HomeMy WebLinkAbout08 - NB-3 - Feasibility and Requirements to Evaluate - 3/1/2011CITY COUNCIL AGENDA REPORT
MEETING DATE: March 1„ 2011 ITEM NUMBER:
SUBJECT: FEASIBILITY AND REQUIREMENTS TO EVALUATE INCREASING CAPACITY TO
COSTA MESA EMERGENCY MEDICAL SERVICES -PARAMEDIC SYSTEM
DATE: FEBRUARY 23, 2011
FROM: CITY MANAGER'S DEPARTMENT
PRESENTATION BY: THOMAS R. HATCH, ASSISTANT CITY MANAGER
FOR FURTHER INFORMATION Thomas R. Hatch, Assistant City Manager at (714) 754-5328.
CONTACT: Terry Matz, Interim Assistant City Manager at (714) 754-5688
RECOMMENDATION:
Provide direction on whether to transmit a letter to the Medical Director of the Orange
County Emergency Medical Services requesting that he determine the feasibility and
requirements to evaluate the addition of the City's ambulance provider as added
capacity to the current Costa Mesa Emergency Medical Service -Paramedic delivery
system.
DISCUSSION:
The Costa Mesa Fire Department provides high-quality, professional Advanced Life
Support (ALS) services through the City's Emergency Medical Service -Paramedic
Program. Mayor Pro -Tem Jim Righeimer has requested that the City Council examine
the option of creating flexibility in the provision of paramedic services to determine if the
City's ambulance provider could provide an efficient and cost-effective method to add
capacity to our paramedic services.
State law governs the provision of ALS services and provides that no person or
organization may provide these services unless that person or organization is part of the
Emergency Medical Services (EMS) system of the local EMS agency. Orange County
Emergency Medical Services (OCEMS) is the local EMS agency and is responsible for
the approval of any emergency medical service -paramedic (EMT -P) provider in Orange
County. The Costa Mesa Fire Department is an approved EMT -P provider.
Any potential EMT -P provider would have to be approved by OCEMS. Accordingly, if
the City Council wishes to examine this option, staff should be directed to transmit a
letter to Dr. Samuel Stratton, Medical Director for OCEMS and request that he provide
Costa Mesa with information concerning the feasibility and requirements to evaluate the
addition of the City's ambulance provider as a way to add capacity to the City of Costa
Mesa EMT -P provider system.
1
Authorizing this letter will allow OCEMS to evaluate this concept and determine if our
ambulance provider — Care Ambulance, would be authorized as a service provider and
therefore an option for the City to consider for added capacity to our current system for
the provision of paramedic services.
ALTERNATIVES CONSIDERED:
The City Council may elect not to investigate the potential option for the provision of
added capacity for Emergency Medical -Paramedic services to Costa Mesa.
FISCAL REVIEW:
The fiscal impact for adding EMT -P system capacity cannot be determined at this time.
Even if OCEMS authorized the City's current ambulance provider to be a paramedic
service provider in concept for Costa Mesa, the City of Costa Mesa would likely need to
conduct a formal bidding process to select a service provider. The requirements for any
bidding process and any related fiscal impacts would need to be fully evaluated and that
evaluation would occur at a later time.
CONCLUSION:
The City Council is requested to discuss the concept of sending a letter to OCEMS to
request that they study the feasibility and requirements for adding capacity to the City of
Costa Mesa's Emergency Medical Service -Paramedic current system as described in
the staff report.
Thomas R. Hatch
Assistant City Manager
Attachments: Attachment 1
Attachment 2
Terry Matz
Interim Assistant City Manager
OCEMS EMT -P Service Provider Criteria
Draft Letter to OCEMS Medical Director
E
ATTACHMENT 1
Orange County EMS Policy/Procedure
#700.00
Page 1 of 3
EMT -P SERVICE PROVIDER CRITERIA Orig. Date 1/84
Revised: 8-24-95
I. AUTHORITY:
Health and Safety Code -1797.178. No person or organization shall provide advanced life support (ALS)
unless that person or organization is an authorized part of the emergency medical services (EMS)
system of the local EMS agency.
