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Emergency Medical Services, a division of the Chief Administrative Office, recommending the Board authorize the Chair to sign a budget transfer for the following:
1) Increase budgeted revenues and expenses by $208,000 in the County Service Area 7 Ambulance account;
2) Decrease budgeted Appropriations for Contingency and increase budgeted expenses by $41,000 in the Maddy/Richie Emergency Medical Services Fund;
3) Increase budgeted revenue and expenses by $5,608 within the Hospital Preparedness Program (HPP) special revenue fund (SRF) and increase the budgeted offsetting revenues and expenses within the HPP General Fund account by the same;
4) Establish budget for the Cities Readiness Initiative (CRI) SRF fund balance for $42, revenues for $2,300, and expenses for $2,342, and establish budget for the offsetting transfer into the CRI General Fund account by increasing revenues and expenses by $2,342, and;
5) Establish budget for the Pandemic Influenza (Pan Flu) SRF fund balance for $991, revenues for $2,900, and expenses for $3,891, and establish budget for the offsetting transfer into the Pan Flu General Fund account by increasing revenues and expenses by $3,891. (4/5 vote required)
FUNDING: No General Fund impact; funding from ambulance service fees, traffic violation fines, interest revenue, and California Department of Public Health grant funds.
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DISCUSSION / BACKGROUND
The Emergency Medical Services (EMS) Division is recommending a budget transfer based on a midyear review of the Fiscal Year (FY) 2024-25 Budget. The recommended budget changes are as follows:
County Service Area No. 7
County Service Area No. 7 (CSA 7) provides ambulance services to the Western Slope of El Dorado County. CSA 7 ambulance revenues and taxes are deposited into the CSA 7 Ambulance account, which is a non-General Fund account. These funds are utilized to cover costs of providing ambulance services within the CSA, and to partially fund the EMS program.
The CSA 7 ambulance fee revenues for Fiscal Year 2024-25 are expected to be higher than budgeted. As a result, the commission-based payments to the contracted billing processor are projected to exceed budget. Staff are recommending that the Board approve a budget transfer amending the Fiscal Year 2024-25 Budget to increase budgeted revenues by $208,000 and increase expenses in the CSA 7 Ambulance account by the same.
Maddy/Richie EMS Fund
The Maddy/Richie Emergency Medical Services Fund (Maddy Fund) provides funding to local physicians/surgeons, hospitals, and a portion for EMS related expenses. The Maddy Fund receives revenues generated from local penalty assessments on traffic violation fines. This revenue is deposited into the Maddy EMS Special Revenue Fund (Maddy SRF) and dispersed as a percentage of total Maddy/Richie revenue, in alignment with the approved use of these funds.
The Maddy Fund penalty assessment disbursements in Fiscal Year 2024-25 are higher than anticipated. As a result, the percentage-based hospital and physician payments will exceed the budgeted amounts. Also, staff time spent working on Maddy Fund related tasks, is projected to exceed budget. Staff are recommending that the Board approve a budget transfer amending the Fiscal Year 2024-25 Budget to decrease Appropriations for Contingency by $41,000 and increase expenses in the Maddy Fund SRF by the same.
Grant Programs
The Division receives grant funding from the California Department of Public Health to run the Hospital Preparedness Program (HPP). This funding is utilized for local emergency response planning and preparedness, and to partially fund the EMS program. Per the grant agreement HPP funds are required to be deposited into a separate account, which is the HPP Special Revenue Fund (HPP SRF), a non-General Fund account. At the end of each fiscal year, the funds are transferred from the HPP SRF account to the General Fund account to reimburse the division for HPP expenses.
The interest revenue received on the cash in the HPP SRF is expected to be higher than budgeted, due to rising interest rates. As a result, the transfer to the HPP General Fund account will be higher than budgeted. Staff are recommending that the Board approve a budget transfer amending the Fiscal Year 2024-25 Budget to increase the budgeted transfer from the HPP SRF to the General Fund by $5,608.
Beginning in FY 2024-25 the City Readiness Initiative (CRI) program and the Pandemic Influenza (Pan Flu) program were transferred from EMS to the County’s Health and Human Services Agency (HHSA). At the end of FY 2023-24, the EMS CRI and Pan Flu SRFs had remaining balances. The recommended budget transfer closes out these funds.
The recommended budget transfer has a no General Fund cost.
ALTERNATIVES
Without a budget amendment, the County will not be able to pay CSA 7 contractual payments to the ambulance billing contractor, pay hospital and physician Maddy Fund payments, transfer the full amount of interest revenue to the HPP General Fund account, and the CRI and Pan Flu SRFs will continue to hold a fund balance. No alternative is recommended.
PRIOR BOARD ACTION
April 23, 2024, Legistar File 24-0219 - Transfer of CRI and Plan Flu grants from EMS to HHSA
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The recommended budget transfer does not have a General Fund cost.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Obtain signature of Chair on budget transfer and forward to the Chief Administrative Office for processing.
STRATEGIC PLAN COMPONENT
N/A
CONTACT
Sue Hennike, Assistant Chief Administrative Officer