HomeMy WebLinkAboutCounty of Tulare-Emergency Medical Services Administration_A-25-463 A-04-104.pdf COtj County of Fresno Hall of Records, Room 301
2281 Tulare Street
Fresno,California
601 Board of Supervisors 93721-2198
O� 1$56 O Telephone: (559)600-3529
FRV,t' Minute Order Toll Free: 1-800-742-1011
www.fresnocountyca.gov
September 9, 2025
Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig,
Chairman Buddy Mendes, and Supervisor Brian Pacheco
Agenda No. 38. Public Health File ID: 25-0496
Re: Approve and authorize the Chairman to execute a retroactive Amendment No. 5 to Agreement No.
90-257 with the County of Kings,for Emergency Medical Services Administration,to modify
compensation terms effective July 1, 2025,with no change to the term of unlimited annual renewals
and increasing the annual maximum by$7,005 to$60,880;Approve and authorize the Chairman to
execute a retroactive Amendment No. 5 to Agreement No. 90-258 with the County of Madera,for
Emergency Medical Services Administration,to modify compensation terms effective July 1, 2025,
with no change to the term of unlimited annual renewals and increasing the annual maximum by
$7,005 to$60,880;Approve and authorize the Chairman to execute a retroactive Amendment No.2 to
Agreement No. 04-104 with the County of Tulare,for Emergency Medical Services Administration, to
modify compensation terms effective July 1, 2025,with no change to the term of unlimited annual
renewals and increasing the annual maximum by$7,005 to$60,880
APPROVED AS RECOMMENDED
Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco
Agreement No. 25-461,Agreement No. 25-462,Agreement No. 25-463
County of Fresno Page 40
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Board Agenda Item 38
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DATE: September 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Retroactive Amendment to Agreements for Emergency Medical Services
Administration with the Counties of Kings, Madera, and Tulare.
RECOMMENDED ACTION(S):
1. Approve and authorize the Chairman to execute a retroactive Amendment No. 5 to
Agreement No. 90-257 with the County of Kings, for Emergency Medical Services
Administration, to modify compensation terms effective July 1, 2025 with no change to the
term of unlimited annual renewals and increasing the annual maximum by$7,005 to $60,880;
2. Approve and authorize the Chairman to execute a retroactive Amendment No. 5 to
Agreement No. 90-258 with the County of Madera, for Emergency Medical Services
Administration, to modify compensation terms effective July 1, 2025 with no change to the
term of unlimited annual renewals and increasing the annual maximum by$7,005 to $60,880;
and
3. Approve and authorize the Chairman to execute a retroactive Amendment No. 2 to
Agreement No. 04-104 with the County of Tulare, for Emergency Medical Services
Administration, to modify compensation terms effective July 1, 2025 with no change to the
term of unlimited annual renewals and increasing the annual maximum by$7,005 to $60,880.
There is no additional Net County Cost associated with the recommended actions. Approval of the
recommended actions will provide for a 13% increase to the base rate for the counties of Kings, Madera,
and Tulare for the Department of Public Health's administration and oversight of emergency medical
services (EMS). This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the cost ($53,857) agreed to in 2019 as part of
the Fourth Amendment for Kings and Madera, and First Amendment for Tulare, would remain unchanged
and the Department would adjust oversight services and corresponding expenditures based on existing
revenue.
RETROACTIVE AGREEMENT:
The recommended amendments are retroactive to July 1, 2025 due to delays in approval by all parties in
getting to their respective Boards, along with internal review of all documents. Initial requests to Counties of
Kings, Madera, and Tulare for the increased compensation were sent by the Department in early April.
FISCAL IMPACT:
There is no increase Net County Cost associated with the recommended actions. The recommended
County of Fresno Page 1 File Number:25-0496
File Number:25-0496
amendments will increase the base rate by 13%, or$7,005; increasing the annual maximum from $53,875
to$60,880 for all three counties. Sufficient appropriations and revenues are included in the Department's
Org 5620 FY 2025-26 Recommended Budget and will be included in budget requests for the duration of the
term.
