HomeMy WebLinkAboutMINUTES - 03221988 - 2.3 2.3
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The Board of Supervisors of Contra Costa County; California
Adopted this Order on March 22. 1988 , by the following vote:
AYES: Supervisors Powers, McPeak, Torlakson, Schroder
NOES: None
ABSENT: Supervisor Fanden
ABSTAIN: None
SUBJECT: Update on Emergency Medical Services
The Board received the recommendations of Marts Finucane, Health Services Director, as contained
in the March 3, 1988, update on emergency medical services. A copy of the referenced update is attached
and included as a part of this Board Order.
Board Members discussed the need to have an assessment of the emergency system in the West
County area and were in agreement to solicit input on this matter from the West County Fire Chiefs.
THEREFORE, IT IS BY THE BOARD ORDERED that the updated report is ACCEPTED.
IT IS FURTHER ORDERED that the Health Services Director is REQUESTED to send a questionaire
to each of the Fire Chiefs in West County requesting their assessment of the Emergency System.
1 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: _March 22, 1988
PHIL BATCHELOR,Clerk of the Board of
Supervisors and County Administrator
By 0. IP !!_,Deputy Clerk
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CC: Health Services Director
West County Fire Chiefs
County Administrator
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ti®003
TO BOARD OF SUPERVISORS
FRAM: Mark Finucane, Contra
Health Services Director Costa
°ATE ' March 3, 1988 County
SUBJECT: Update on Emergency Medical Services
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
- Accept report from Health Services Director Mark Finucane on the status of Emergency
Medical Services (EMS) in Contra Costa County.
- Direct the Emergency Medical Care Committee to conduct an annual assessment of Emer-
gency Medical Services in Contra Costa County and report to the Board of Supervisors,
Health Services Director, Health Officer, and Emergency Medical Services Director.
FINANCIAL_ IMPACT:
None
BACKGROUND:
On July 28, 1986 we submitted to your Board a "Report on Emergency Medical Services" along
with a recommendation that an advisory measure be placed on the November 1986 ballot to
establish a Countywide EMS benefit assessment district. The recommendation, which was
supported by the Emergency Medical Care Committee,. was referred to your Advisory Committee
on Funding County Programs which, although finding the $2 million EMS funding proposal to
be "fully justified", recommended that first priority be given to funding a program of
mental health and social services for children.
The EMS funding proposal , as presented in 1986, would have significantly upgraded existing
EMS services by providing a comprehensive emergency medical services program including
Countywide paramedic coverage, first responder training and purchase of medical equipment,
establishment of a new medical communications system, central ambulance dispatching,
designation and monitoring of emergency care facilities, public education, disaster
planning, and administration. Since deficiencies had been identified and goals set for
correcting these deficiencies in the 1985 EMS System Plan and various recommendations of the
EMCC, we have requested the EMCC to undertake a review of the current status of EMS in
Contra Costa County and to report periodically on program goals and priorities.
CONTINUED ON ATTACHMENT: YES SIGNATURE;
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER.
SIGNATURE(S):
ACTION OF BOARD ON 3APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I EBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES. AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: SUPERVISORS ON THE DATE SHOWN.
cc: Health Services Directo ATTESTED
Emergency Medical vices Director PHIL BAT OR, CLERK OF THE BOARD OF
Emergency Med' Care Committee SUPERVISORS I COUNTY ADMINISTRATOR
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The July 28, 1986 report identified three particularly pressing deficiencies in the EMS
program at that time:
- an inadequate system for paramedic-to-hospital communications,
- lack of a data system for monitoring ambulance responses and
prehospital care monitoring, and
- inadequate paramedic coverage.
Since issuance of the 1986 report, various developments and advances in the EMS system have
lessened these deficiencies.
Paramedic-to-Hospital Communications
At the time of the July 1986 EMS Report, paramedic-to-hospital communications were
limited to a single MEDARS radio channel used countywide. The volume of traffic on this
channel and FCC restrictions related to use of this channel for biotelemetry and trans-
missions from medical helicopter severely hampered appropriate medical direction of pre-
hospital emergency medical care.
The development of cellular telephone technology, however, has provided a
relatively inexpensive alternative to installing additional County communi -
cation capability. Presently, all paramedic units in the County are equipped
with cellular telephones which enable paramedics to contact their base hospitals
by telephone from the ambulance when the radio channel is in use. Cellular
telephone cost is borne by the ambulance provider agency.
The County has also been successful in obtaining waivers from FCC allowing use
of the MEDARS radio frequencies for telemetry and transmissions from low flying
aircraft.
Ambulance Response and Prehospital Monitoring
Lack of a data system to monitor ambulance responses, patient transports, and prehospital
medical care was a second major deficiency identified in the 1986 EMS report.
A limited system for monitoring ambulance responses in central and west county
has been established by EMS using data available from the Sheri-ff's dispatch
center (COMM-7) . Recently, the establishment of computer-aided dispatch by
Regional Medical Systems has enabled EMS to obtain reliable response time data
directly from the contractor for monitoring contract compliance.
Paramedic Ambulance Coverage
A third deficiency cited in the 1986 EMS report was the lack of adequate paramedic ambu-
lance coverage. At that time, only ten paramedic ambulance units were available within
the County.
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Since then, two additional paramedic units have been added by Regional Medical
Systems and a third is planned by San Ramon Valley Fire. They will increase the
total number of paramedic units available within the County from ten units to
thirteen units as follows:
Regional Medical Systems 10 units
San Ramon Valley Fire 2 units
Moraga Fire 1 unit
This will increase paramedic coverage from approximately 70 percent of emergency
ambulance requests to about 90 percent of emergency ambulance requests. This
still means, however, that about one of every ten medical emergencies will not
receive a paramedic response.
Summary and Recommendation
Continued improvements in the County's EMS system during the past 18 months have reduced
some of the major deficiencies previously reported. There remain,, however, many areas of
needed improvement in order to establish a fully comprehensive system of emergency medical
services. Additionally, advances in prehospital emergency medicine and changes in State
EMS regulations have opened new areas for enhancement of emergency medical services. It
is therefore recommended:
That the Emergency Medical Care Committee (EMCC) conduct an annual assessment of
emergency medical services in Contra Costa County and report to the Board of
Supervisors, Health Services Director, Health Officer, and Emergency Medical
Services Director.
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