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File #: 14-1194    Version: 1
Type: Agenda Item Status: Approved
File created: 8/25/2014 In control: Board of Supervisors
On agenda: 9/9/2014 Final action: 9/9/2014
Title: Health and Human Services Agency recommending the Board approve and authorize the Chair to sign Agreement 200-F1511 with the Shingle Springs Band of Miwok Indians for a term effective September 9, 2014, through September 9, 2017, to reimburse the County for prehospital Advanced Life Support emergency medical services, with a base reimbursement rate of $200,000 per year for the first one hundred (100) calls for services and an additional $2,000 per call for service for all calls in excess of one hundred (100) calls per year. FUNDING: Shingle Springs Band of Miwok Indians.
Attachments: 1. A - Approved CRS 9-9-14, 2. B - Agreement 200-F1511 9-9-14, 3. Executed Agreement 200-F1511 (BOS 9-9-14)
Related files: 22-1026
Title
Health and Human Services Agency recommending the Board approve and authorize the Chair to sign Agreement 200-F1511 with the Shingle Springs Band of Miwok Indians for a term effective September 9, 2014, through September 9, 2017, to reimburse the County for prehospital Advanced Life Support emergency medical services, with a base reimbursement rate of $200,000 per year for the first one hundred (100) calls for services and an additional $2,000 per call for service for all calls in excess of one hundred (100) calls per year.    
 
FUNDING: Shingle Springs Band of Miwok Indians.
Body
Fiscal Impact/Change to Net County Cost
Funding for ambulance services on the West Slope is paid out of County Service Area (CSA) 7 which includes sufficient appropriations to continue providing ambulance services.  
 
Background/Reason for Recommendation
The Shingle Springs Band of Miwok Indians (Tribe) is the beneficiary of trust land entitled the Shingle Springs Rancheria, which is located within the geographical boundaries of El Dorado County.  Historically, the Tribe has contracted with the County to provide prehospital Advanced Life Support (ALS) emergency medical services on tribal land when gaming operations commenced, and the Tribe contributed funding to the County to assist in defraying the increased costs and expenses of providing such prehospital ALS emergency medical services.  The most recent agreement expired on June 30, 2013, and since that time the Tribe agreed to reimburse the County on a monthly basis while contract negotiations were taking place.  In addition, under the prior agreement the County was responsible for covering all costs associated with a Mass Casualty Incident at the Rancheria, which could potentially result in hundreds of thousands of dollars depending on the incident.  
 
At this time, the Tribe is evaluating establishing its own ambulance services specific to the Rancheria.  However, during this transition they are requesting continued services from the County.  Under this new Agreement the Tribe will be reimbursing the County on a per ALS Medic Unit Response basis, in the amount of $2,000 per ALS Medic Unit Response.  The Tribe will also be responsible for all non-reimbursable costs associated with a Mass Casualty Incident.
 
Over the past five years the Tribe has received an average of 204 calls for service per year, with a low of 159 calls for service in 2013 and a high of 243 calls for service in 2011.  As a result, Health and Human Services Agency (HHSA) anticipates receiving approximately $400,000 in revenue each year over the term of this Agreement, or until the Tribe transitions to an alternative arrangement for services by an appropriate entity.
 
Approval and authorization of this Agreement will ensure that citizens visiting the Rancheria have access to ALS ambulance services in the event of a life-threatening situation, and will defray some of the cost to County of providing prehospital ALS emergency medical services specifically within County Service Area No. 7 and the areas surrounding the Rancheria.
 
Clerk of the Board Follow up Actions
1. Clerk of the Board to obtain signature of the Chair on two (2) original Agreements with the Tribe.
2. Clerk of the Board to provide one (1) original Agreement to HHSA Contracts Unit at 3057 Briw Road.
 
Contact
Don Ashton, M.P.A., Director
 
Concurrences
County Counsel and Risk Management