DISCUSSION:
California Health and Safety Code, section 1797.200 requires that each County designate an EMS Agency to
implement, monitor, and evaluate its EMS system. Since 1990, the Counties of Kings and Madera have
contracted with the Department for administration and oversight of their EMS system. Since 2004, the
County of Tulare has contracted with the Department for administration and oversight of their EMS system.
Contracted oversight responsibilities include development of policies and procedures, certification/l ice nsure
of EMS personnel, designation of trauma centers, investigations/background checks, oversight of
ambulance contracts, management of disaster medical services, approval of EMS training courses,
designation of exclusive operating areas, and oversight of EMS system operations.
On June 19, 1990, the Board approved Agreement Nos. 90-257 and 90-258, which officially designated the
County as the Local EMS Agency in accordance with Health and Safety Code, section 1797.200 for the
Counties of Kings and Madera. On November 10, 1992, the Board approved the First Amendments,
Agreement Nos. 92-594 and 92-595, which clarified approval of provider agreements and modified the
compensation for services. On June 14, 1994, the Board approved the Second Amendments, Agreement
Nos. 94-244 and 94-245, which allowed for EMS "on-call"services and added language that would trigger a
renegotiation of compensation in the event of reduction in California Emergency Medical Services Authority
(EMSA)funding. On May 11, 1999, the Board approved the Third Amendments, Agreement Nos. 99-171 and
99-172, which modified compensation due to increases in State EMSA funding. On August 20, 2019, the
Board approved the Fourth Amendments, Agreements No. 19-414 and 19-415, which modified
compensation due to static EMSA funding and rising personnel costs.
On March 16, 2004, the Board approved Agreement No. 04-104, which officially designated the County as
the Local EMS Agency for Tulare County in accordance with Health and Safety Code, section 1797.200. On
November 5, 2019, the Board approved the First Amendment, Agreement No. 04-104-1, which modified
compensation due to static EMSA funding and rising personnel costs.
The Department's administration and oversight of emergency medical services costs to the Counties of
Kings, Madera, and Tulare has remained unchanged due to funding provided by the State EMSA, which has
offset the costs to each of the Counties for the provision of services by the County. Despite an increase in
State EMSA funds in 2022, County personnel and software costs have increased beyond that provided by
State EMSA Funds requiring an increase in compensation from each of the Counties. The County is
designated as the local EMS Agency for four counties: Fresno, Kings, Madera, and Tulare. The State EMSA
recognizes the County as a regional EMS Agency known as the Central California EMS Agency. In
accordance with Health and Safety Code, section 1797.108, the State EMSA supports the regionalization
and inclusion of rural counties and assists the County with regional funding to support and offset the cost of
EMS administration for the smaller counties.
With your Board's approval, Amendment No. 5 to the Agreements with the Counties of Kings and Madera
and Amendment No. 2 to the Agreement with the County of Tulare, will be amended to include an increase in
costs for EMS administration and oversight.
REFERENCE MATERIAL:
BAI #36, November 5, 2019
BAI #35, August 20, 2019
BAI #44, March 16, 2004
BAI #41 B, May 11, 1999
County of Fresno Page 2 File Number.25-0496
File Number:25-0496
BAI #32C, June 14, 1994
BAI #18J, November 10, 1992
BAI #31 L, June 19, 1990
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment No. 5 to Agreement No. 90-257 with the County of Kings
On file with Clerk-Amendment No. 5 to Agreement No. 90-258 with the County of Madera
On file with Clerk-Amendment No. 2 to Agreement No. 04-104 with the County of Tulare
CAO ANALYST:
Ronald Alexander
County of Fresno Page 3 File Number:25-0496
Agreement No. 25-463
1 AMENDMENT NO. 2 TO AGREEMENT A-04-104
2 This Amendment No. 2 to Agreement ("Amendment No. 2") is dated
3 September 9, 2025 and is between County of Tulare, a political Subdivision of the State of
4 California ("Tulare"), and County of Fresno, a political subdivision of the State of California
5 ("Fresno").
