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Public Health Department recommending Chairman be authorized to sign Amendment I to Agreement 200-S0811 with El Dorado County Regional Prehospital Emergency Services Operations Authority (JPA) to amend Section V, Article XI - Response Time Standards, Letter C. Maximum Response Times, to provide prehospital Advanced Life Support (ALS) services and dispatch services within County Service Area No. 7.
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Fiscal Impact/Change to Net County Cost: There is no fiscal impact or net County cost associated with this item.
Background: Effective July 1, 2006, the West Slope JPA entered into a new five-year contract with the County to provide ALS ambulance service to the West Slope service area. Since that time, the West Slope JPA has been unable to consistently meet response time requirements for the Urban and Rural areas, prompting the EMS Agency to provide a notice of minor breach to the West Slope JPA each month since July, 2006.
Beginning in November 2006, the West Slope JPA and Public Health Department/EMSA began meeting to discuss response time compliance. The States EMS Systems Standards and Guidelines states: each local EMS agency shall develop response time standards for medical responses. The ones currently being used in the CSA 7 response area were developed more than eight years ago and had not been reviewed since that time. After discussions with the West Slope JPA, it was determined that an analysis of actual performance data might suggest more appropriate response time standards. Such an analysis was performed by the County's EMS Agency using West Slope JPA response time performance data from 2006.
Currently, the West Slope JPA is substantially exceeding response time standards in semi-rural areas and is not meeting response time standards in urban and rural areas. The analysis was reviewed by a subcommittee of the West Slope JPA, consisting of fire chiefs, board members and staff. The subcommittee's recommendation to the West Slope JPA to modify the response time standards to more accurately reflect community conditions was ultimately approved by the West Slope JPA Board. Staff recommends that, through a collaboration between the West Slope JPA and the Public Health Department/EMSA, a regular, ongoing review of these standards occur in the future.
Reason for Recommendation: The analysis of actual response time performance suggests that the standards should be modified for CSA 7 response area. Amendment I will modify response time standards to allow the West Slope JPA to meet contractual requirements with existing resources. A comparison of the current maximum response time requirements to the amended response time requirements is presented as Attachment A, Response Time Comparison, to this agenda item.
Modifying selected response time standards for ambulances will:
· More accurately reflect current achievable community response times relative to the existing resource level
· Allow West Slope JPA to meet contractual requirements and stop the issuance of letters of minor breach
Modifying selected response time standards for ambulances will not:
· Promote any longer responses than are currently experienced
· Change the level of patient care currently provided
· Impact the arrival of an EMT or paramedic-staffed engine company prior to the ambulance
Not approving the amendment will result in the continued issuance of letters of minor breach to the West Slope JPA so long as response time standards are not met. Ultimately, if these minor breaches continue, a determination will need to be made of when multiple minor breaches rise to the level of a major breach.
Action to be taken following Board approval: Chairman to sign three (3) copies of attached amendment; Board Clerk's Office to return two (2) signed originals to Public Health; Public Health to forward one original to West Slope JPA and distribute as appropriate.
Contact: Dan Buffalo
Concurrences: