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C. 61

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	February 25, 2020

Contra

Costa

County

Subject:

Memorandum of Understanding #28-910 for Emergency Medical and Health Disaster Response Mutual Aid and Mutual Assistance with Counties in California

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 02/25/2020

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:	Chris Farnitano, 925-408-1547
cc:	Marcy Wilhelm

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: February 25, 2020
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Officer acting as the Medical Health Operational Area Coordinator (MHOAC), or designee, to execute the California Statewide Memorandum of Understanding (MOU) #28-910 for Emergency Medical and Health Disaster Response Mutual Aid and Mutual Assistance, through June 30, 2029.

FISCAL IMPACT:

There is no Net County Cost associated with signing this MOU.

BACKGROUND:

The Medical Mutual Aid/Assistance system for California strictly follows the California Department of Public Health’s statewide Public Health and Medical Emergency Operations Manual (EOM). Compliant with the State Emergency Management System (SEMS) and the Incident Command System (ICS), the EOM dictates the pathway for situational awareness and resource requests during a disaster, from the event to the county/operational area, region, and state.

BACKGROUND: (CONT'D)

The County of Contra Costa (County) belongs to California Medical Mutual Aid Region II (Region II). In addition to the County, the Region II operational areas and local public health jurisdictions are: City of Berkeley, the City and County of San Francisco, and the Counties of Alameda, Del Norte, Humboldt, Lake, Marin, Mendocino, Monterey, Napa, San Mateo, San Benito, Santa Clara, Santa Cruz, Solano, and Sonoma.

Contra Costa signed an agreement between the counties in Region II to formalize the medical and health mutual aid/assistance program. Since signing the Region II MOU Contra Costa has responded to disasters within Region II and to counties outside of the region to support the medical and health needs of Counties in need. It is anticipated that Contra Costa would request assistance from counties within Region II prior to seeking assistance from counties outside of the region. In the event of an earthquake where many, if not all, of the counties within the region could be impacted, assistance would be needed and requested from jurisdiction outside of the impacted counties.

Unfortunately, in recent years disasters in California have overwhelmed local emergency medical and health response systems and have exhausted mutual aid/assistance from counties within the medical and health mutual aid/assistance regions. The medical and health mutual assistance program has recently seen extensive use supporting major incidents in California. The Oroville Dam incident, Santa Rosa/Napa Fires last fall, the Thomas Fire in Ventura and Santa Barbara Counties, the mudslides in Montecito, and the major fires in Redding and Mendocino County have all relied upon medical and health mutual assistance as a significant part of the response. Medical and health mutual assistance is becoming a routine aspect of disaster response in California.

Operationally, the Medical Health Operational Area Coordination (MHOAC) program functions very well. However, there have been significant challenges when it comes to reimbursing providers who supply these resources. These disasters have required assistance from counties outside of the region throughout the state. This was especially evident with request for environmental health and mental health mutual assistance. Contra Costa County sent Medical and Health personnel including the Contra Costa Medical Reserve Corps and county Environmental Health inspectors to support health response activities in response to the Paradise Fire, which is outside of the Region II’s mutual aid/assistance region.

Currently, there is no agreement between the counties and local health jurisdictions for sharing resources and/or financial responsibility for reimbursement outside of one’s assigned region. Further, the lack of pre-event agreements to share emergency medical and health resources between counties and local health beyond regional boundaries during a disaster prevents the impacted county from quickly qualifying and/or obtaining potential recovery costs from the State or the Federal Emergency Management Agency (FEMA).

CONSEQUENCE OF NEGATIVE ACTION:

This statewide MOU would allow impacted counties to request and unimpacted counties to share resources during a disaster, seek reimbursement, in accordance with state and federal disaster relief fund requirements. A statewide MOU would enable an expedited process to access needed resources outside of the existing regional medical and health mutual aid/assistance areas when necessary. Having an MOU in place between all counties in California for medical and health emergency and disaster response, clarifies the process and makes it easier for both the requesting and responding counties to meet the needs of the communities impacted by the events. An MOU provides for a clear process to receive funds and get reimbursement for services rendered during an emergency.