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D.3

To:	Contra Costa County Fire Protection District Board of Directors
From:	Lewis T. Broschard III, Chief, Contra Costa Fire Protection District
Date:	December 8, 2020

Contra

Costa

County

Subject:

ET3 – Emergency Triage, Treat and Transport Model Participation Agreement Under the Center for Medicare and Medicaid Innovation

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/08/2020

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, Director
Candace Andersen, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover, Director

Contact:

Terry Carey, Assistant Chief 925-941-3300

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 8, 2020
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

1. APPROVE and AUTHORIZE the Fire Chief, or designee, to include the Contra Costa County Fire Protection District in the Centers for Medicare and Medicaid Services program titled ET3 - Emergency Triage, Treat and Transport Mode Participation Agreement, for the period January 1, 2021, through December 31, 2025.

2. APPROVE and AUTHORIZE the Fire Chief, or designee, to sign any necessary agreements required to participate in the ET3 Program.

FISCAL IMPACT:

Currently, the Centers for Medicare and Medicaid Services (CMS) will only pay for ambulance transport to a hospital emergency department or other covered destination. District participation in the ET3 model will allow for additional revenue recovery for emergency ambulance transports to an alternative destination and for treatment in place.

BACKGROUND:

Emergency Triage, Treat, and Transport (ET3) is a voluntary, five-year payment model that will provide greater flexibility to ambulance care teams to address the emergency health care needs of Medicare Fee-for-Service (FFS) beneficiaries following a 911 call.

While the program is offered by CMS to a subset of Medicare patients, the Contra Costa County Fire Protection District (District) proposes to implement the program offering the services to all 911 users.

CMS will continue to pay to transport a Medicare FFS beneficiary to a hospital emergency department or other covered destination, which is the current process. In addition, under the ET3 model, CMS will now reimburse for services such as:

1.Transport to an alternative destination partner, such as a primary care office, urgent care clinic, or a community mental health center (CMHC); or
2. Initiate and facilitate treatment in place with a qualified health care partner, either at the scene of the 911 emergency response or via telehealth.

The District intends to implement an alternative destination (Mental Health facility) as well as a telehealth program, and will provide these new services to all of our citizens, without regard to payer status.

The primary goal of the ET3 Model is to test whether paying for (1) Transport to an Alternative Destination and (2) Treatment in Place, each furnished to low-acuity Medicare FFS beneficiaries following a 911 call, will reduce avoidable transports of Medicare FFS beneficiaries to emergency departments and/or utilization of other covered services. The secondary goal of this model is that these services be provided to all users of the 911 system, and that it not be limited only to Medicare FFS beneficiaries.