Agenda

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C. 46

To:	Board of Supervisors
From:	David Twa, County Administrator
Date:	December 8, 2020

Contra

Costa

County

Subject:

Authorization of County Sponsored Bill for 2021

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, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:

L. DeLaney, 925-655-2057

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):

AUTHORIZE the County Administrator, or designee, to seek and advocate for sponsored legislation to permit fire protection districts to establish by subcontract a partnership or alliance with a private emergency ambulance service provider for the provision of emergency ambulance services.

FISCAL IMPACT:

There is no additional fiscal impact to the County from sponsoring this bill, as the County's legislative advocates receive a fixed montly retainer for their advocacy efforts.

BACKGROUND:

The Contra Costa County Board of Supervisors' Legislation Committee (Mitchoff/Burgis) is expected to review this sponsored legislation proposal at its December 3, 2020 meeting as a component of the Draft 2021-22 State Legislative Platform. The California Assembly and Senate are planning to convene on December 7, 2020. Legislative packages for the 2021-22 session are currently in development with legislators. Therefore, this matter cannot wait until the Board of Supervisors is expected to take action on the Proposed 2021-22 State Legislative Platform in January 2021.

BACKGROUND: (CONT'D)

Bill Proposal Background

The Contra Costa County Fire Protection District provides 911 emergency ambulance services to nearly one million Contra Costa County residents. The Fire District provides these emergency ambulance services under a long-term contract with Contra Costa County. Contra Costa County and the Contra Costa County Fire Protection District are separate legal entities governed by the Contra Costa County Board of Supervisors.

The County and Fire District entered into the contract in November 2015 at the conclusion of a competitive bidding process conducted in accordance with the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act (the EMS Act; H&S Code §§ 1797-1799.207) and approved by the state Emergency Medical Services Authority (EMSA). The Fire District began providing ambulance services to the County on January 1, 2016, under a subcontract with American Medical Response West (AMR). The Fire District’s partnership with AMR is commonly known as the “Fire-EMS Alliance.”

Since the County-Fire District contract went into effect nearly 5 years ago, the public has seen increased efficiencies in operations and improved response times. The Fire-EMS Alliance has enhanced clinical quality improvement, increased the total number of ambulances deployed daily, and improved the overall level and efficiency of 911 emergency ambulance service provided to County residents. The Fire District responds annually to more than 97,500 calls and provides 77,000 transports. Emergency medical dispatch and 911 call processing times have been reduced by almost a full minute through a combined Fire-EMS dispatch and communications center managed by the Fire District.

Previously, fire engines with paramedics were dispatched from a local dispatch center while ambulances were dispatched from an AMR dispatch center in Sacramento. Overall response times have become shorter through improved and enhanced communications between ambulance and fire crews, and through improved mapping and routing technology provided to responding ambulances. The County-Fire District contract requires the Fire District to meet response time benchmarks 90 percent of the time. The Fire District consistently exceeds these contractual benchmarks, meeting them at least 95 percent of the time. Patient reporting systems also have improved. Fire and ambulance personnel now use the same patient care reporting system, which means that when a patient arrives at a hospital emergency room, the emergency doctors receive only one consolidated patient care report. In addition, the system has remained fiscally sustainable since its inception.

EMSA has proposed amendments to the EMS System Regulations (Chapter 13 of Division 9 of Title 22 of the California Code of Regulations) that purport to prohibit subcontracting similar to the successful subcontract model in place between the Fire District and AMR.

The proposed legislation is necessary to authorize the Fire District to continue to utilize the effective “Fire-EMS Alliance” model in the future as well as provide this subcontracting model as an option for other counties and fire agencies to use for their own emergency ambulance deployment systems.