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HEARING - Health and Human Services Agency recommending the Board adopt and authorize the Chair to sign Resolution 123-2018, revising the Emergency Medical Services Agency Fee Schedule effective July 17, 2018, which includes the following fee additions and expansions:
1) Expansion of the "Permitting Application Agreement" (formerly "Contract Application") fee to include permit applications for Advanced Life Support (ALS) Non Transporting and Assessment Units;
2) New fee for replacement EMT card fee of $10 per card;
3) New fee for Public Safety First Aid and CPR training courses of $100 initially and upon each four-year renewal;
4) New fee for Emergency Medical Responder (EMR) training courses of $200 initially and upon each four-year renewal; and
5) New fee for patient record requests, when such requests are made by a law firm or by subpoena, of $20 each. (Cont. 6/12/18, Item 40) (Est. Time: 15 Min.)
FUNDING: Fee for Service.
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Health and Human Services Agency (HHSA) recommending the Board adopt and authorize the Chair to sign Resolution 123-2018, to update and replace the current fee schedule for the Emergency Medical Services Agency.
DISCUSSION / BACKGROUND:
At the Board of Supervisors meeting on March 21, 2017 (17-0224, Item 12), the Board approved Resolution 056-2017 to revise Emergency Medical Services (EMS) fees based on a Fee Study and the need to bring fees into compliance with Health and Safety Code Section 11362.755 which was amended by Proposition 64, Section 5.3. Effective November 8, 2016, Resolution 056-2017 superseded the previous Resolution 144-2016 and established fees in accordance with the new laws.
The Board of Supervisors is authorized to adopt new fees, fee levels, and charges pursuant to Government Code Section 54985. Based on the latest fee review, it is recommended that a new Fee Schedule (Attachment A, page 2, Exhibit A to Resolution) be adopted in which the existing fees will be kept at current rates, with the addition of new language to clarify frequency for some services that require renewals and are subject to renewal fees. To cover the administrative costs incurred for services, using the same methodology used to determine current fees, five (5) new fees are proposed:
1) Expansion of the "Permitting Application Agreement" (formerly "Contract Application") fee to include permit applications for Advanced Life Support (ALS) Non Transporting and Assessment Units;
2) New fee for replacement EMT card fee of $10 per card;
3) New fee for Public Safety First Aid and CPR training courses of $100 initially and upon each four-year renewal;
4) New fee for Emergency Medical Responder (EMR) training courses of $200 initially and upon each four-year renewal; and
5) New fee for patient record requests, when such requests are made by a law firm or by subpoena, of $20 each. (Cont. 6/12/18, Item 40) (Est. Time: 15 min.)
The above fees are expected to recover 15% of HHSA's costs for processing the Permitting Application Fee.
Fees for permitting of Advanced Life Support (ALS) Non Transporting and Assessment Units will be charged to fire districts that operate ALS units within the County, and are included in the Resolution authorizing the newly developed permitting application agreement being brought to the Board July 17, 2018, under File ID 18-0524. These fees already apply to the Interfacility Transfer (IFT) and Critical Care Transfer (CCT) permitting application process for IFTs and CCTs in the non-exclusive operating area of County Service Area 7. Fees for training courses and card replacements are specific to the applicant. Fees for records requests are paid by the requestor, unless the requestor is the patient, in which case there is no fee.
In accordance with Government Code Section 6066, notice of today’s public hearing to consider the adoption of a Resolution revising the Emergency Medical Services Agency Fee Schedule was published in the Mountain Democrat and the Tahoe Daily Tribune on May 25, 2018 and June 1, 2018.
ALTERNATIVES:
The Board could choose to decline to adopt the proposed Resolution, thereby retaining the existing fee structure.
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel.
CAO RECOMMENDATION:
Continue to July 17, 2018
FINANCIAL IMPACT:
There is potential for decrease to the Net County Cost for these services. The EMS program is funded primarily with General Fund dollars, offset by any fee revenue and ground emergency medical transport revenue that is received. Therefore, changes to the fee structure have the potential to increase or decrease the General Fund cost of the program.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one Resolution; and return one certified copy of Resolution to the HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
Health and Human Services Agency Strategic Plan Goal 2 - Fiscal Responsibility, Objective 2.2.1 - Develop an updated standardized structure for fees, fines, and services.
CONTACT
Patricia Charles-Heathers, Ph.D., M.P.A., Director