CITY COUNCIL: Resolution Authorizing City to Enter into a Memorandum of Understanding with Monterey County Emergency Medical Services AGency & Local Provider Agencies to Support Monterey County EMS Training & Equipment Expenditures for Emergency First Responders

City Council
Agenda Item Summary

Name: Consideration of a Resolution authorizing the City to enter into a Memorandum of Understanding with Monterey County Emergency Medical Services Agency (MCEMS Agency) and local provider agencies to support Monterey County EMS training and equipment expenditures for emergency first responders.

Description: On July 20, 2010, the Emergency Medical Care Committee (EMCC) approved the establishment of a $1.5 million reserve and the disbursement of available CSA 74 funds to approved jurisdictions within Monterey County identified as participating provider agencies. CSA 74 funds are based on a $12.00-per-unit parcel tax assessment levied annually for EMS care and training. These emergency first responders include public safety, paramedic, EMT and ambulance services authorized to respond to medical
emergencies within their jurisdiction. The purpose of these funds is to provide continual funding for emergency medical care services, equipment, and training. (See Attachment A – Recommended EMS equipment and training approval worksheet).
The City of Carmel by-the-Sea will receive a one-time allocation of $55,404 this year and an annual distribution for FY 2009/10 of $10,355 for a total of $65,759. Future distributions will be contingent upon availability and at the discretion of the EMS Agency.
The City Attorney has reviewed the Memorandum of Agreement.

Overall Cost: None.

Staff Recommendation: Adopt the Resolution authorizing the City to enter into a Memorandum of Understanding with Monterey County Emergency Medical Services Agency and local provider agencies to support emergency medical services.

Important Considerations: The term of the agreement shall be for a period of one year commencing on the date the agreement is fully executed.
Decision Record: None

Reviewed by:

______________________________ _________________
John Goss, Interim City Administrator Date
CITY OF CARMEL-BY-THE-SEA
CITY COUNCIL
RESOLUTION 2011-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA AUTHORIZING THE CITY TO ENTER INTO A MEMORANDUM OF UNDERSTANDING WITH MONTEREY COUNTY EMERGENCY SERVICES AND LOCAL PROVIDER AGENCIES TO SUPPORT MONTEREY COUNTY EMS TRAINING AND EQUIPMENT EXPENDITURES FOR EMERGENCY FIRST RESPONDERS
__________________________________________________________________
WHEREAS, the City of Carmel-by-the-Sea Police Department desires to contract with Monterey County Emergency Services and local providers to support Monterey County Emergency Medical Services; and

WHEREAS, the Monterey County Emergency Services desires to contract with the City of Carmel-by-the-Sea to support Monterey County EMS training and equipment expenditures for emergency first responders; and

WHEREAS, the City of Carmel-by-the-Sea will receive a one-time allocation in the amount of $55,404 and an annual distribution of $10,355 for FY 2009/10 for the purchase of medical care training and equipment.

NOW, THEREFORE, BE IT RESOLVED THAT THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA DOES:

1. Authorize entering into a contract with Monterey County Emergency Services to support Monterey County Emergency Medical Services.

PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA
this 7th day of June, 2011 by the following roll call vote:
AYES: COUNCIL MEMBERS:
NOES: COUNCIL MEMBERS:
ABSENT: COUNCIL MEMBERS:

SIGNED:

