|
DATE: |
March 15, 2022 and April 5, 2022 |
18 |
SUBJECT
Title
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE ORDINANCE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES (DISTRICTS: ALL)
Body
OVERVIEW
Today’s action requests that the San Diego County Board of Supervisors (Board) approve amendments to Article XX of the San Diego County Administrative Code and waive Board Policy B-29, Fees, Grants, and Revenue Contracts - Department responsibility for full cost recovery, related to fees charged for services by the County of San Diego (County) Emergency Medical Services Office (EMS). The Board last approved revisions to EMS’s fees on May 4, 2021 (18).
By regularly reviewing costs and fees, departments can recuperate costs in a systematic manner, ensure all fees are fair and equitable, and enable stakeholders to plan for fee increases. In accordance with Board Policy B-29, County EMS recently reviewed eight fees and associated costs, and proposes adjustments to seven of those fees during Fiscal Year 2022-23, including five fee increases and two fee decreases. One fee remains unchanged. Attachment A is a summary comparison of current and proposed fees. The Auditor and Controller has reviewed and approved the supporting documentation and methodology for the proposed fee adjustments.
Today’s request includes two steps. On March 15, 2022, the Board is asked to consider an Ordinance amending sections of the San Diego County Administrative Code related to EMS fees. If the Board takes actions as recommended, then on April 5, 2022, the proposed Ordinance will be brought back to the Board for consideration and adoption.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
On March 15, 2022:
1. Waive Board Policy B-29, Fees, Grants, and Revenue Contracts - Department Responsibility for Cost Recovery which requires full cost recovery for services.
2. Approve the introduction of the Ordinance (first reading), read title, and waive further reading of the Ordinance:
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 367. COUNTY SERVICE AREA 69 RESIDENT USER FEE.
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 369. COUNTY SERVICE AREA 17 RESIDENT USER FEE.
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 370. EMERGENCY MEDICAL SERVICES FEES.
If, on March 15, 2022, the Board takes actions recommended in Items 1-2 above, then on April 5, 2022:
1. Consider and adopt (second reading):
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 367. COUNTY SERVICE AREA 69 RESIDENT USER FEE.
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 369. COUNTY SERVICE AREA 17 RESIDENT USER FEE.
AN ORDINANCE AMENDING ARTICLE XX OF THE SAN DIEGO COUNTY ADMINISTRATIVE CODE, RELATING TO SAN DIEGO COUNTY EMERGENCY MEDICAL SERVICES FEES
SEC. 370. EMERGENCY MEDICAL SERVICES FEES.
EQUITY IMPACT STATEMENT
Services and oversight provided by the San Diego County Emergency Medical Services Office (EMS) is supported through a fee for individuals and agencies for the credentialing of prehospital personnel (Emergency Medical Technicians, Paramedics and Mobile Intensive Care Nurses), ambulance permitting and inspections for private agencies, approval for continuing education providers and the hospital specialty care designations for base stations and trauma centers. The EMS office provides this detailed level of oversight ensuring the San Diego community receives equitable medical care by appropriately licensed and verified personnel, properly permitted transport vehicles and appropriately designated hospital facilities.
FISCAL IMPACT
There is no fiscal impact in the current fiscal year. If approved, additional funds from the revised EMS fees, estimated at $112,000, will be included in the Fiscal Year 2022-24 CAO Recommended Operational Plan for San Diego County Fire. There is no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
This item was presented as an informational item on February 24, 2022 to the Emergency Medical Care Committee.
BACKGROUND
The County of San Diego (County) Emergency Medical Services Office (EMS) is committed to maintaining the highest quality work product and customer service while continuously evaluating its services provided for efficiency, accuracy and equity. The continued increases in the cost of doing business requires the evaluation of fees to align with current costs. Today’s proposed fee changes reflect standard assumptions made by the County and do not address cost increases based on negotiated labor agreements, due to the timing of the fee package and the labor negotiations. Increased costs in Fiscal Year 2022-23 due to approved labor negotiations will be reflected in future cost recovery packages.
On May 4, 2021 (18), the Board approved a three-year phased approach to achieve cost recovery through fees charged to prehospital personnel as described in Attachment D. In order to continue the phased fee increases to address full cost recovery for purposes of EMS personnel fees, County EMS performed an analysis of all services provided to customers to examine the tasks and functions performed, including the direct and indirect costs of performing those tasks in relation to the specific services. Criteria were established to determine a fair and equitable fee for direct services provided.
County EMS is proposing updates to seven of the eight fees it reviewed. The proposed fee package reflects known costs as accurately as possible and compliance with Board Policy B-29. The County Auditor and Controller reviewed and approved the supporting documentation and methodology of EMS fee updates. In future EMS advisory committee meetings, County EMS will reinforce with stakeholders the County’s obligation for full cost recovery and the department’s commitment to revisit the fees annually. The overall analysis results in the following fee recommendations (see Attachments A and D for additional details):
|
Action |
Number of Fees |
Description |
|
Increases |
5 |
• EMT/Advanced EMT Initial/Renewal from current $106 to $126 • Paramedic Accreditation Initial from current $106 to $126 • Mobile Intensive Care Nurse Authorization Initial from current $106 to $126 • Continuing Education Provider from current $1,135 to $1,335 • Base Station Hospital Designation from current $19,972 to $24,888 |
|
Decreases |
2 |
• Annual Vehicle Inspection from current $392 to $325 • Trauma Center Hospital Designation from current $52,419 to $47,503 |
|
No Change |
1 |
• Ambulance Provider Permit remains $3,549 |
|
Total Fees |
8 |
|
Today’s action proposes to update seven fees, change ordinance language per Attachment B, and amend the County Administrative Code Article XX Section 370 Emergency Medical Services Fees. If approved, fee updates will be effective July 1, 2022.
Additionally, due to the transition of County EMS to the Public Safety Group as of July 1, 2021, today’s action updates County Administrative Code Article XX Section 367 (County Service Area 69 Resident User Fee) and Section 369 (County Service Area 17 Resident User Fee) to clarify that the Public Safety Group Deputy Chief Administrative Officer or designee is responsible for fee waivers.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Empower and Equity Initiatives in the County of San Diego’s (County) 2022-2027 Strategic Plan. Periodically reviewing the San Diego County Emergency Medical Services Office fees ensures that the County has optimized its service delivery system to ensure efficiency, integration and innovation while maintaining fiscal stability.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
Attachment A: Summary Comparison of Current and Proposed Fees
Attachment B: An Ordinance Amending Article XX of the San Diego County Administrative Code, Relating to San Diego County Emergency Medical Services Fees (Clean Copy)
Attachment C: An Ordinance Amending Article XX of the San Diego County Administrative Code, Relating to San Diego County Emergency Medical Services Fees (Informational Copy)
Attachment D: Summary of Cost Recovery Proposal Actions
Attachment E: Approved 3-Year Phase-in of EMS Personnel Fees
Attachment F: An Ordinance Amending Article XX of the Administrative Code, Relating to County Service Area 69 Resident User Fee (Clean Copy)
Attachment G: An Ordinance Amending Article XX of the Administrative Code, Relating to County Service Area 69 Resident User Fee (Informational Copy)
Attachment H: An Ordinance Amending Article XX of the Administrative Code, Relating to County Service Area 17 Resident User Fee (Clean Copy)
Attachment I: An Ordinance Amending Article XX of the Administrative Code, Relating to County Service Area 17 Resident User Fee (Informational Copy)