HomeMy WebLinkAboutMINUTES - 07092013 - D.4RECOMMENDATION(S):
CONSIDER accepting additional information regarding the impact of the new population based allocation method
for the distribution of fire first responder funding to various fire districts.
FISCAL IMPACT:
No fiscal impact. This report is informational only.
BACKGROUND:
On May 14, 2013 the Board of Supervisors approved the adoption of a population based formula to allocate the
portion of Measure H funding supporting fire first responder training, equipment, and fire agency quality oversight of
paramedic staffed engines. The prior funding formula was based on the number of 24/7 operational engines
maintained by each fire district. As fire districts began experiencing funding difficulties due to the recession, they
began to reduce the number of 24/7 engines, requiring “brown outs" and station closures.. This situation resulted in
the unintended consequence of disproportionally reducing funding for those fire agencies experiencing fire station
closures. Because of this the EMS Director recommended and the Board of Supervisors approved a new population
based allocation method. This method includes a 25% enhancement for those districts that have implemented an
advance life support (paramedic) fire first response service model.
There are three 24/7 operational fire districts - El Cerrito/Kensington Fire, Pinole Fire, and Moraga Orinda Fire -
which will experience a reduction in their funding under a population based allocation methodology. However, in
response to these lower funding allocations, EMS recommended and the Board of Supervisors approved a two-year
transition period where no 24/7 operational fire district will receive less funding than they did in the 2012/13 fiscal
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 07/09/2013 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, Director
Candace Andersen,
Director
Mary N. Piepho, Director
Karen Mitchoff, Director
Federal D. Glover, Director
Contact: Patricia Frost,
925-313-9554
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: July 9, 2013
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
D.4
To:Board of Supervisors
From:William Walker, M.D.
Date:July 9, 2013
Contra
Costa
County
Subject:Follow-up on EMS Population Based Allocation Plan
year from this funding source.
It should be acknowledged that the transition funding plan is interim in nature and that over the two year transition
period, which runs from July 2013 through June of 2015, there are several major initiatives that will impact the
delivery of EMS services throughout the County. The first initiative is the EMS System and separate CCFPD Fire
Service studies currently underway by Fitch and Associates. These reviews of services, delivery methods, and
funding are anticipated to be completed in late 2013 and will provide valuable information on policy issues that will
need to be addressed. Once this information is received, the population based allocation method can then be
reviewed, refined and adjusted.
In addition to the Fitch EMS study, the Health Services EMS staff will be issuing a request for proposals (RFP) for
County-wide emergency ambulance services. This RFP is anticipated to be issued in mid-2014 for a new contract to
begin in January 2016.
At this point in time, EMS and CAO staff believe that the population based transition formula, which insures a base
level of funding for the next two years, is both reasonable and prudent. However, staff also believe that once the
above initiatives are completed and the information has been received and evaluated, a new review of Measure H
funding should be conducted.
On June 4, 2013, the Board acknowledged the previous approval of the new allocation method, received updated
information on the impact of the new methodology, and acknowledged that all available Measure H revenue is
allocated. During the discussion, several questions arose. Below are answers to those questions:
Q1. How much additional funding would have to be allocated in this category to keep everyone the same and increase
those fire districts who we are decreasing under the population based formula?
A1. To maintain the funding levels at the 2012/13 fiscal year level for the three fire districts that will receive less
funding beginning in the 2015/16 fiscal year, an additional $144,519
BACKGROUND: (CONT'D)
per year would be required after the transition period.
Q2. Would additional funding be available should the Board decide to implement a revised funding allocation?
A2. All available Measure H revenue has been allocated and there is no mechanism for growth in funding levels.
Therefore, the only way additional funds could be made available would be to decrease funding allocations to
other Measure H funded priorities as specified by the CSA-EM-1 voter advisory. EMS staff do not recommend
any changes to the current funding allocations. It should be noted that the Fire Districts currently receive 60% of
all available Measure H funding. The balance is distributed as follows: 5% to Sheriff Dispatch; 18% to County
departments outside of EMS, and 17% to support the EMS program. Funds allocated to the EMS program support
critical EMS System functions and programs supporting Trauma, STEMI, Stroke, contracted ambulance
compliance, paramedic certification, CPR/AED and HeartSafe Communities. Attached is a chart which shows
how the 2013-14 Measure H funding is distributed.
Q3. Provide an updated chart to show how much each fire district received in 2012/13, how much they will
receive under the population based method, how much more or less they will receive, how much more would be
needed to keep all fire districts "whole".