Title -22, 100168. A local EMS agency with an ALS system shall establish policies and procedures for
the approval, designation, and evaluation through its quality assurance system, of all EMT -P service
provider(s). These policies and procedures shall include provisions requiring an EMT -P to be affiliated
with an approved EMT -P service provider in order to perform the scope of practice specified in this
chapter for an EMT -P.
An approved EMT -P service provider shall: (T-22, 100167)
1. Provide emergency medical service response on a continuous twenty-four (24) hours per day basis,
unless otherwise specified by the local EMS agency, in which case there shall be adequate
justification for the exemption (e. g., lifeguards, ski patrol personnel, etc.).
2. Utilize and maintain telecommunications as specified by the focal EMS agency.
3. Maintain a drug and solution inventory as specified by the local EMS agency, of basic and
advanced life support equipment, and supplies commensurate with the scope of practice.
4. Have a written agreement with the local EMS agency to participate in the ALS program and to
comply with all applicable State regulations and local policies and procedures, including
participation in the local EMS agency's quality assurance system as specified in Section 100166
and 100168.
II. APPLICATION:
This policy defines the criteria for approval of an emergency medical service -paramedic (EMT -P) service
provider and designation by the Orange County Emergency Medical Services (OCEMS)_
III. CRITERIA:
A. Based on State regulations and guidelines, County standards, and the Orange County Fire
Service/Paramedic Master Plan, the EMT -P service provider shall identify the number of ALS units
and geographical placements best suited to fulfill the prehospital emergency care needs in its
jurisdiction.
B. A prospective EMT -P service provider agency shall submit a written application to the OCEMS.
The application shall include:
1. A commitment of support from a responsible local government agency, i.e., city, County, or fire
district.
A commitment to respond, treat, and coordinate transport for any patient found within its
service area.
ITALICIZED TEXT IDENTIFIES QUOTATIONS FROM AN AUTHORITY OUTSIDE THE OCEMS
Approved:
P/P: 700.00
Implementation Date: 8-24-95
Reformatted: February, 2004
Orange County EMS Policy/Procedure
EMT -P SERVICE PROVIDER CRITERIA
ATTACHMENT 1
#700.00
Page 2 of 3 !
Ong. Date 1/84 +
Revised: 8-24-95
3. A commitment to provide emergency service response on a continuous 24 hour per day basis.
Included shall be a listing of the provider agency response capabilities, e.g., the number of ALS
units, number of paramedic assessment units, number of first responder units, and number of
units with first responder defibrillation equipment.
4. A commitment to adhere to applicable sections of the California Health and Safety Code and to
the OCEMS policies and procedures.
5. A commitment to provide ALS service meeting OCEMS staffing requirements for each unit. (2
EMT -Ps per ALS unit; 1 EMT -P per paramedic assessment unit.)
6. A list of all licensed and locally accredited EMT -Ps affiliated with the EMT -P service provider,
identifying active or inactive status.
7. Information on geographical locations and primary response areas of proposed service units
8. Applicant's plan for adhering to Board of Supervisor's Resolution 79-240: "Written plan for
responding EMT -P units into geographically contiguous areas on a mutual aid and/or back-up
response when requested without regard to governmental boundaries". Each plan shall
address the Board recommendations:
a. One unit for every 64,000 populations; or one unit per 16 square miles; or an average of
five minutes, or less response time; or adjacent units are at or above 300 total
responses/month.
b. Plan for implementing boundary drops within the fire net or modified net, including:
• current boundary commitments and deadlines for future implementation;
• closest paramedic unit responses irrespective of governmental boundaries:
• consideration of centralized dispatch and communications;
• automatic paramedic unit back-up coverage of at least 3-5 units;
• commitment to internet mutual aid agreement.
