Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Travis Kusman, Director, Emergency Medical Services
Subject: Agreement with EMS Disaster Fellowship, Inc. to provide a Medical Director to the Emergency Medical Services Agency
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with EMS Disaster Fellowship, Inc. to provide a Medical Director to the Emergency Medical Services Agency, for the term of September 1, 2020 through August 31, 2023, in an amount not to exceed $405,000.
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BACKGROUND:
California law requires that each local Emergency Medical Services (EMS) agency have a Medical Director who is a physician experienced in emergency medicine and specifies that the service may be provided by contract. In collaboration with San Mateo County EMS Agency (EMS Agency) Director, the EMS Medical Director provides oversight and coordination of the countywide EMS system. This includes 9-1-1 emergency medical dispatch, fire service paramedic first response, and emergency paramedic ground and air ambulance transport services. The Medical Director is also responsible for creating medical treatment protocols, developing medical policies, conducting medical research, supporting medical and health response to disasters and public health emergencies, along with performing other key functions.
Dr. Gregory Gilbert has served as the Medical Director for the EMS Agency since March 1, 2013 through a service agreement with Stanford Health Care where he is a practicing emergency physician. In Spring of 2016, to update the Medical Director scope of work and to ensure a competitive process for the position, a request for letters of interest was sent to the EMS Medical Directors 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 Dr. Gilbert was selected by the EMS Agency to continue in the Medical Director role through a subsequent agreement with Stanford Health Care, beginning July 1, 2016.
Dr. Gilbert has extensive experience as an emergency and teaching physician. Dr. Gilbert is a leader in EMS throughout the State of California and an active member of various regional and state EMS committees representing San Mateo County.
DISCUSSION:
The EMS Agency is requesting approval of a new agreement with EMS Disaster Fellowship, Inc., a C corporation owned and operated by Dr. Gilbert, to provide Medical Director services. Due to internal restructuring at Stanford Health Care, to assure continuity of services and avoidance of any potential conflict of interest, upon approval of this agreement, the EMS Agency will cancel the current agreement with Stanford Health Care pursuant to its provisions. There will be no resultant duplication of effort or services and no change in cost to the County as a result of this transition in contracting which will enable continuity and stability of the essential services of the EMS Agency Medical Director.
The agreement will allow Dr. Gilbert to continue work in several key areas, including an evidence-based update of the EMS clinical field treatment protocols, support with projects related to EMS system performance, oversight critical to the continued success of the recently implemented 911 Emergency Ambulance Services with Advanced Life Support (ALS), Ambulance Transport, and the San Mateo County Pre-hospital EMS Group Paramedic First Response Provider agreements, and therefore the delivery of high quality care to the public.
Given the on-going COVID-19 pandemic response and Dr. Gilbert’s role in support of medical and health operations in the San Mateo County Emergency Operations Center and San Mateo County EMS system providers, the Procurement Manager has approved a waiver on the Request for Proposals requirement to allow a three-year agreement.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
The resolution contains the County’s standard provision allowing amendment of County’s fiscal obligation by a maximum of $25,000 (in aggregate).
It is anticipated that the Medical Director will attend and/or facilitate 30 clinical quality improvement activities and other EMS meetings.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Actual |
FY 2020-21 Projected |
|
Number of clinical quality improvement activities and other EMS meetings that the Medical Director will attend and/or facilitate |
27 activities |
30 activities |
FISCAL IMPACT:
The term of the agreement is September 1, 2020 through August 31, 2023. The amount of the agreement is not to exceed $405,000 for the three-year term. This new agreement maintains the current cost of services at $135,000 per year. The amount has been included in the EMS FY 2020-21 Recommended Budget. Similar arrangements will be made for future budget years. This agreement is funded by revenue from the County’s Emergency Ambulance Services with ALS Ambulance Transport Agreement with American Medical Response and Maddy funds. There is no net county cost associated with this agreement.