______________________
SUE McCLOUD, MAYOR

ATTEST:
_____________________
Heidi Burch, City Clerk

MEMORANDUM OF UNDERSTANDING
I. DECLARATION
This MEMORANDUM OF UNDERSTANDING, hereinafter called the AGREEMENT, is entered into as of this 8th day of June, 2011, by and between the
Monterey County Emergency Medical Services Agency, hereinafter called EMS
AGENCY, and the City of Carmel by-the-Sea; City of Del Rey Oaks; City of Gonzales; Greenfield FPD; City of King; City of Marina; City of Monterey; City of Pacific Grove; City of Salinas; City of Sand; City of Seaside; City Soledad; Aromas Tri-County FPD (CALFIRE); Cypress FPD (CALFIRE); Pebble Beach CSD (CALFIRE); Carmel Highlands FPD (CALFIRE); South Monterey County FPD (CALFIRE); Cachagua Fire Protection District; North County Fire Protection District; Mid-Coast Fire Brigade; Carmel Valley Fire Protection District; Monterey County Regional Fire Dirstrict; Big Sur Volunteer Fire Brigade; San Ardo Volunteer Fire Department; Spreckels Volunteer Fire Department; Monterey Peninsula Airport District; and Monterey County Parks
Department, hereinafter called the PROVIDERS for the purpose of receiving,
administering, and accounting available County Service Agreement (CSA) 74 funds to
support Monterey County emergency medical services training and equipment
expenditures. Distributed CSA74 funds can only be used for direct EMS training and
equipment expenses.
II. BACKGROUND
A. This AGREEMENT is intended to support the countywide EMS training and
equipment activities of emergency first responders and is funded with available
CSA74 funds.
B. County Service Area (CSA) 74 Fund – General RequirementsProvide for
paramedic ambulances staffed with at least one paramedic and one emergency
technician;Make available EMS training programs for pre-hospital care personnel;
1. Provide funding to train, certify, and recertify emergency medical 9-1-1
dispatchers, first responders, and mobile intensive care nurses, and to equip first
responding vehicles with appropriate medical equipment;
2. Expand and upgrade the specialized medical radio communications system
equipment and operators;
3. Provide financial assistance to designate ALS base hospitals; and
4. Provide necessary staffing and support to the EMS Agency.
III. DEFINTIONS
A. EMS AGENCY is designated under California law as the local Emergency
Medical Services (EMS) responsible for planning, implementing, and evaluating the
local EMS system throughout Monterey County.

B. PROVIDERS are public agencies that are legally authorized to respond to medical emergencies within their jurisdiction and routinely respond to medical emergencies.

IV. DUTIES AND RESPONSIBILITIES
A. General: All services provided pursuant to this AGREEMENT shall be in strict compliance with existing federal, state, and local laws, ordinances, and regulations and with all resolutions, practices, and procedures now in effect or which may be promulgated in the future by the Monterey County EMS Agency Director,
Monterey County EMS Medical Director, and/or Monterey County Board of
Supervisors applicable to emergency medical services and fiscal management.
B. Distribution Formula: The formula for the distribution of available CSA74 funds
was developed in concert with Monterey County’s Chief Administrative Officer,
County Counsel, Director of Health, Interim Emergency Medical Services Director,
Monterey County Fire Chiefs’ Association, Monterey County Law Enforcement
Chief Officers’ Association, and the Emergency Medical Care Committee (EMCC).
The formula represents twenty-seven (27) independent jurisdictions; only approved
jurisdictions (per Attachment A) are entitled to receive available CSA74 funds.
Review of the approved CSA74 fund distribution formula (Attachment A) will be
conducted every five (5) years by the EMS AGENCY in concert with the EMCC
or if two (2) or more participating entities request the EMS AGENCY initiate a
formal review of the distribution formula.
C. This AGREEMENT is contingent upon the availability of funds collected through
CSA74 and does not obligate the EMS AGENCY to distribute funds to support the
PROVIDERS’ EMS training and equipment activities. CSA74 monies will be
available for distribution after the EMS Budget has been approved.
D. PROVIDERS:

1. The PROVIDERS will ensure that all EMS personnel (employees) within
their organization be at least certified as a Public Safety Responder in accordance with the Department of Transportation national standard first responder curriculum and California Code of Regulations Division 9 directives (Chapters 1.5, 2, and 4) and in concert with the standards (list) endorsed by the EMCC.