6 Recitals
7 A. On March 16 ,2004, Fresno and Tulare entered into Agreement Number A-04-104
8 ("Agreement"), which Fresno agreed to provide Emergency Medical Services Agency
9 Administration to Tulare.
10 B. On July 1, 2019, Fresno and Tulare amended the Agreement.
11 C. Fresno and Tulare now desire to further amend the Agreement in order to modify
12 compensation terms.
13 The parties therefore agree as follows:
14 1. Section F ("Compensation") of the Agreement, as previously amended, located on page
15 1, line 17 through line 19 of the Fourth Amendment to the Agreement is deleted in its entirety
16 and replaced with the following:
17 "Effective July 1, 2025, compensation paid by Tulare to Fresno under this
18 Agreement for the provision of services hereunder shall be at a rate of Sixty
19 Thousand, Eight Hundred Eighty Dollars and 00/100 ($60,880.00) annually."
20 2. When both parties have signed this Amendment No. 2, the Agreement, the First through
21 Fourth Amendments, and this Amendment No. 2 together constitute the Agreement.
22 3. Tulare represents and warrants to Fresno that:
23 a. Tulare is duly authorized and empowered to sign and perform its obligations under
24 this Amendment.
25 b. The individual signing this Amendment on behalf of Tulare is duly authorized to do so
26 and his or her signature on this Amendment legally binds Tulare to the terms of this
27 Amendment.
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1 4. The parties agree that this Amendment may be executed by electronic signature as
2 provided in this section.
3 a. An "electronic signature" means any symbol or process intended by an individual
4 signing this Amendment to represent their signature, including but not limited to (1) a
5 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
6 electronically scanned and transmitted (for example by PDF document) version of an
7 original handwritten signature.
8 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
9 equivalent to a valid original handwritten signature of the person signing this
10 Amendment for all purposes, including but not limited to evidentiary proof in any
11 administrative or judicial proceeding, and (2) has the same force and effect as the
12 valid original handwritten signature of that person.
13 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
14 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
15 2, Title 2.5, beginning with section 1633.1).
16 d. Each party using a digital signature represents that it has undertaken and satisfied
17 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
18 through (5), and agrees that each other party may rely upon that representation.
19 e. This Amendment is not conditioned upon the parties conducting the transactions
20 under it by electronic means and either party may sign this Amendment with an
21 original handwritten signature.
22 5. This Amendment may be signed in counterparts, each of which is an original, and all of
23 which together constitute this Amendment.
24 6. The Agreement as previously amended and as amended by this Amendment No. 2 is
25 ratified and continued. All provisions of the Agreement as previously amended and not
26 amended by this Amendment No. 2 remain in full force and effect.
27 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No. 2 on the date stated in the introductory
2 clause.
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C(6N4Y OF TULARE COUNTY OF FRESNO
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6 Pete Vander Poel, Chair, Board of Ernest Buddy Mendes, hairman of the
Supervisors of the County of Tulare Board of Supervisors of County of Fresno
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Attest: Attest:
8 Jason T. Britt Bernice E. Seidel
County Administrative Officer/Clerk of the Clerk of the Board of Supervisors
9 Board of the Supervisors of the County of County of Fresno, State of California
Tulare
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r By:
11 Deputy
12 Deputy Clerk
13 =j
For accounting use only:
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Org No.: 56201692
15 Account No.: 4895
Fund No.: 0001
16 Subclass No.: 10000
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19 Approve As To Form:
County Counsel
20 By: ucN. aott
21 Deputy
22 Date: 6/13/2025
23 Matter No: 2025711
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