A3. Please see the attached chart. This chart shows how much would be required should the Board decide to
augment only those fire districts that, beginning in 2015/16 fiscal would not receive at least as much as they did in
the 2012/13 fiscal year. By making a special allocation of this type, the EMS staff would no longer have a clear,
transparent methodology with which to make future allocations. Should the Board decide to both maintain the
population based methodology and maintain the 2012/13 allocation as a "floor" an increase of $2,627,707 would
be required for a total allocation of $4,958,841. This is not reasonable or feasible as the total revenue from
Measure H is estimated to be $4,655,128 in the 2013/14 fiscal year and beyond. All other funding allocations
would have to be eliminated and there still would not be sufficient funds.
In addition to the Measure H Zone B fire allocation chart mentioned above, there are three additional documents
attached including:
A list of the anticipated allocation of Measure H funds by project or program.
A pie chart which displays these the allocations by major category. Please note that the Fire Districts receive
60% of all Measure H funding.
A table displaying allocations of Measure H funding to major special projects over the past nine years.
CONSEQUENCE OF NEGATIVE ACTION:
The questions of the Board of Supervisors and the public will not be addressed.
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
Measure H Zone B Allocations
2013-14 Measure H EMS System Enhancement and Population Based First Responder Allocations
Pie Chart
Special Project Expenditures
ABCD EAgencyTOTAL 2012/13 FUNDING ALLOCATION ‐ Engine BasedEMS Agency Transition Funding 2013/14 thru FY 2014/15 ‐ Population BasedIncrease or Decrease During Transition PeriodNew Population Based Allocation Beginning in 2015/16Amount Necessary to Fund at the 2012/13 Level for Impacted Districts (Column A minus Column D)Richmond (BLS)$33,982 $177,670 $143,688 $223,022El Cerrito & Kensington Fire (ALS)$119,315 $119,315 $0 $111,012$8,303Pinole Fire (ALS)$79,543 $79,543 $0 $49,437$30,106Rodeo‐Hercules Fire (ALS)$79,543 $79,543 $0 $88,004Crocket‐Carquinez Fire (BLS)$7,063 * $7,063 $0 $7,063Moraga Orinda Fire (ALS/Transport)$198,858 $198,858 $0 $92,748$106,110East Contra Costa Fire (BLS)$19,418 $180,773 $161,355 $226,125Contra Costa Fire (ALS)$1,183,136 $1,488,368 $305,232 $1,533,722Total$1,720,858 $2,331,133 $610,275 $2,331,133 $144,519* In 2012 was a two year catch‐up period. A total of $14,564 was distributed for two payments. The above amount reflectsthe 2012‐13 distribution only.Column Definitions:Column A ‐ The starting point in 2012/13 with unspent funds going to special projects primarily benefitting fire.Column B ‐ What fire districts would receive under a transition plan based on population and 2012/13 distributions.Column C ‐ The difference between column B and column A. This column shows that no fire district will be adversely impacted during the transition period.Column D ‐ What fire districts will receive beginning in the 2015/16 fiscal year using the newly approved population based formula with a 25% ALS differential.Column E ‐ This column shows how much additional funding would be necessary beginning in the 2015/16 fiscal year to maintain funding at a minimum of the 2012/13 levels.MEASURE H ZONE B FIRE ALLOCATIONSFIRE FIRST RESPONDER
Project or Program Recipient(s)2013‐14 Annual Amount Comments Stakeholder CategoryMeti Mobile Prehospital SimulationTraining Program All fire agencies$26,570Normal run costs to sustain program. Investment does not reflect start up costsFire SupportZone A First Responder Training and Equipment San Ramon Zone A Allocation$33,000Zone A allocationFire SupportEMS Field Manuals All fire agencies $10,000Annual EMS System protocal updateFire Support0.5 FTE Medical Director for Advance Life Support Fire Agencies ALS Fire Provider Agencies$140,607Required for Fire Provider ALS ProgramsFire SupportZoll ePCR (electronic patient care record) used by Fire Agencies All fire agencies excluding Richmond and Crockett$112,000Includes Zoll Maintenance, periodic upgrades, licenses and Contractor IT support Since 2006Fire SupportPhysio Control Annual Fees (First Responder AED program related) All fire agencies $58,410Consolidated service agreement supporting AEDs (automatic external defibrillators) supporting sustainable service of 1 per engine LifePak External Defibrillators Since 7/2008Fire SupportSubtotal Measure H Fire (EMS pays on Fire's Behalf)$380,587Sheriffs Dispatch Funding Sheriffs Communications$250,000EMS System Dispatch Support ReddiNet communication, multicasualty Incident communications and resource allocations , Hospital