2. The PROVIDERS will use CSA74 funds only for EMS training and
equipment needs. The recommended list of EMS equipment endorsed by the EMCC is
encouraged. The recommended EMS equipment list is annually reviewed by the EMS
Operations Committee and submitted to the EMCC for consideration.
3. The PROVIDER will participate in the Monterey County EMS systemequipment
exchange program.
4. The PROVIDERS will provide the EMS AGENCY with quarterly
training schedules that will be consolidated and posted to the EMS web site.
PROVIDERS’ EMS training opportunities shall be open, and made available to all
county responder agency personnel regardless of affiliation status or parent agency.
5. The PROVIDERS recognize the need for quality EMS training to small,
remote, and volunteer first responding agencies that might not have their own training
resources, and agree to provide and/or assist with all necessary training to satisfy the
minimum training requirements.
6. PROVIDERS that are approved Continuing Education (CE) Providers
shall grant course completion documentation and continuing education credit/certificates
to local first responder personnel. In addition, approved CE Providers that are
PROVIDERS shall provide Emergency Medical Technician skills verification for recertification
at no charge to non-affiliated personnel through their respective training
programs and instructors.
7. PROVIDERS will submit an annual funding request and prior-year
expenditure and training summary report to the EMS AGENCY by the last business day
of June which summarizes all EMS training provided/supported; EMS equipment
expenditures; and the number of medical responses.) Failure to submit this report before
the EMS AGENCY’s announced deadline may jeopardize receipt of available CSA74
EMS training and equipment funds. The EMS AGENCY is responsible for maintaining
the report’s format and will provide to PROVIDERS as requested.
8. PROVIDERS will maintain training records to include the number of
students; subject/topic of training; length, date, and location of training; and agency and
primary instructor’s name.
9. PROVIDERS shall retain all training and equipment expenditure records
for at least four (4) years for possible audit and inspections.

10. PROVIDERS shall comply with all accepted financial management
requirements and procedures and be subject to periodic audits by the EMS AGENCY
and the PROVIDERS’ governing body.
11. Documentation shall be made available to the EMS AGENCY within
thirty (30) calendar days of presenting the audit request to the PROVIDERS. At least
twenty-five percent (25%) of the PROVIDERS will be annually audited by the EMS
AGENCY. Additional audits may be conducted if warranted.
12. PROVIDERS agree that failure to comply with the elements of this
AGREEMENT may result in PROVIDERS’ forfeiture of funds and/or PROVIDERS’
reimbursement of distributed funds. PROVIDERS may make a written appeal of any
decision concerning distribution, forfeiture and reimbursement of CSA 74 funds, in
writing, to the Monterey County Director of Health within thirty (30) calendar days of
any notice of decision. The Director of Health will review the decisions and a definitive
ruling by the Director of Health will be made within fifteen (15) calendar days of the
receipt of written appeal. The ruling of the Director of Health will be final and binding.
Significant fiscal discrepancies and non compliance of subject AGREEMENT may
require cancelling this AGREEMENT and suspending receipt of available CSA74 EMS
training and equipment funds.
E. EMS AGENCY:
1. EMS AGENCY has overall responsibility for monitoring the
PROVIDERS’ EMS training programs to ensure compliance with the AGREEMENT.
The EMS AGENCY will no longer provide direct or indirect EMS training to first
responders or the public; this includes American Heart Association (AHA) CPR training
and certification. The Monterey County EMS AHA Training Center will be closed thirty
(30) days following the execution of this AGREEMENT.
2. Contingent on availability and at the discretion of the EMS AGENCY,
annual distribution of available and designated CSA74 funds will be made to the
PROVIDERS by December of each calendar year if all financial and inventory
documentation requirements have been satisfied.
V. GENERAL PROVISIONS
A. Terms:
1. This term of this AGREEMENT shall be for a period of one (1) year,
commencing on the date the Agreement is fully executed. Thereafter the
AGREEMENT shall renew on a one year basis unless either party notifies the other it
wishes to terminate by giving thirty (30) days advance written notice to the other of its
intention to terminate.
2. PROVIDERS shall return any unused funds to the EMS AGENCY
within ten (10) business days following termination of this AGREEMENT. Unused
funds from the PROVIDERS will be re-allocated by the EMS Director in accordance

