Title
Chief Administrative Office (CAO) recommending the Board:
1) Approve and authorize the Chair to sign Resolution 014-2019 adopting the Manager, Emergency Medical Services, Preparedness and Response job class number, salary range, bargaining unit, and department-specific class specification;
2) Approve and authorize the Chair to sign Resolution 015-2019, amending the Authorized Personnel Allocation Resolution 132-2018, as follows, in order to begin the reorganization of the County’s Emergency Preparedness and Response program and the Emergency Medical Services (EMS) program (including oversight of Ambulance services), and prepare for the transfer of the two programs to the Chief Administrative Office:
a) Delete 1.0 FTE EMS Agency Administrator position (vacant) from the Health & Human Services personnel allocation;
b) Add 1.0 FTE Manager, Emergency Medical Services, Preparedness & Response to the Health and Human Services personnel allocation; and
c) Add 1.0 FTE Deputy Chief Administrative Officer to the CAO personnel allocation.
3) Direct staff to incorporate the transfer of the two programs as part of the Fiscal Year 2019-20 budget process. (Est. Time 15 Min.)
FUNDING: Combination of CSA, State, and General Fund.
Body
DISCUSSION / BACKGROUND
As was presented in the December 11, 2018 report, per Board policy, the Chief Administrative Officer is responsible for the overall operation of the County’s Emergency Management Policy for governmental departments, but has no direct involvement with or authority over disaster/emergency operations as those are administered by the elected Sheriff and the Director of HHSA.
Additionally, HHSA’s primary responsibility is to provide mandated and discretionary services to disadvantaged and vulnerable residents. The role of EMS and Emergency Preparedness is to serve all residents, including large organizations such as hospitals and government bodies. It was discussed that, due to the size and complexity of HHSA programs, EMS and Preparedness programs likely do not receive the level of attention and prioritization necessary.
At that meeting, the Chief Administrative Office recommended that the County could benefit from transferring the responsibility of the EMS and Emergency Preparedness functions to the Chief Administrative Office, to help ensure coordination between emergency preparedness, emergency medical services, and the many independent districts that provide fire and emergency response services within the County.
The recommended reorganization and transfer of the two programs will consolidate duties that are currently split among the equivalent of 7.45 Full Time Equivalent (FTE) positions that are directly related to the two programs.
Administrative support positions which perform administration and finance related duties require additional analysis before a detailed recommendation can be made. These duties and related positions will be evaluated in the coming months, with a recommendation for how to continue to perform this support work to be brought to the Board with a subsequent report, and the changes will be implemented as part of the FY 2019-20 Budget process.
The transfer of oversight of the Community Service Areas (CSAs) will also be assessed in the coming months, with recommendations for on-going management of those functions included in the subsequent report. This function is currently included under the EMS program; however, a significant portion of the administrative work is housed within the HHSA Administration and Finance Division. The Emergency Medical Services Agency is funded through the CSAs that have been established for the provision of prehospital emergency medical services and transport within the County. CSA 7 covers the West Slope and CSA 3 encompasses the Tahoe Basin. The Board of Supervisors is the governing body of these voter-created service areas. The EMS agency administers contracts with ambulance transport providers, base hospitals, and prehospital advanced life support providers within the CSAs. The EMS Agency Administrator is directly responsible for administration of the programs funded through the CSAs; however, the HHSA Administration and Finance group has been administering the fiscal management of the CSAs. The fiscal management of the CSAs includes budget development, rate and fee development, preparation of the direct charge tax levy, billing for ambulance transports, and processing payments to ambulance transport contractors.
Due to the complexity of how costs are allocated in HHSA, the Auditor is requesting the transfer and reorganization of the two programs be incorporated into the Fiscal Year 2019-20 budget process. However, considering the existing EMS Agency Administrator position is vacant, staff is recommending this position be deleted now and replaced with a new classification titled Manager, Emergency Medical Services, Preparedness & Response. This position is intended to be the subject matter expert and the individual responsible for day-to-day management responsibilities of the emergency medical services and countywide emergency preparedness and response two programs. If approved, the recruitment for the position will be initiated by HHSA, but the CAO’s office will be involved the selection process. This is a first step in the reorganization and will ideally enhance the level of service provided to beginning immediately, as opposed to waiting until July to begin the process.
Additionally, in order to provide appropriate fiscal and budget analysis of the emergency management system, along with fire liaison responsibilities, it is recommended that this new program report directly to a Deputy Chief Administrative Officer (CAO) position. This will require the addition of one Deputy CAO position, and is also consider a first step toward the reorganization and transfer of the two identified programs, allowing the CAO’s office to begin the recruitment and selection of the individual and ease the transition when the transfer from HHSA to the CAO is implemented effective July 1, 2019. It should also be noted that there are internal candidates in the CAO’s office who will likely be interested in this position. If one of those candidates is selected, staff will return to the Board during the FY 2019-20 Budget process to delete an existing Principal Management Analyst position, thereby reducing the net fiscal impact.
ALTERNATIVES
The Board could opt to not approve the recommended action, or may provide alternate direction to staff.
PRIOR BOARD ACTION
On December 11, 2018 (Legistar #18-1740) the Board provided direction to proceed with the transfer of the emergency preparedness and response and emergency medical services program functions from the Health and Human Services Agency to the Chief Administrative Office, and directed the Chief Administrative Officer to return in the next 30 days with appropriate personnel resolution amendments and budget transfers to effect this transfer. On December 11, 2018, the Board also directed the CAO and Sheriff, with participation of HHSA, to return to the Board with recommended updates and revisions to Policy K-3, Emergency Management Policy. No revisions are recommended at this time, however once the transition is complete, staff will begin a review of all policies.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
HHSA - EMS and Preparedness, Human Resources
FINANCIAL IMPACT
The deletion of the EMS Agency Administrator and the addition of the Manager, Emergency Medical Services, Preparedness & Response position would result in a net increase in staff costs of approximately $23,000 each year, and a prorated cost of approximately $6,600 for the remainder of FY 2018-19 in HHSA, which will be covered by vacancy savings. The addition of a Deputy CAO position, assuming Step 3 of the salary schedule, would be approximately $210,000 annually, and a prorated cost of approximately $60,000 for the remainder of the fiscal year.
No budget transfer is recommended at this time. It is anticipated that the current peronnel changes will be covered by savings. However, should a candidate be chosen from outside the CAO office and/or savings not be identified prior to hire, staff will return to the Board with a budget transfer to add appropriations. Any additional cost in FY 2018-19 would be covered from the Appropriation for Contingency for the remainder of the year.
With the full implementation of the reorganization and transfer of the two programs to the Chief Administrative Office, it is anticipated that these net costs will be reduced. However, the full impacts are unknown at this time as the new structure, and related program budgets, is still being evaluated.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Upon Board adoption and approval, please provide a fully executed Resolution to the Katie Lee in Human Resources.
STRATEGIC PLAN COMPONENT
Public Safety; Good Governance
CONTACT
Don Ashton, Chief Administrative Officer