DEPARTMENT: SAFD
DEPARTMENT HEAD: Charles N. Hood
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Extending Interlocal Agreements with UTHSCSA relating to EMS Medical Director, Medical Control and Training
SUMMARY:
The University of Texas Health Science Center at San Antonio (UTHSCSA) has provided the San Antonio Fire Department (SAFD) with EMT Basic and Paramedic training, EMS Medical Director services and EMS system oversight for the past 38 years and is the current service provider. The two current EMS Medical Control and Training Agreements with UTHSCSA were approved by City Council on August 18, 2011, by Ordinance #2011-08-18-0677. The agreements were for a two year period, which will terminate on September 30, 2015. The parties agreed to extend the current agreement under the same terms and conditions to December 31, 2015 and will return to council for consideration of a two year extension before December 31, 2015.
BACKGROUND INFORMATION:
UTHSCSA has provided the Fire Department with EMT Basic and Paramedic training, EMS Medical Director services and EMS system oversight for the past 38 years and is the current service provider. The current EMS Medical Control and Training Agreement with UTHSCSA was approved by City Council on August 18, 2011, by Ordinance #2011-08-18-0677. This contract was for a two year period, which will terminate on September 30, 2015.
A consultant was hired in February 2011 to evaluate the current provision of both medical training and medical direction as compared to best practices throughout the country. The consultant’s findings were presented to the Public Safety Committee in May 2011 and a recommendation was made by staff to continue the agreements with UTHSCSA. Several key issues were identified and acted upon, such as:
• Separate the Medical Direction from the existing contract so as to provide a more direct link to the Fire Chief,
• Provide the flexibility that would allow the SAFD to take over the basic EMT training and continuing education at any time during the term of the agreements given proper advance notification, and
• Provide for the waiver of all tuition for EMT Basic and EMT Paramedic initial education as required by the Texas Education Code.
As a result of the study, the SAFD and the UTHSCSA are able to continue to improve how services are to be delivered and communication was enhanced between the parties. The consultant recommended that the SAFD continue to contract out these services with UTHSCSA. Another recommendation was for the SAFD to assume the functions of Infection Control services. This was implemented in FY 2013 and the current contract reflects the reduction of these services.
ISSUE:
In order for the SAFD to provide emergency medical services, the State requires the City to have Medical Director Services, Emergency Medical Technician and Paramedic professional training that has been approved by the Texas Department of State Health Services in accordance with the Texas Administrative Code, and mandated continuing education for all levels of Emergency Medical Technicians (EMT) and Paramedics. The State requires the city to operate its EMS system under a State of Texas licensed physician. In addition, the City is required to have treatment and transport protocols approved and signed by the Medical Director.
The medical training and continuing education is provided to all members of the SAFD. The training and provision of emergency medical services is essential to the mission of the Fire Department. This year to date, 81% of all calls responded to were medical in nature.
The City operates the Emergency Medical Services throughout the City of San Antonio and other municipalities. These two contract extensions and amendments for Medical Control and Training, as well as Medical Direction, with the UTHSCSA will meet the State mandated requirements to train emergency medical personnel and oversee the City’s Emergency Medical System.
ALTERNATIVES:
City Council could opt to extend the current contract for less than 90 days or not extend the contract at all. Without this contract, SAFD would not be in compliance with state regulations and would need to find a different provider of these mandated services
FISCAL IMPACT:
In FY 2013, the cost of the EMT training and EMS system oversight contract was $1,257,291.22. The extension and amendment to the agreement was not to exceed $1,405,817.62 in FY 2014 and $1,431,763.21 in FY 2015. The second extension is an amount not to exceed $332,318.51 in 90 days.
In FY 2013, the cost of the EMS Medical Director services contract was $634,824.30. The extension and amendment to the agreement was not to exceed $665,003.96 in FY 2014 and $683,973.15 in FY2015. The second extension is an amount not to exceed $170,993.28 in 90 days.
There is sufficient funding in Fire’s FY 2016 adopted operating budget for this extension.
RECOMMENDATION:
The staff recommends the approval of the 90 day extension and amendment to both Interlocal Agreements with the University of Texas Health Science Center to provide the City with State-mandated EMS oversight and training and EMS Medical Director services.