with the guidance of the EMCC and in compliance with proposals and goals of the CSA74 Fund.
B. Costs: EMS AGENCY shall not be liable for any costs or expenses incurred by the PROVIDERS as a result of this AGREEMENT, including but not limited to, the cost of training and equipment.
C. Mutual Indemnification:
1. PROVIDERS hereby agrees to indemnify, defend, and hold harmless the
EMS AGENCY, the County of Monterey and their officers, agents, employees, and
employers, to the extent permitted by applicable law, from and against all claims and/or
losses whatsoever accruing or resulting to any person, firm or corporation for damages,
injuries or death incurred by reasons of any act or failure to act by the PROVIDERS or
PROVIDERS’ officers, agents, and employees in connection with the performance of
this AGREEMENT.
2. The EMS AGENCY hereby agrees to indemnify, defend, and hold
harmless the PROVIDERS and its officers, agents, employees, and employers, to the
extent permitted by applicable law, from and against all claims and/or losses whatsoever
accruing or resulting to any person, firm or corporation for damages, injuries or death
incurred by reasons of any act or failure to act by the EMS AGENCY or EMS
AGENCY’s officers, agents, and employees in connection with the performance of this
AGREEMENT.
VI. NOTICE
Notice to any party in connection with this AGREEMENT shall be given either
personally or by U.S. Mail, certified return receipt requested to the EMS AGENCY and
all PROVIDERS at their normal place of business.
VII. COUNTERPARTS
The parties agree that this AGREEMENT may be executed in counterparts. Each of the
undersigned, whether signing separately or on the same document with other parties,
agrees to each and every part of the above AGREEMENT.

In WITNESS WHEREOF the parties heretofore, first being duly authorized, have executed this AGREEMENT as of the date and year first above written.
Emergency Medical Services Agency APPROVED AS TO LEGAL FORM
Charles J. McKee, Monterey County Counsel
By _________________________ By _______________________________
Director of Health Susan Blitch, Deputy County Counsel

City of Carmel-by-the-Sea City of Del Rey Oaks
By _________________________ By __________________________
Signature & Title Signature & Title
City of Gonzales Greenfield FPD
By _________________________ By __________________________
Signature & Title Signature & Title
City of King City of Marina
By _________________________ By __________________________
Signature & Title Signature & Title
City of Monterey City of Pacific Grove
By _________________________ By __________________________
Signature & Title Signature & Title
City of Salinas City of Sand
By _________________________ By __________________________
Signature & Title Signature & Title

City of Seaside City of Soledad
By _________________________ By __________________________
Signature & Title Signature & Title

Aromas Tri-County FPD (CALFIRE) Cypress FPD (CALFIRE)
By _________________________ By __________________________
Signature & Title Signature & Title
Pebble Beach CSD (CALFIRE) Carmel Highlands FPD (CALFIRE)
By _________________________ By __________________________
Signature & Title Signature & Title
Cachagua FPD South Monterey County FPD (CALFIRE)
By _________________________ By __________________________
Signature & Title Signature & Title
North County FPD Mid-Coast Fire Brigade
By _________________________ By __________________________
Signature & Title Signature & Title
Carmel Valley FPD Monterey County Regional Fire District
By _________________________ By __________________________
Signature & Title Signature & Title

Big Sur Volunteer Fire Brigade San Ardo Volunteer Fire Department
By _________________________ By __________________________
Signature & Title Signature & Title

Spreckels Volunteer Fire Department Monterey Peninsula Airport
By _________________________ By __________________________
Signature & Title Signature & Title

Monterey County Parks Department
By _________________________
Signature & Title

Procedure: Yearly disbursement of CSA 74 funds to participating jurisdictions.

Back ground: There is a $12.00 per unit parcel tax assessment levied each year through the tax rolls. This assessment provides funding for the following:
1. Provide for paramedic ambulances staffed with at least one paramedic and one
emergency medical technician.
2. Make available EMS training programs for pre-hospital care personnel.
3. Provide funding to train, certify, and recertify emergency medical 9-1-1 dispatchers,
first-responders and mobile intensive care nurses, and to equip first responder
vehicles with appropriate medical equipment.
4. Expand and upgrade the specialized medical radio communications system equipment
and operators.
5. Provide financial assistance to designated ALS base hospitals.
6. Provide necessary staffing and support to the EMS Agency.
On July 20, 2010, the Emergency Medical Care Committee (EMCC) approved the establishment
of a $1.5 million dollar reserve and the disbursement of available CSA 74 funds (after funding
the EMS Agency’s budget) to approved jurisdictions using the same formula as the annual 9-1-
1 dispatch billing. This formula uses Assessed Values, Population counts and workload numbers
to compute a weighted average percentage. This percentage is then used to distribute the
available fund balance after the fiscal year has closed. The jurisdictions included within the
“COUNTY” - San Ardo, MidCoast, Big Sur, Spreckels, and Monterey County Parks, shall have
those funds distributed via a separate mechanism.
Purpose: CSA 74 assessments shall be distributed to participating agencies after all
funding needs of the EMS Agency have been met. The distribution formula approved by the
EMCC is based on the 9-1-1 dispatch billing formula.
Time Frame: After close of the final period for the fiscal year as scheduled by the Auditor
Controller’s Office.
Required Source Documents: (examples of all information are attached to this packet)
1. Assessed Values – Values by Taxing Agency – found in the yearly Monterey County
Tax Rates publication posted on line at the Auditor Controller’s Website,
.co.monterey.ca.us/auditor/pdfs/2009TaxRateBook.
The “Total” amount is the figure used for the calculations. This includes both the
secured and unsecured values. The assessed values used in this formula should be
cross checked against the values used on the yearly dispatch billing.
2. Population counts - the majority of the population estimates are found on Schedule
E-4 on the California Department of Finance Website,
.dof.ca.gov/research/demographic/reports/estimates/e-.
Cachagua Fire Protection District, Cypress Fire, Carmel Highlands, and South
Monterey County Fire population counts can be found in the most recent

