Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Nancy Lapolla, MPH, Director, Emergency Medical Services
Subject: Amendment to the Agreement with Stanford Health Care for an EMS Medical Director
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Stanford Health Care to provide a Medical Director to the Emergency Medical Services division, increasing the amount by $260,000 to an amount not to exceed $368,000 and extending the term of the agreement to June 30, 2019
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BACKGROUND:
California law requires that each local Emergency Medical Services (EMS) agency have a Medical Director and specifies that the service may be provided by contract. In collaboration with the Director of EMS, the EMS Medical Director (Medical Director) helps provide oversight and coordination of the countywide EMS system that includes 911 emergency medical dispatch, fire paramedic first response, and emergency paramedic ground and air ambulance transport services. In addition, the Medical Director is responsible for creating medical treatment protocols, developing medical policies, and conducting medical research, in addition to other duties.
Since March 1, 2013, Dr. Gregory Gilbert has served as the Medical Director.
In December 2015, to update the Medical Director scope of work and ensure a competitive process for the position, a request for letters of interest was sent out to the EMS Medical Director Association of California and emergency physician stakeholder groups within San Mateo County. As a result of that process, panel interviews with interested candidates were conducted, and in March 2016, Dr. Gilbert was selected by EMS to continue in the Medical Director role.
Dr. Gilbert is an employee of Stanford Health Care and, therefore, the County has contracted with Stanford Health Care for the time that Dr. Gilbert spends as the Medical Director.
On June 21, 2016, your Board approved an agreement with Stanford Health Care to provide a Medical Director in an amount not to exceed $108,000 for a period ending on June 30, 2017.
Care rendered to patients in the pre-hospital environment includes the use of controlled substances administered to mitigate pain, control seizures, or manage behavioral emergencies. These medications are necessary and used every day in our community by paramedics while caring for patients. The use of controlled substances in the EMS pre-hospital setting requires strict US Drug Enforcement Agency (DEA) oversight and management, and designated licensed physician to act as the DEA physician registrant.
Until now, the County’s Health Officer has served as EMS’ DEA physician registrant. However, this arrangement is unusual and not a best practice; most other California counties rely on their EMS medical director to fulfill this function.
DISCUSSION:
Health System is requesting an amendment to the agreement to (1) extend the term; and (2) allow the Medical Director to function as DEA physician registrant.
The Resolution contains the County’s standard provision allowing amendment of County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by County Counsel as to form.
This amendment to the agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing quality oversight and emergency medical care to the people of San Mateo County through the 911 System and emergency preparedness activities. It is anticipated that the Medical Director will attend or facilitate 25 clinical quality improvement activities.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Number of clinical quality improvement activities and other EMS meetings attended and/or facilitated by Medical Director |
25 |
25 |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2016 through June 30, 2019. The amount of the agreement is not to exceed $368,000. This amendment increases the contract amount by $260,000. This amount has been included in the E MS FY 2017-18 and FY 2018-19 Recommended Budgets. This agreement is 100% funded with “Maddy” funds, with no associated Net County Cost.