Title
Chief Administrative Office recommending the Board:
1) Receive and file a report on the County’s emergency response system, including operational roles and responsibilities, and funding sources and uses;
2) Provide direction to staff to proceed with the transfer of existing Emergency Preparedness and Emergency Medical System program functions from the Health and Human Services Agency to the Chief Administrative Office, as outlined in Recommendation (1) below; and
3) Provide direction to staff regarding which, if any, of the remaining three (3) recommendations, detailed at the end of this report, should be implemented. (Est. Time: 30 Min.)
FUNDING: State and Federal; General Fund.
Body
DISCUSSION/BACKGROUND:
On September 11, 2018, the Board directed the CAO to work with the Sheriff's Office and Health and Human Services Agency to produce a report detailing the funding sources and uses related to the County's emergency response system.
Through our review of the various programs and their individual funding streams and related program requirements, staff identified additional information that factors into the discussion of emergency management and response in El Dorado County. This information is included in this report because staff ultimately reached the conclusion that in order to provide a complete picture of emergency response funding and uses, the discussion should include information on how funds are used in El Dorado County to provide emergency related services, and the way in which services are provided. Additionally, the recent flood damage and wildfires in El Dorado County and nearby counties, as well as recent incidents related to the El Dorado Irrigation District water supply and PG&E’s determination to shut off power in hazardous weather conditions, highlights the importance of having a broader understanding of the emergency funding that is available, how the funding is used, and whether adjustments to the County’s organizational structure should be considered in order to achieve operational efficiencies and improve communication/coordination across all components of the County’s emergency response system.
Therefore, this report includes the requested information regarding funding sources and allowed uses, as well as a summary of the emergency response system operational roles and responsibilities. The discussion on operational roles and responsibilities also includes information on County ordinances and policies relevant to the County’s emergency management system. Additional funding detail is included as Attachment A.
It should be noted that this report reflects information for the elements of emergency response for which County government is responsible. The countywide emergency response system relies on coordination among many agencies, including fire districts, cities, and non-governmental organizations.
Operational Roles and Responsibilities
The California Emergency Services Act (“Act”) provides the framework for the state to plan for and respond to human-caused and natural emergencies such as floods, wildfires, droughts, terrorism, pandemics and hazardous material spills. The Act also sets forth requirements for local governments to follow in order to receive state and federal funding for activities related to emergency preparedness, planning, and response. At the County level, these activities are primarily housed in the Health and Human Services Agency and the Sheriff's Office.
County Ordinance Code Chapter 2.21, Emergency Organizations and Functions, was adopted by the Board of Supervisors on December 12, 2017. The Ordinance identifies essential responsibilities of the emergency management/response system. The declared purposes of this chapter (Section 2.21.010) are to (1) provide for the preparation and carrying out of plans for the protection of persons and property within the County in the event of an emergency, and (2) to provide for the coordination of the emergency functions of the County with any incorporated city within the County (currently the City of Placerville and the City of South Lake Tahoe) and all other affected public agencies, corporations and organizations within the County in compliance with the California Emergency Services Act. The following sections are most relevant to this review:
Section 2.21.020 - Definitions
Emergency is defined as:
“the actual or threatened existence of conditions of disaster or of extreme peril to the safety of persons or property within the county caused by such conditions as fire, flood, storm, earthquake, drought, air pollution, epidemic, riot, sudden or severe energy shortage or other conditions including conditions resulting from war or imminent threat of war, which conditions are or are likely to be beyond the control of the services, personnel, equipment, and facilities of the county, requiring the combined forces of other political subdivisions to combat or mitigate.”
Section 2.21.030: Office of Emergency Services
This section provides that the Director of the Office of Emergency Services (OES) shall be the Sheriff. The Sheriff serves as the County's Director of Emergency Services, the Chair of the Disaster Council, and coordinates the services and staff necessary to conduct emergency response operations in accordance with the Act. The Sheriff also administers federal Homeland Security grants funds that are passed through the state to fund local agency personnel and equipment for terrorism prevention, response, mitigation, and recovery.
The Sheriff’s Office of Emergency Services has responsibility to prepare, respond, and recover from natural and manmade disasters that threaten life, property, and the environment in our county. In addition, the Office of Emergency Services coordinates public, private, non-profit, and volunteer agencies and groups who respond to these disasters by staffing and maintaining the El Dorado County Operational Area Emergency Operations Center (EOC).
The personnel assigned to the Office of Emergency Services maintain ongoing close working relationships with personnel from numerous Local, State, and Federal agencies through meetings, trainings, workshops, drills, and exercises in order to carry out their responsibilities.