LAFCO Muncipal Service Review reports for Greater Carmel Valley Area,
Monterey Peninsula and Central and South Salinas Valley, respectively.
Unincorporated areas of the County can be calculated by using the California
Department of Finance growth factor which can be computed using Schedule E-
4.
The population figures used in this formula should be cross checked against the
population counts used on the yearly dispatch billing.
3. Workload Information: This distribution differs from the 9-1-1 annual distribution
as only Medical Calls for Law and Fire are used in the calculation. This information
will be extracted using the CARs reporting system. This reporting system extracts
data from the CAD 9-1-1 Dispatch system and can be accessed by the EMS Analyst
with licensing privileges and access to CARs. The dates of the report should be July
01, 20xx through June 30, 20xx and can be run anytime after mid July of the next
billing year. For example, the workload report for July 01, 2009 through June 30,
2010 can be run on July 01, 2010. This will allow the system time to capture the calls
from June 30, 2010. The parameters for both Law and Fire are:
Call Number
Dispatch First Date
Jurisdiction
Call Type Final – GSW (Gun Shot Wound – new in FY 2011), MEO (medical),
UIA (unknown injury accident), VIA (vehicle injury accident)
Location
Primary Unit (this will ensure that each call is counted only once).
Workload information for Aromas Fire Protection District, Cypress Fire,
Pebble Beach CSD, Carmel Highlands, So Monterey County Fire and Cachagua
Fire Protection District will be provided by CalFire. The President of the
Chief’s Association can provide contact information.
4. Cost sharing ratio worksheet for Law and Fire Medical Responses. This excel
spreadsheet is populated by information gathered from the documents above and used
to distribute the available revenue accordingly.
Procedural Steps:
1. Assessed Values
The Assessed Values can be obtained through the Auditor Controller’s Website (listed
above):
The recap of “Values by Taxing Agencies” – The first annual disbursement will use the
2009.10 Tax rate book.

The “Values by Taxing Agency” page shows the total secured and unsecured values for the entire county as $51,230,774,397. This figure is inserted in the “County wide” Assessed Value cell on the Cost Sharing Ratio worksheet (1). The City Agencies totals will be
inserted in the “Assessed Value” cell of each corresponding City Agency on the Cost Sharing
Ratio worksheet. (For Gonzales, Greenfield, and Soledad, Fire Protection Agency totals are
included in the City Agency totals and must be backed out if they are to be presented
separately.)
The Fire Agency Assessed Values are found on the “Other Special District pages.” . The
Total (secured plus unsecured) value will be inserted in the “Assessed Value” cell for each
Fire District with the exception of Gonzales Rural Fire Protection (added to Gonzales City),
Greenfield Fire Protection (See the attached exhibit A for Greenfield property and
assessed value calculation examples) and Mission-Soledad Rural Fire (added to Soledad
City).
The balance of the assessed values will calculate in the “County” assessed value cell. This
figure will be used in the separate mechanism for the agencies assigned under “County.”
2. Population
The Table 2: E-4 Population Estimates for Cities, Counties and State on the California
Department of Finance Website will provide population figures for the following:
Monterey County
Carmel by the Sea
Del Rey Oaks
Gonzales
Greenfield
King City
Marina
Monterey
Pacific Grove
Salinas
Sand City
Seaside
Soledad
The population counts for Carmel Valley, Carmel City, North County Fire and Monterey
County Regional Fire can be found on the 9-1-1 annual dispatch billing
Cachagua Fire Protection District, Cypress Fire, Carmel Highlands, and South Monterey
County Fire population counts can be found in the most recent LAFCO Muncipal Service
Review reports for Greater Carmel Valley Area. Monterey Peninsula and Central and South
Salinas Valley, respectively.
For the Cities that are not listed on the E-4 Schedule, or on the 911 annual dispatch
billing, a growth factor for the unincorporated areas will be applied. Using the E-4
Schedule, this factor is computed by subtracting the prior year’s population from