patient movement and medical surge management suportSheriffSubtotal Measure H Emergency Communications$250,000Subtotal Measure H Fire First Responder Funds $2,331,134EMS Agency Administrative support for Paramedic Programs 7406 EMS Staff EMS Agency 5 FTEs of Professional Staff directly supporting Cardiac Arrest, Trauma, Stroke, STEMI and and 3 FTEs of Support Staff positions$675,907Funds EMS Agency Staff Positions responsible for EMS System Enhancement Programs and countywide paramedic program oversight Under Health and Safety Code Division 2.5. Enhancement programs include Trauma, STEMI, Stroke, EMS for Children, HeartSafe Communities and Ambulance Contract ComplianceEMS Systems of Care Administration and OversightAllocation for EMS System and Impact Studies CCHS and EMS System$100,000System design, EMS system impact studies, feasability studies, new program and consultative reportsEMS Systems of Care Administration and OversightSubtotal Measure H EMS System Oversight Staff and Study Funding$775,907EMS System Enhancement Funds RequestsAll Fire Provider Agencies and EMS System Providers Eligible$100,000One time funding:special projects programs , communications, dispatch, training, special equipment, studies or other related projectsPrimarily Fire Subtotal Measure H Special Project Enhancement Funds$100,000Taxes/Assessment Levy Collections County Assessor/CAO$295,000Includes Zone A and Zone B admin fees charged by county to manage collection of benefit assessmentCountyDOIT/Communictation Charges County$22,500fees for radios, transmission,telecom data processing associated with emergency and normal EMS communicationsCountyIndigent Ambulance Care County$350,000Funding for ambulance services for indigent 9‐1‐1CountyHazMat Charges County$150,000Support for CCHS HazMat services CountySubtotal Measure H County Allocations$817,500$4,655,128Measure H utilization for systemwide benefit and enhancements2013‐14 Measure H EMS System Enhancement and Population Based First Responder AllocationsTotal Measure H Annual Expenditures$2,331,134Final 7.9.13 Fire Board ReportOn May 14, 2013 Fire First Responder Paramedic Engine Fund, Fire First Responder Training and Equipment Allocations and Fire Quality Improvement Program Oversight Funding was consolidated into a single Fire First Responder Population Based Fund. Allocations will be distributed to all fire agencies with a 25% differential for those fire agencies with advanced life support. Fire SupportAll Zone B Fire Agencies. These include Richmond Fire, Moraga Orinda Fire, El Cerrito/Kensington, Rodeo Hercules, Crocket Carquinez, Contra Costa Fire, East Contra Costa Fire, and Pinole FireFire First Responder Population Based Fund
Fire Subtotal, $2,811,721, 60%Sheriff Subtotal, $250,000, 5%EMS System Programs and Studies Subtotal$775,907, 17%County Subtotal, $817,500, 18%Measure H Fire and Non‐Fire Distributions2013‐14 Projected Annual AllocationsTotal Allocation $4,655,128
Project PurposeAmountMeti Mobile Prehospital Simulation Program Fire‐EMS Simulation Training Equipment and Materials$566,662HeartSafe Communities Public CPR and AED Program$46,795County wide Fire Dispatch and Communication Equipment Fire Radio and Dispatch Communications$993,174Cardiac Monitoring Service and Equipment Cardiac Monitors, AEDs, Automated CPR Devices Fire EMS Advanced Life Support Equipment$618,149Pulse Point Fire Dispatch Software Integration$19,741Knox Med Vault Boxes Fire Narcotic control and inventory system$166,657ReddiNetEMS System Med/Health Disaster and Diversion Communication Platform$206,922Fire EMS System Oversight Quality Training (50 scholarships) Fire‐EMS IHI Open School Online Certification Program$3,000Oxygen Fill Station Oxygen resupply Station for Fire Agencies$17,600ProQA Dispatch Software Richmond DispatchQuality System Software for Fire Emergency Medical Dispatch$40,000AFG Grant Match for regional grant for 12 lead monitors Fire Replacement monitors with 5 year service agreement$810,000Urban Search and Rescue Fire Training Grant Fire Emergency and Disaster Response and Rescue $182,000Zoll Electronic Patient Care Record Fire EMS Fire Patient Care Documentation Software and patient care oversight data system$822,705Training Manikins and Materials Fire‐EMS Training$82,221Triage Tags Fire MCI Equipment$10,314Computer Aided Dispatch Software and Service Fire Emergency Medical Dispatch Software and Support$117,109First Watch EMS System Situation Status and Performance Data System $336,282EMS System Studies and Consults RFP, EMS System Studies, EMS System Impact Studies$250,300Total Major Project InvestmentEMS System Enhancement and Coordination $5,289,630Major Special Project Funding for EMS System Enhancements 2004‐2012