|
|
|
|
|
|
|
|
|
|
|
COUNTY OF SAN MATEOInter-Departmental Correspondence |
Health Services Agency |
| |
DATE: |
September 19, 2002 |
BOARD MEETING DATE: |
October 8, 2002 |
| |
TO: |
Honorable Board of Supervisors |
FROM: |
Margaret Taylor, Director of Health Services |
Barbara Pletz, EMS Administrator
|
SUBJECT: |
Amendments to the Agreements with American Medical Response West (AMR) for: |
| |
a. |
Countywide Advanced Life Support First Response and Emergency Ambulance Service |
| |
b. |
Medical and Nonmedical Transportation of Selected Patients |
| |
Recommendation |
| |
Adopt a resolution authorizing the President of the Board to execute Amendments to the Agreements with AMR for: |
| |
1) |
Countywide Advanced Life Support First Response and Emergency Ambulance Service, and |
| |
2) |
Medical and Nonmedical Transportation of Selected Patients. |
| |
Background |
| |
In 1998 your Board approved an agreement with AMR for Countywide Advanced Life Support First Response and Emergency Ambulance Service. For this contract, referred to as the "911 contract," the services are provided by AMR and its subcontractors which are the San Mateo Emergency Medical Services Group (JPA), the California Department of Forestry and Fire Protection, and the City and County of San Francisco through its Airport Commission. This EMS model fully integrates dispatch, first response, and ambulance transport into a seamless system of response and care. It has received awards for excellence at the state, national, and international levels. The model requires a high degree of cooperation and collaboration between the County and the Contractor, and between the Contractor and its public safety partners. Significant financial relationships are also key to the success of this model. |
| |
In 1999 your Board approved an agreement with AMR for the transportation of selected county patients. This contract is referred to as the "Nonemergency Contract." |
| |
Discussion |
| |
911 Contract |
The 911 contract is performance-based with detailed requirements in such areas as response times, training and education, patient care records, vehicle specifications, equipment and supplies, patient charges and billing practices. The response times are tracked monthly. Both the Contractor and its subcontractors are required to meet or exceed 90% compliance with the response time standards. Compliance data are included as Attachment A. |
| |
The EMS Program staff recently completed a full contract compliance audit of AMR. Contract compliance was determined to be excellent in most categories. The Executive Summary and the list of recommendations are contained in Attachment B; many of these recommendations concern the inadequacy of documentation provided by the subcontractors to the Contractor. |
| |
The proposed amendment to the "911 contract" relates to requested patient fee increases by the Contractor. Also contained in the amendments are some increased fees charged by the County to the Contractor; a change of the requirement that AMR's EMS Clinical Coordinator be a registered nurse to allow paramedics to fill this position; and the addition of several functions that the County EMS Program staff will perform for the Contractor. |
| |
An analysis of the requested fee increases is contained in Attachment C. Attachment C also discusses 911 ambulance fees charged in other Bay Area counties and some of the factors to be considered when making comparisons. |
| |
Nonemergency Contract |
The proposed amendment to the nonemergency contract includes clarification of policies and procedures between the Contractor and the County related to response times; transportation of medically stable, non-urgent and other patients; annual summary reports to the County; the monthly subsidy for transportation of mental health clients who have no federal, state or private coverage and are unable to pay privately for services; and billing requirements for authorized inter-facility transfers. These amendments do not change service levels or fees. |
| |
| |
Vision Alignment |
| |
These amendments to the agreements with AMR keep the commitment of Ensuring Basic Health and Safety for All and goal number 7-maintain and enhance the public safety of all residents and visitors. The amended agreements contribute to this commitment and goal by providing immediate first response and ambulance services to all 911 medical requests. |
| |
Term and Fiscal Impact |
| |
The amendments to the 911 contract will increase revenue to the County as follows: |
| |
| |
Purpose |
Amount |
Frequency |
|
EMS Program will provide additional services to contractor. |
$100,000 |
On-going annual fee beginning in FY 2002/03 |
Contractor will fund its share of County Public Safety Communications backup center for fire/EMS |
$ 87,426 |
One time payment in FY 2002/03 |
| |
In addition to these changes, both amendments also now include the County's non-discrimination and equal benefits language and language regarding compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements. |
| |
There are no increased costs to County as the result of the contract amendments to either 911 or nonemergency contract, nor is there any change in the contract term. |