current year and then dividing that sum by the prior year’s population number. Using 2010’s numbers as an example:
2010 Total County population 435,878
2009 Total County population (431,041)
4,837
4,837/431,041 = 1.12% growth factor
The County wide total will be input into the County Wide cell for Population (2) on the Cost
Sharing Ratio Worksheet. (the 9-1-1 Administrative Manager can provide a copy of the sheet
once the billing has been completed).
The population counts for the remaining Fire Agencies were found on line through
Wikepedia, Census Track, or the annual LAFCO Municipal Service Review. Once a
reasonable base line number has been established, those population numbers can be
increased/decreased yearly by the growth factor computed on schedule E-4. While this is not
an exact number, it is within a reasonable parameter for our distribution purposes. The
formulas in the worksheet will allow for the unassigned population to be assigned to the
“County.” This figure will be used in the separate mechanism for the agencies assigned
under “County.”
A comparison to the prior year’s figures should be done and any anomalies found should be
researched and resolved. The 9-1-1 Administrative Manager can provide all source
documentation after the finalization of the yearly billing.
3. Workload
A Medical response workload report for (Final Call Types) GSW, MEO, UIA, and VIA
from the CAR’s reporting system from both Law and Fire will be run in mid July to capture
calls from the previous year (July 01, xx through June 30, xx). The CAR’s system extracts
data from the 9-1-1 CAD dispatch system and can be accessed through the EMS Analyst
with licensing/viewing permissions. The additional parameters for the report are listed
above. The raw data will be sent via email and will need to be reviewed, sorted, totaled by
jurisdiction and recapped for input into the Cost Sharing Ratio Worksheet. The total
Workload information will go in the County Wide cell for Medical Calls for Service (3) on
the Cost Sharing Ratio Worksheet. A comparison of the previous year’s numbers should be
done and any anomalies researched and noted.
Workload information for the Agencies that contract out with CalFire, Aromas Fire
Protection District, Cypress Fire, Pebble Beach CSD, Carmel Highlands, South Monterey
County Fire, and the Cachagua Fire Protection District, will be provided by CalFire. The
President of the Fire Chief’s Association may work as a liaison between the EMS Agency
and CalFire.

4. Cost Ratio Worksheet
Once all the source documents have been obtained and the workload reports are recapped,
the information can be input into the appropriate cells on the Cost Ratio Worksheet. The
total amount to be distributed is entered in the Billable Ratio cell (4). There has been a
minimum distribution amount of $2,500 established (note: for one - time $2,000,000
distribution, minimum amount will be $5,000). The spreadsheet will automatically
increase any Agency below that threshold and lower the other agencies accordingly. All
reasonable efforts should be made to obtain all information. If data cannot be found with
reasonable research, the EMS Director will be notified and his direction requested.
The Agencies determined to be contained within the “County” designation will have their
funds distributed as follows:
• For each participating Agency there has been a minimum distribution amount of
$2,500.00 established (note: for one - time $2,000,000 distribution, minimum
amount will be $5,000).
• Any amount left in the “County” distribution total shall be held in a reserve fund.
Agencies with a medical response component shall submit an application to the
EMCC for a portion of the reserved fund. The EMCC will develop an approval
process.
Any funds that have not been distributed by the close of the County’s fiscal year will be
carried over to the following year and distributed out to all participating agencies via the
established and agreed upon formulas.