Title
Recommendation to Authorize the City Manager to Execute: 1) An Emergency Medical Services First Responder Advanced Life Support Agreement with the County of Alameda, for Five Years with the Option of Five One-Year Extensions; and
2) An Ambulance Transport Services Agreement with the County of Alameda, for Five Years with the Option of Five One-Year Extensions. (Fire 3200)
Body
To: Honorable Mayor and Members of the City Council
EXECUTIVE SUMMARY
The City of Alameda (City), under Health and Safety Code Section 1797.201, is an authorized provider of provide basic life support, advanced life support (ALS) and emergency ambulance transport services in the City. Additionally, the City must have a written agreement per Health and Safety Code 201 with the County Local Emergency Medical Services Agency (LEMSA) to be “authorized” to provide ALS. The original agreement was executed in 2011, however new mandates and requirements necessitate two separate new agreements. The Emergency Medical Services (EMS) First Responder Advanced Life Support (FRALS) Services Agreement and the EMS Ambulance Transport Services Agreement which includes an increased City Transport User Fees.
It is recommended that the City Council authorize the City Manager to execute the EMS FRALS and Ambulance Transport Services Agreements with Alameda County (County).
BACKGROUND
Under Health and Safety Code 201, to be an authorized provider of ALS, the City must have a written agreement with the LEMSA. This agreement meet this requirement for the City to provide ALS and Ambulance Transport Services. The original Ambulance and Paramedic Provider Agreement between the City and County was executed on December 14, 1999. It has been replaced by subsequent agreements.
The current agreement between the City and County was adopted by the City Council on October 18, 2011, and went into effect November 1, 2011. Six Amendments were executed to allow the Fire Department to continue providing basic life support, advanced life support and ambulance transport services to the community. The agreement will expire on June 30, 2023, with one additional five-year option to be exercised by either party.
DISCUSSION
The EMS FRALS Services and Ambulance Transport Services Agreement has historically been one agreement. However, due to recent mandates and requirements, the Alameda County Emergency Medical Services Agency will execute two separate contracts with EMS providers to assure availability of emergency medical response and transportation services. The Alameda Fire Department has been in active negotiations for replacement agreements with the County EMS Agency.
The EMS FRALS Service Agreement changes includes:
• A five-year agreement term with five optional one-year extensions.
• Service response procedures based on the algorithms in the Medical Priority Dispatch System protocols including 5150 calls.
• 5150 calls in accordance with the California Code of Regulations Welfare and Institutions Code, §5150 and EMS Policies. Services involving a patient who has been (or shall be) placed on a hold for psychiatric evaluation, including transport to a psychiatric facility.
• Additional Service Provisions in which the City shall respond with paramedic ALS level personnel to 5150 calls dispatched as Priority 2.
• Performance Standards to include response times in which the City shall make a best effort to achieve a 90% performance level based upon County EMS Agency Personnel and Response Time Requirements.
The EMS Ambulance Transport Services Agreement changes includes:
• A five-year agreement term with five optional one-year extensions.
• Increased user fees, the Agreement between the City and County stipulates that the County establishes user fees the City can charge patients for emergency medical services. The agreement states that "the rates shall be frozen until the County's contract “Private Provider” rates exceed the rates described in the agreement.”
• City User Fees - 911 System
|
|
Current Rate |
New Rate (effective 7/1/19) |
|
Base Rate: |
$ 2,181.38 |
$ 2,295.00 |
|
Mileage (per mile) |
$ 50.71 |
$ 51.78 |
|
Oxygen |
$ 167.91 |
$ 171.45 |
|
Treat, Non-Transport Rate: |
$ 450.77 |
$ 460.27 |
• Ambulance staffing requirements as specified in the County EMS Policies.
• The agreements include the removal of the majority of penalties that can assessed against the City in relation to patient transports. The City and the County have mutually agreed to implement a collaborative process to address issues.
ALTERNATIVES
Failure to not have the agreements will result in the City not being authorized to provide ALS and Transport Services.
FINANCIAL IMPACT
Budget for the contract debt repayment will be included in the Fire Department General Fund 3210.
The City’s total debt owed to the County was $3,621,887 for services provided to the City by the County EMS District from Fiscal Year (FY) 2005-06 through FY 2009-10. The debt was a result of the City not becoming a member of the EMS District until 2011. Due to this, the EMS District Special Tax was not collected during that time period.
When the previous 2011 agreement was executed, the City agreed to contribute the amount equivalent to the amount that would have been generated by an EMS District Special Tax. The City’s annual assessment was paid in quarterly installments using the City FRALS quarterly subsidy to pay down the debt. The County suspended the FRALS quarterly subsidy in FY 2018-19 and funds were subsequently budgeted to make the quarterly installments.
The debt balance ending June 30, 2019 will be $1,970,922.10. The EMS Ambulance Transport Services Agreement provides for quarterly installments of $53,763.55 in FY 2019-20 with a 3% annual escalator. The debt is estimated to be paid in full in 2028.
Two of the quarterly installments are being forgiven by the County and approximately $107,527 will be allocated to the Paramedicine Program.
FY 2019-20, Fire Department appropriations will include the debt repayment of $107,527.
MUNICIPAL CODE/POLICY DOCUMENT CROSS REFERENCE
There is no Alameda Municipal Code/policy document cross-reference.
ENVIRONMENTAL REVIEW
This action is not a project for the purposes of the California Environmental Quality Act (CEQA) pursuant to CEQA Guidelines section 10561(b)(3) as there is no possibility that this action may have a significant effect on the environment.
CLIMATE IMPACTS
There are no climate impacts with this action.
RECOMMENDATION
Authorize the City Manager to execute: 1) An Emergency Medical Services First Responder Advanced Life Support Agreement with the County of Alameda, for five years with the option of five one-year extensions; and
2) An Ambulance Transport Services Agreement with the County of Alameda, for five years with the option of five one-year extensions.
CITY MANAGER RECOMMENDATION
The City Manager recommends approval of the execution of the agreements with the County.
Respectfully submitted,
Edmond Rodriguez, Fire Chief
By,
Monique Raqueno, Fire Admin Services Manager
Financial Impact section reviewed,
Elena Adair, Finance Director
Exhibits:
1. Advanced Life Support Services Agreement
2. Ambulance Transport Services Agreement
cc: Eric Levitt, City Manager