Title
Chief Administrative Office, Emergency Medical Services and Emergency Preparedness and Response Division, recommending the Board consider the following:
1) Make a finding that the work requires specialty skills and qualifications not expressly identified in County classification are involved in the performance of the work per Ordinance 5116, Title 3, Chapter 3.13, Section 3.13.030; and
2) Approve and authorize the Chair to execute agreement 5873 with California Tahoe Emergency Services Operations Authority for advanced life support ambulance operations services within County Service Area 3 (CSA 3) for the period beginning September 1, 2021 through August 31, 2031, with an option to exercise a five (5) year extension.
FUNDING: CSA 3 - Ambulance service fees and benefit assessment revenue.
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DISCUSSION / BACKGROUND
The County is responsible for ensuring the provision of prehospital Advanced Life Support (ALS) services to the residents of the County, and does so by contracting for these services through County Service Areas. The County is divided into two County Service Areas (CSAs) for the provision of ambulance services. CSA 3 includes the Lake Tahoe Basin, the City of South Lake Tahoe, Meeks Bay, and Tahoma. CTESOA has been the contracted ambulance operator in the CSA 3 South Shore operating area for 20 years.
The County’s Emergency Medical Services (EMS) System is authorized by County Ordinance Code Chapter 8.74 - County Emergency Medical Service and Medical Transportation Ordinance (“EMS Ordinance”), under the provisions of Title 22 of the California EMS Act and the California Health and Safety Code.
The current contract expires August 31, 2021. On June 22, 2021, the Board awarded RFP 21-990-036 to CTESOA and authorized the Chief Administrative Officer or designee to negotiate an agreement for services with CTESOA for Board consideration. Effective September 1, 2021, the new contract term covers a period of ten (10) years with an optional five-year extension. The first year's compensation is $3,779,425. This will be increased annually by the Ambulance Inflation Factor set by the Center for Medicare Services. In addition, the compensation schedule includes annual increases for certain line items whose costs are beyond CTESOA's ability to control, such as dispatch and fuel. CTESOA's proposal also included a request for a one-time payment to cover facility costs to complete the build-out of its operations center. The proposed agreement includes an acknowledgement that the County and CTESOA will negotiate the amount to be paid by the County once the costs are known. CTESOA will solicit bids for the work, and the County will have the opportunity to review the plans before the bid solicitation. The facility payment will be addressed through a separate funding agreement, estimated to be brought before the Board by the end of this calendar year.
ALTERNATIVES
The Board could choose not to execute the agreement; however, failure to complete this process and enter into a contract before August 31, 2021 would violate the terms of our settlement agreement with Cal EMSA.
PRIOR BOARD ACTION
21-0953 - 06/22/2021: The Board awarded RFP 21-990-036 to CTESOA and authorize the Chief Administrative Officer or designee to negotiate an agreement for services with CTESOA.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Cal EMSA reviewed the RFP and draft contract.
CAO RECOMMENDATION
Approve as recommended.
FINANCIAL IMPACT
The contract amount for year one exceeds the current revenue estimate for CSA 3; however, there is sufficient fund balance in the CSA to cover the agreement for the first year costs ($3,779,425) while maintaining adequate reserves for economic uncertainty. Staff will return to the Board with recommendations for increasing ambulance rates in CSA 3 to cover future year costs. Ambulance rates in the County are currently approximately 25% below the median of other jurisdictions' rates.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Return the executed agreement to Chief Administrative Office, Central Fiscal Services, ATTN: Gina De Martini-Kuhns for further processing.
STRATEGIC PLAN COMPONENT
Public Safety
CONTACT
Sue Hennike, Deputy CAO