The personnel assigned to the Office of Emergency Services receive additional specialized training and in Emergency Management, Incident Command Operations, All Hazards Mitigation, Response and Recovery, EOC Operations, Domestic/International Terrorism, School Safety, and Work Place Violence Prevention.
The following is a brief summary of the functions and responsibilities of the El Dorado County Sheriff’s Office of Emergency Services:
• Emergency Operations Planning
• Emergency Operations Center (Operations, Maintenance, and Training)
• Emergency Plans Management (EOP, LHMP, K-3 COOP COG, Evacuations, Care & Sheltering, etc.)
• Grant Management (EMPG, DHS)
• National Incident Management System (NIMS) Compliance and Training
• State Emergency Management System (SEMS) Compliance and Training
• School Safety and Emergency Response Planning
• Violence in the Workplace Threat Assessment and Training
• Terrorism Liaison Officer (TLO) and TLO Coordinator (TLOC)
• Community Safety Meetings
• Large Event Planning and Support
As provided by ordinance, the Disaster Council has the duty and the authority to develop emergency services plans and agreements for adoption by the Board of Supervisors. The Council is also responsible for making recommendations on plans that pertain to state and local emergencies including the County Emergency Operation Plan, Emergency and Mutual Aid Plan and agreements, and for recommending new or amended ordinances or resolutions that may be necessary to implement such plans and agreements. The authority to declare a local emergency ultimately rests with the Board.
Section 2.21.070-090: Disaster Council
Membership on the Disaster Council (Section 2.21.070) shall consist of the following:
- The Director of the Office of Emergency Services or designee shall be Chair.
- The El Dorado County Operational Area Fire and Rescue Coordinator or designee shall be Vice Chair. This position is appointed by the El Dorado County Fire Chiefs Association.
- One representative or designee from each incorporated city within the County, to be appointed by the respective City Managers.
- The Chief Administrative Officer of the County, or designee.
Under the previous ordinance, the Council's membership included qualified, Board-appointed persons, and the following ex officio members, without a vote: Deputy Director of Emergency Services or his or her assistant, County Counsel or deputy, Sheriff or deputy, Director of Department of Transportation, and Director of Health Services or deputy.
The change to membership was recommended based on the specialized work requiring skills, knowledge, and expertise of emergency management professionals.
The Disaster Council is to meet at least twice annually, either publicly or in closed session when needed, in accordance with Government Code §54957.
The Disaster Council is also charged with facilitating the exchange of information between emergency first responders and emergency planning personnel (2.21.080). The Council has not convened in the recent past, which prevents a high level of collaboration between County departments, fire districts and incorporated cities.
Emergency Preparedness and Emergency Medical Services are administered within the Health and Human Services Agency.
In the Health and Human Services Agency, the Emergency Preparedness and Response Division focuses on building community resilience and disaster preparedness through education and action. Since the Sand and King fires in 2014, the division has had primary responsibility for organizing mass care/sheltering operations, as well as medical and health resources in a disaster. The division coordinates with other County departments and community partners such as local hospitals, schools, community groups and volunteers to provide services such as continuity of operations planning, all-hazard emergency planning, County employee preparedness training, and community education.
The Emergency Medical Services (EMS) Division serves as the Local Emergency Medical Services Agency (LEMSA) to provide management and oversight of pre-hospital emergency medical care countywide. As a result of the fire/ambulance delivery system in El Dorado County, HHSA works closely with the local fire districts who currently contract with the County to provide ambulance services. Health and Human Services also administers state funding for emergency medical services for indigent patients who are treated at Barton and Marshall Hospitals.
The Chief Administrative Office serves as the liaison to our local fire districts on issues specifically related to fire. Until recently, the Chief Administrative Office did not engage in discussions with the fire districts relative to ambulance services and referred those discussions to HHSA. However, in an effort to encourage more collaboration, CAO staff have assumed oversight roles in various aspects of the service delivery system.
In addition, Board Policy K-3, adopted in 2003 with no other revisions, also provides direction to County departments for Emergency Management. The Policy is specifically related to the continuity of County services during an emergency and the safety of employees and the public. The policy identifies the Chief Administrative Officer as being responsible for the overall operation of the County’s Emergency Management Policy for government departments.
All of these departments should coordinate with other County departments and divisions and with other governmental agencies and community organizations as part of a complex and comprehensive system. While all agencies have worked well together in past emergency events, especially in regard to fires in El Dorado County, based on discussions with staff from multiple organizations, including HHSA, fire districts, and the City of Placerville, improvements could be made with regard to the level of collaboration and partnership among all agencies. In addition, improved collaboration will help to ensure that the funding allocated to emergency services programs, the majority of which is State and Federal funding, is distributed in a comprehensive manner that prioritizes the needs of all emergency service providers.
