Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Nancy Lapolla, MPH, Director, Emergency Medical Services Agency
Subject: Agreement with the San Mateo County Pre-Hospital Emergency Medical Services Group to be a Designated Paramedic First Response Provider
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with the San Mateo County Pre-Hospital Emergency Medical Services Group (JPA) to be a designated paramedic first response provider and to authorize the Emergency Medical Services Agency to provide funding identified in the American Medical Response West (AMR) contract to the JPA for the term of July 1, 2019 through June 30, 2024, with an option to extend until June 30, 2029.
body
BACKGROUND:
The San Mateo County Emergency Medical Services Agency (EMS Agency), housed within County Health, provides administrative and regulatory oversight for the local EMS system. The EMS Agency’s primary function is to plan, implement, and evaluate the local EMS system and its various components. This includes authorizing advanced life support (ALS) providers (paramedic level) for the delivery of emergency medical care to the sick and injured. Title 22, Division 9, Section 100168 requires an EMT-Paramedic Service Provider to have a written agreement with the local EMS agency to participate in the advanced life support program and to comply with all applicable State regulations and local policies and procedures, including participation in the local EMS agency’s quality improvement system.
On May 14, 2019, your Board approved a resolution authorizing an agreement with AMR for the provision of emergency ambulance services with ALS ambulance transport, which includes a payment to the JPA for first response paramedic services. This agreement allows the JPA to continue to be designated by the EMS Agency as a Paramedic Service Provider and enables the pass-through of funds from the County’s agreement with AMR to the JPA for the medical first response services it provides.
DISCUSSION:
The JPA is comprised of City of Brisbane, City of Burlingame, City of Daly City, City of Foster City, Town of Hillsborough, City of Millbrae, City of Pacifica, City of Redwood City, City of San Bruno, City of San Carlos, City of San Mateo, City of South San Francisco, Belmont Fire Protection District, Coastside Fire Protection District, Colma Fire Protection District, County of San Mateo, Menlo Park Fire Protection District, and Woodside Fire Protection District. The JPA provides Countywide paramedic first responder services prior to the arrival of an AMR ALS ambulance, except within the City of South San Francisco.
The JPA provides a valuable service to the residents and visitors of San Mateo County. Pursuant to this Agreement, the JPA will staff ALS fire first response vehicles to respond to 9-1-1 emergency medical requests in urban areas within 6:59 minutes, exceeding the California Standard of 8:00 minutes. This quick response allows AMR to extend ALS ambulance response times to 12:59 minutes while the patient is receiving initial ALS medical care from JPA first response paramedics. AMR will provide funding for the JPA first response services to the EMS Agency.
The EMS system in San Mateo County has been a model for many systems throughout California. The strong partnerships between both public and private providers has delivered excellent prehospital medical care to our communities. It is anticipated that response times to all 9-1-1 emergency medical requests will be delivered in accordance with the chart below 90 percent of the time.
|
Urban/Suburban - Response to 90 percent of calls each month shall be compliant |
|
Code Type |
JPA ALS First Responder |
AMR Emergency Ambulance |
|
Code 3 |
6:59 minutes |
12:59 minutes |
|
Code 2 |
14:59 minutes |
22:59 minutes |
|
|
|
Rural - Response to 90 percent of calls each month shall be compliant |
|
Code Type |
JPA ALS First Responder |
AMR Emergency Ambulance |
|
Code 3 |
11:59 minutes |
19:59 minutes |
|
Code 2 |
24:59 minutes |
59:59 minutes |
|
|
|
Remote - Response to 90 percent of calls each month shall be compliant |
|
Code Type |
JPA ALS First Responder |
AMR Emergency Ambulance |
|
Code 3 |
21:59 minutes |
39:59 minutes |
|
Code 2 |
29:59 minutes |
59:59 minutes |
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Estimate |
FY 2019-20 Projected |
|
Percent compliance with fire/first responder response standards |
95% |
90% |
*Please note that the JPA is contractually obligated to achieve a 90% compliance rate, however, it is expected to exceed that rate by 5% in FY 2018-19.
The County’s agreement with AMR provides an annual first year payment of $4,815,508 to support the cost of ALS first response by the JPA. AMR will make monthly payments of $401,292.33 to the County EMS Agency and the EMS Agency will forward this amount to the JPA. The EMS Agency may increase this payment annually beginning July 1, 2020; however, such increases may not exceed the Consumer Price Index All Urban Consumers San Francisco‐Oakland‐San Jose ("Bay Area CPI") increases for the previous year.
FISCAL IMPACT:
There is no cost to the County associated with this agreement as AMR recovers fees from users of ambulance services and their insurance providers to compensate the JPA for the services identified in this agreement.