally and linguistically appropriate, customer friendly, quality health services. Additionally, this work supports three of the 10 Essential Public Health Services: 3. Inform, educate and empower people about health issues; 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:
Office of the County Counsel-Risk Management and the Auditor-Controller have reviewed the two Agreements as to legal form and fiscal provisions, respectively.
FINANCING:
There is no impact to the County’s General Fund resulting from this action as there is no cost associated with each of these actions. The cost of the services to be provided under the already approved ESO Agreement awarded under RFP #10588 will be covered by the CSA-74 special tax (Fund 092). The funds for this Agreement are included in the Health Department’s Emergency Medical Services Bureau (HEA006, Unit 8109) FY 2018-19 Adopted Budget and will be included in its FY 2019-20 Requested Budget.
EMS is funded by the CSA-74 special tax (Fund 092), which generates approximately $1.8 million in funds each year, which is a consistent revenue source that can sustain the cost of the services to be provided under these Agreements for the projected period.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
a. Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☒Administration:
b. Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
c. 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:
d. Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
e. 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: Fred Claridge, EMS Analyst, 4920
Approved by: Elsa Jimenez, Director of Health, 4526
Attachments:
a. County of Monterey Department of Health, Emergency Medical Services Agency Agreement with ESO and Providers for Reporting to the California Emergency Medical Services Authority on file with the Clerk of the Board
b. County of Monterey Emergency Services Agency Agreement with EMS Providers for QA/QI Oversight and Data Collection/Aggregation on file with the Clerk of the Board
c. Exhibit A is on file with the Clerk of the Board