Given the multiple disciplines and agencies involved, it is critical to streamline the structure to maximize efficiencies. Appropriate placement of these functions within the County governance structure is imperative to support critical interactions with other County departments and vital stakeholders. As an example, the continuity of operations and continuity of government plans require extensive participation, communication, and engagement with all departments. Such an effort would usually be coordinated by the Chief Administrative Office or the County’s executive leadership team.
Operational Roles and Responsibilities Findings
1) The Disaster Council is required to meet at least twice per year.
2) Regular meetings of the Disaster Council will help increase the level of collaboration between County departments, fire districts and incorporated cities would likely improve and provide an overall benefit to El Dorado County residents.
3) The EMS and Emergency Preparedness programs of HHSA determine how a portion of the County’s emergency services funding is spent, but is not a member of the Disaster Council.
4) Per Board policy, the Chief Administrative Officer is responsible for the overall operation of the County’s Emergency Management Policy for governmental departments, but has no direct involvement with or authority over disaster/emergency operations as those are administered by the elected Sheriff and the Director of HHSA.
5) HHSA’s primary responsibility is to provide mandated and discretionary services to disadvantaged and vulnerable residents. The role of EMS and Emergency Preparedness is to serve all residents, including large organizations such as hospitals and government bodies. Due to the size and complexity of HHSA programs, EMS and Preparedness programs likely do not receive the level of attention and prioritization needed.
6) The County could benefit from relocating the EMS and Emergency Preparedness functions to the Chief Administrative Office. This could help to ensure coordination between emergency preparedness, emergency medical services, and the many independent districts that provide fire and emergency response services within the County. As emergency medical services are primarily fire-based within the county, it would also be beneficial to combine the fire liaison duties with management of the ambulance service contracts.
Funding
El Dorado County receives funding from a variety of sources, with those funds managed across several County departments. As noted in the Operational Summary, emergency management and related activities are not organized within one single department. Rather, several departments are responsible, either directly or indirectly, for various components of the emergency response function.
Following is a summary of the funding sources and uses, categorized by department and function. A more detailed summary of revenues and expenditures associated with emergency management functions in El Dorado County for Fiscal Year 2018-19 is provided as an attachment to this report.
HHSA - Emergency Preparedness and Response
The FY 2018-19 revenue budget for Emergency Preparedness and Response is $666,000, funded $508,000 (76.3%) by the Federal and State Public Health Emergency Preparedness Grant, $25,000 (3.7%) by an interagency contract with Alpine County for staffing, joint exercises and training, $123,000 (18.5%) by Public Health Realignment and $10,000 (1.5%) by a Homeland Security grant (pass through from Sheriff Office).
The above funding pays for 4.05 program staff positions, administrative costs, and contracts with local agencies, including hospitals, for preparedness activities.
HHSA - Emergency Medical Services (EMS)
The FY 2018-19 revenue budget for EMS is $1,074,600, funded $37,000 (3.4%) by Fees from EMT certifications and training, $9,600 (.9%) State reimbursement for legal services to handle disciplinary appeals, $866,564 (80.6%) Ground Emergency Medical Transportation (GEMT) fund balance, and $161,436 (15.1%) County General Fund.
The above funding pays for 3.4 program staff positions, administrative costs, various contracts including ambulance service consulting, Sacramento Metro GEMT administration, software maintenance and support and the Electronic Pre Care Reporting System. A one-time cost of $310,000 is budgeted in FY 2018-19 for the GEMT audit payback for 2010-2016 findings.
HHSA - EMS Maddie Fund
The FY 2018-19 revenue budget for the Maddie fund is $639,957, funded by court fines $350,000 (54.7%), $288,457 (45.1%) fund balance, and $1,500 (.2%) interest.
The above revenue funds contracts with hospitals and reimbursement to physicians for indigent patients who received emergency medical services. A specific portion (15%, Ritchie fund) funds pediatric trauma services.
HHSA - EMS CSA 3 (South Lake Tahoe) Ambulance Services
The FY 2018-19 revenue budget for CSA 3 is $3,707,772, funded by $2,123,356 (57.3%) ambulance fees, $106,900 (2.9%) special taxes, $561,700 (15.1%) special benefit assessment, $15,750 (.4%) fines and penalties, $10,000 (.3%) interest and $890,066 (24.0%) fund balance.
The above funding pays for CSA 3 payments to JPA and North Tahoe Fire Protection, ambulance billing, and consulting, auditing and collections fees.
