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Health and Human Services Agency, Public Health Division and Human Resources, recommending the Board adopt Resolution 003-2015 amending the Salary Schedule for the Emergency Medial Services (EMS) Agency Medical Director Classification, reduce the EMS Agency Medical Director allocation by .1 FTE and delete the Public Health Clinician - Board Certified (Extra Help) salary from the County Salary Schedule.
FUNDING: General Fund.
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Fiscal Impact/Change to Net County Cost
There is a projected increase in Net County Cost for FY 2014-15 of approximately $10,377 from the amount budgeted for this position. This increase reflects the benefit cost associated with the regular part-time position. Sufficient funds have been included in the FY 2014-15 budget to cover the increased costs and will be included in future budgets.
Background
California Health and Safety Code section 1797.202 requires every local Emergency Medical Services (EMS) agency have a full- or part-time licensed physician and surgeon as Medical Director. To comply with this requirement, the Public Health Division has budgeted a .40 Full Time Equivalent (FTE) EMS Agency Medical Director classification with a total annual budgeted expenditure totaling $133,737. The minimum requirements for the position require the incumbent to have a license to practice medicine in the State of California, and two years of experience as an emergency room physician and/or trauma surgeon, OR two years of administrative experience in designing, implementing, and/or directing the emergency medical care services for an EMS provider organization, Base Hospital or Trauma Center.
The Public Health Division was unsuccessful in recruiting a part-time EMS Agency Medical Director in 2002, 2004 and 2007. It was determined that the salary at that time was too low to attract qualified applicants. As a result, to ensure compliance with State Law the Board adopted a salary for a position titled Public Health Clinician - Board Certified (Extra Help) with a maximum hourly rate of $96.20.
Since 2004, the Public Health Division has retained an EMS Agency Medical Director through the use of Public Health Clinician - Board Certified (Extra Help) classification. However, as a result of changes in requirements relative to the use of Extra Help employees, the County is not in compliance with County Extra Help rules.
The EMS Agency Medical Director classification is currently set at $72.20/hour, which is still well below average for licensed medical doctors with this level of experience. To correct this issue, Human Resources conducted a survey of comparable counties. The survey identified only one comparable county, Sacramento, that hires their own EMS Agency Medical Director at a rate of $100/hr. In review of the other counties of similar size to El Dorado County, Human Resources identified those counties comply with the California Health and Safety Code by participating as members of a Regional or Multi County EMS Agency system through a Joint Powers Authority (JPA) agreement. Specifically, Amador County EMS Services are provided through an agreement with the Mountain Valley EMS Agency (a Multi County LEMSA) JPA, and the other comparable counties, Nevada, Placer, Sutter, Yolo, and Yuba, belong to the Sierra-Sacramento Valley EMS Agency JPA. In all cases the EMS Agency Medical Director is a contract provider and the rates range from $100-$119 per hour without benefits.
Participating in a JPA for these services is not an option since El Dorado County operates under the Public Utility Model (PUM) for the provision of Emergency Medical Services. Under the PUM the government is a "purchaser" of dispatchers, emergency medical technicians and paramedic providers from an EMS provider (contractor). As a member of a JPA, El Dorado County would not be able to meet the requirements of the PUM.
Based on these findings, the Director of HHSA and the Director of Human Resources are recommending the salary for the EMS Agency Medical Director be increased to a range of $79.14/hour - $96.20/hour, as well as the salary for the Public Health Clinician - Board Certified be removed from the salary schedule since there is not a corresponding job classification
Reason for Recommendation
Currently HHSA has a vacant 0.5 FTE EMS Agency Medical Director position; however, an analysis of the actual hours worked by the EMS Agency Medical Director identified the total hours equivalent to .4 FTE. The increase in the salary schedule is necessary to successfully recruit and retain a qualified EMS Agency Medical Director to meet the state mandated requirements, which has been alternately staffed since 2004 in order to comply with State law.
Clerk of the Board Follow Up Actions
Provide the Health and Human Services Agency, at Briw Rd, with one (1) certified Resolution and Human Resources with one (1) certified Resolution signed by the Chair.
Contact
Don Ashton, M.P.A., Director