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D. 1

To:	Board of Supervisors
From:	William Walker, M.D., Health Services
Date:	December 11, 2012

Contra

Costa

County

Subject:

Emergency Medical Services (EMS) System Re-evaluation

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/11/2012

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Mary N. Piepho, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Patricia Frost 646-4690
cc:	Tasha Scott D Gary Juliene Latteri

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: December 11, 2012
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

CONSIDER directing Contra Costa Health Services to conduct an EMS System re-evaluation and report findings and recommendations to the Board of Supervisors.

FISCAL IMPACT:

No general fund impact.

BACKGROUND:

In 2004, the Contra Costa Board of Supervisors approved a major redesign of the EMS System to provide timely paramedic response in most areas of the county from the ambulance provider and fire service paramedic first responders. Recent changes nationally in health care services, at the State level in the prehospital scope of practice, and locally in fire service funding have created new challenges and opportunities for the Contra Costa EMS System.

BACKGROUND: (CONT'D)

The Contra Costa EMS system is a high performance, collaborative network of public safety, private transport, and hospital personnel committed to providing care and transport to patients experiencing medical emergencies. Recently, several fire services in Contra Costa have been forced to close fire stations reducing the ability of fire first responders to meet response time goals. These changes have significant impacts for the EMS System and threaten fire first responder paramedic program sustainability. Changes in State EMS regulations have made certain life-saving measures previously available only to paramedics now available the advanced level emergency medical technicians. Health care reform at the national level may offer opportunities for partnership between hospitals and prehospital EMS providers to reduce unnecessary ambulance transports.

The system re-evaluation will explore opportunities to improve efficiencies within the current EMS System for benefiting patients, stakeholders and communities. The system re-evaluation will also explore evidenced-based alternative service models that support improved patient outcomes and the goals of health care reform. Review and recommendations for changes in the provision of emergency and non-emergency ambulance service will be evaluated as part of this report.

CONSEQUENCE OF NEGATIVE ACTION:

If this Board Order is not approved, opportunities to improve efficiencies, reduce cost and encourage sustainability of EMS System capabilities may be missed.

CHILDREN'S IMPACT STATEMENT:

None.

CLERK'S ADDENDUM

Speaker: Leslie Mueller, American Medical Response

DIRECTED Contra Costa Health Services to conduct an EMS System re-evaluation and report findings and recommendations to the Board of Supervisors by no later than February 28, 2013, or sooner if feasible.