9. A commitment:
a. To comply with OCEMS requirements for uniform record keeping, data collection and an
OCEMS approved quality assurance plan as set forth by OCEMS policy and procedures.
b. To maintain a paramedic program coordinator who will be the liaison person with the
OCEMS and the assigned base hospital (BH).
c. To notify the OCEMS of all EMT -P service provider operational modifications including:
1) Proposed changes in number of units and/or unit locations.
2) Major EMT -P service provider administrative personnel changes.
3) Changes in status of licensed/accredited personnel.
Approved:
P/P: 700.00
Implementation Date: 8-24-95
Reformatted: February, 2004
ATTACHMENT 1
Orange County EMS Policy/Procedure
#700.00
Page 3 of 3
EMT -P SERVICE PROVIDER CRITERIA Orig. Date 1/84
Revised: 8-24-95
d. To notify the OCEMS of all unusual incidents involving medical aid responses
including but not limited to:
1) Patient complaints
2) Hospital complaints
3) Ambulance company complaints
4) Violations of State or OCEM medical policies and procedures, protocols,
rules, and/or regulations
(Included with each report of an unusual incident shall be a summary of
the agency's internal response, if any, to the incident.)
e. To work in conjunction with the OCEMS when evaluating EMT -P
medical/communication equipment.
f. To comply with treatment guidelines as approved by the OCEMS Medical
Director.
g. When feasible, to provide field internship opportunities to EMT -P trainees from
the OCEMS approved paramedic training program.
h. To provide orientation and training opportunities to EMT -P challenge candidates
for local accreditation to practice.
i. To work with the OCEMS in medical disaster preparedness.
10. An internal policy for:
a. The systematic reporting of radio communications problems to Orange County
Communications for resolution.
b. The routine dissemination of information to appropriate personnel from the
OCEMS and its advisory committees.
c. The timely reporting of infectious disease exposures.
d. Resupplying of controlled substances and expendable medical supplies.
e. Addressing the approved method for handling, transporting, storing, and
disposing of biomedical waste.
IV. HEARING/SUSPENSION/REVOCATION:
A. T-100168: The local EMS agency shall review its agreement plan with each EMT -P service
provider at least every two years. Such agreement may be changed, renewed, canceled or
otherwise modified, when necessary.
B. The local EMS agency may deny, suspend, or revoke
the approval of an EMT -P service provider for failure to comply with applicable policies.
Approved:
3
P/P: 700.00
Implementation Date: 8-24-95
Reformatted: February, 2004
DRAFT
March 2, 2011
Samuel J. Stratton, MD, MPH
Medical Director
Orange County Emergency Medical Services
405 W. Fifth Street
Santa Ana, CA 92701
Re: Emergency Medical Services — Paramedic (EMT -P)
Dear Doctor Stratton:
ATTACHMENT 2
The City of Costa Mesa provides Advance Life Support (ALS) services through the
Costa Mesa Fire Department's Emergency Medical Services- Paramedic program. The
Department has long provided excellent, high-quality emergency care for residents,
businesses and visitors to our community.
The City is reviewing the way in which it delivers all of its services and is interested in
reviewing methods for delivering the highest level for the Community. The City Council
is interested in understanding whether it is feasible for our ambulance provider, Care
Ambulance, to be authorized by Orange County Emergency Medical Services as a
provider of paramedic services in Orange County and therefore an option for the City of
Costa Mesa to consider as a way to add capacity to our paramedic system.
Accordingly, we are requesting that your agency make a determination as to the
feasibility and requirements to evaluate our ambulance provider Care Ambulance for
authorization by OCEMS as an Emergency Medical Service -Paramedic delivery system
provider to add capacity to our existing Costa Mesa system.
Your assistance in this matter is greatly appreciated. If you have any questions, please
contact me at 714-754-5328.
Sincerely,
Thomas R. Hatch
Assistant City Manager