HHSA - EMS CSA 7 (West Slope) Ambulance Services
The FY 2018-19 revenue budget for CSA 7 is $14,098,086, and is funded by $7,274,900 (51.6%) ambulance fees, $3,134,500 (22.2%) property taxes, $1,638,800 (11.6%) special parcel tax, $300,000 (2.1%) revenue from the Shingle Springs Band of Miwok Indians, $43,000 (.3%) interest and fines, and $1,706,886 (12.2%) use of fund balance.
The above funding pays for CSA 7 payments, ambulance billing, and consulting, auditing and collections fees.
HHSA - Ambulance Billing
The FY 2018-19 revenue budget for Ambulance Billing is $918,534. This pays for 2.0 FTEs who support the ambulance billing financial processes, administrative costs, and the Intermedix Advanced Data Processing billing system. These costs are paid for by CSA 3 and CSA 7.
Sheriff - Office of Emergency Services
The FY 2018-19 revenue budget for OES is $1,438,018; however, $1,275,000 of this is one-time funding from the Sheriff’s Rural Counties special revenue fund, for the purchase of a mobile command center. The Emergency Management Performance Grant provides $162,612, which partially offsets the on-going operational cost of $1,074,211. These costs include $913,902 for salaries, benefits, and overtime for 4.0 FTEs who directly support OES operations. The remainder of the cost covers Services and Supplies expenses. The total General Fund cost of this program is $836,659 for FY 2018-19.
Sheriff - Homeland Security Grant
The County receives funding from the Department of Homeland Security to help local jurisdictions support the National Preparedness System. Annual funding varies, averaging approximately $260,000 per year over the last four years. The Sheriff’s Office manages the grant and coordinates meetings of the approval body, which determines how the funds are to be spent. The approval body consists of:
• County Public Health Officer or designee responsible for Emergency Medical Services
• County Fire Chief or Fire Authority
• Municipal Fire Chief
• County Sheriff
• Chief of Police
Funding is distributed to agencies for equipment and training that support emergency preparedness and anti-terrorism efforts in accordance with grant guidelines.
Chief Administrative Office
The Chief Administrative Office supplements the internal / external communication of the Sheriff and HHSA, and is the primary department responsible for communication with member of the Board of Supervisors and communication and coordination with affected County departments. One Principal Analyst serves as the primary liaison to fire districts, in addition to other duties, and the office currently provides a high level of oversight/assistance to the EMS and Emergency Preparedness functions within HHSA. No outside funding is received in support of these activities.
Funding Findings/Conclusions
1) The General Fund budget for the Office of Emergency Services in the Sheriffs’ Office is $836,659 in Fiscal Year 2018-19.
2) Excluding funding dedicated to the ambulance delivery system and the Maddie Funds which are dedicated to hospitals, HHSA is allocated $1,734,600 in Fiscal Year 2018-19 for emergency management services, $161,436 of which is County General Fund.
3) Approximately $422,000 of funding dedicated to the emergency management system is spent to cover indirect overhead costs in HHSA, including HHSA and Public Health Administration and A-87 Cost Plan/mail/courier charges.
Recommendations
1) Approve the transfer of the emergency preparedness and response and emergency medical services program functions from the Health and Human Services Agency to the Chief Administrative Office, direct the Chief Administrative Officer to return in the next 30 days with appropriate personnel resolution amendments and budget transfers to effect this transfer, and direct the Chief Administrative Officer to return to the Board in the next 90 days with a final assessment and any further recommended revisions to the organizational structure, in order to provide effective and efficient support to the Emergency Medical Services and Preparedness programs.
2) Direct the Chief Administrative Officer and the Health and Human Services Agency to identify and evaluate additional organizational and/or funding alternatives, in order to reduce the identified administrative overhead costs so that more State and Federal funding could be allocated to direct emergency management program functions.
3) Formally request that the Sheriff, as the Chair of the Disaster Council, ensures that the Disaster Council holds the required number of meetings each year.
4) Direct the Chief Administrative Officer and the Sheriff, with participation of the Health and Human Services Agency, to return to the Board in the next 60 days with recommended updates and revisions to Policy K-3.
ALTERNATIVES
The Board could choose to receive and file the report and take no further action.
PRIOR BOARD ACTION
At its September 11, 2018, meeting, the Board directed staff to report back on funding sources and uses (Legistar #18-1370).
OTHER DEPARTMENT / AGENCY INVOLVEMENT
Health and Human Services; Sheriff
CAO RECOMMENDATION / COMMENTS
Receive and file the report.
FINANCIAL IMPACT
N/A
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Good Governance
CONTACT
Don Ashton, CAO