To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
2.4% Rate Increase – Sonoma County Fire District Agreement
End
Recommended Action:
Recommended action
Approve a 2.4% rate Increase in Emergency Medical Service rates with Sonoma County Fire District, pursuant to the Exclusive Operating Area 1 (EOA-1) Professional Services Agreement.
end
Executive Summary:
This item requests Board approval of a 2.4% increase in Emergency Medical transportation service rates charged by Sonoma County Fire District (SCFD) in the Exclusive Operating Area (EOA-1), which encompasses Santa Rosa and neighboring communities. SCFD provides emergency medical services transport exclusively within the EOA-1 under a contract awarded as a result of a competitive request for proposal process conducted in 2023 by the Department of Health Services.
Under state law, these services may be exclusively provided in an area if the Local Medical Services Agency (LEMSA) has conducted a competitive procurement under the review of the state Emergency Medical Services Authority (EMSA). The current contract, approved by LEMSA and the Board in 2023, authorizes the LEMSA to adjust SCFD rates annually based on the consumer price index.
Discussion:
On June 6, 2023, the Board authorized the Director of Health Services, or designee, to execute a 5-year contract with SCFD for emergency ground ambulance service in Sonoma County Exclusive Operating Area 1 (EOA-1) in a form approved by County Counsel that includes an option to extend for an additional 5 years (Attachment 1). The Board also adopted a Resolution making certain findings and adopting the County of Sonoma’s Written Policy Regarding Emergency Ambulance Services Contracts Pursuant to Health and Safety Code Section 1797.230.
The agreement was executed in December 2023, and services began January 16, 2024. Section 10.2.A of this Agreement establishes the criteria and process by which SCFD may request an increase in the rates they charge for providing Advanced Life Support transportation to a trauma center within EOA-1:
DISTRICT’s rates for Contract Services may be adjusted annually to compensate for inflation which shall be based on the Bay Area Consumer Price Index (CPI) and/or other appropriate indices reflecting increased costs of operations.
Following a thorough review of the SCFD Agreement and confirmation regarding the Bay Area CPI for last year, staff have determined that the current request for a 2.4% rate increase is consistent with the Agreement and falls under the 10% threshold that would require a local program audit process (per Section 10.2.D of the Agreement).
In accordance with the agreement and to ensure adequate resources for EMS services within EOA-1, staff recommends approval of the 2.4% rate increase. This is expected to generate approximately $42,000 in additional revenue for SCFD.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 2: Identify gaps in the Safety Net system of services and identify areas where departments can address those gaps directly, and seek guidance from the Board when additional resources and/or policy direction is needed.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On June 6, 2023, the Board A) Authorized the Director of Health Services, or designee, to execute a 5-year contract for emergency ground ambulance service in Sonoma County Exclusive Operating Area 1 with Sonoma County Fire District in a form approved by County Counsel that includes an option to extend for an additional 5 years; and B) Adopted a Resolution Making Certain Findings and Adopting the County of Sonoma’s Written Policy Regarding Emergency Ambulance Services Contracts Pursuant to Health and Safety Code Section 1797.230.
On October 18, 2022, the Board approved a modified RFP with the following direction: A) Authorize the Director to resubmit the RFP to California EMSA. B) Authorize the Director to make minor modifications prior to RFP release for non-substantive changes. C) Authorize the Director to issue the RFP to potential Proposers for responses.
On November 2, 2021, the Board approved the RFP with the following direction: A) Approve the revisions to the Request for Proposal (RFP) approved by the Board on April 13, 2021. B) Authorized the Director to resubmit the RFP to California EMSA. C) Authorize the Director to make minor modifications prior to RFP release for non-substantive changes. D) Authorize the Director to issue the RFP to potential Proposers for responses.
On April 13, 2021, the Board A) reviewed the Matrix of Public Comments and Staff responses and Recommendations; B) approved changes to be incorporated into the RFP; and C) approved the RFP for submission to California Emergency Medical Services Authority (EMSA).
On March 23, 2021, the Board deliberated on the proposed components of the draft RFP for Exclusive Operating Area #1 (EOA 1) for the purposes of submitting the RFP to the California EMS Authority for approval based on the provision of Sonoma County Code Chapter 28-17, adopted by the Board on November 12, 2019.
On October 22, 2019, the Board approved an agreement with Endpoint EMS Consulting, LLC for subject matter expertise and support in developing a request for proposals for an exclusive provider of emergency ground ambulance services in an amount not-to-exceed $161,000 through December 31, 2021.
On May 21, 2019, the Board approved the third amendment to an agreement with American Medical Response West for emergency ground ambulance services, providing for an extension of the term through June 30, 2022 with an additional two one-year options and authorizing service rate increases effective July 1, 2019.
On May 8, 2018, the Board authorized the Chair to submit a letter expressing County support for a one-year extension request of the California Emergency Medical Services Authority for the Exclusive Operating Area Ambulance Services Agreement covering central Sonoma County and work with the area's Assembly members and State Senator to support this request.
On December 16, 2008, the Board approved the Emergency Ground Ambulance Services Agreement with American Medical Response West.
Fiscal Summary
|
Expenditures |
FY25-26 Adopted |
FY26-27 Projected |
FY27-28 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
0 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
|
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
0 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
The rate increase of 2.4% from Sonoma County Fire Department is to be applied to individuals receiving medical transport, resulting in no fiscal impact to the County associated with this item.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Agreement
Related Items “On File” with the Clerk of the Board:
None