CITY COUNCIL: Three Resolutions Integrating Carmel Regional Fire Ambulance Authority into City of Carmel-by-the-Sea

Meeting Date: October 4, 2011
Prepared by: John Goss

City Council
Agenda Item Summary

Name: Consideration of three Resolutions integrating the Carmel Regional Fire Ambulance Authority into the City of Carmel-by-the-Sea.

Description: The Carmel Regional Fire Ambulance Authority (CRFA) is a joint powers authority (JPA) initially consisting of the City of Carmel-by-the-Sea and the Carmel Valley Fire District. The District was absorbed by the Monterey County Regional Fire District and the JPA is scheduled to dissolve in December.

In anticipation of the JPA’s dissolution, the City has taken preliminary action to move the CRFA ambulance operation under the jurisdiction of the City, with the six CRFA’s paramedics/firefighters becoming City employees. In May 2011, Council directed the City to gather information and policy options from CRFA addressing the Health and Safety Code Section 1797.201 (201 rights), and ALS staffing. In June 2011, Council, in reviewing a proposal for CRFA employees becoming City employees, took action to “approve the plan – in concept – and to have John Goss, Gerard Rose and Dave Jedinak work together to develop an action plan addressing the specific issues involved in having CRFA employees become City employees.”

At the September 13 Council meeting the City Council took action to have staff develop a draft contract with the City of Monterey to merge Carmel’s Fire Department with the Monterey Fire Department. As part of that discussion it was represented that, if the City took over the ambulance service as a direct provider, then the ambulance service would not merge with Monterey Fire, but become a separate division of the integrated Fire
Department.

Overall Cost: There will be savings by bringing the ambulance operation into the City’s organization. First, CRFA contributes to the employees’ Social Security, and the City does not. This will result in an annual savings of $35,000. Second, there will be savings related to worker’s compensation (estimate $18,000 savings) and liability insurance (estimated $10,000 savings). The City already coordinated this fiscal year with CRFA
for the conduct of their audit, saving CRFA $6,000.

Staff Recommendation: Approve the three Resolutions.

Important Considerations: There are advantages to the City assuming the ambulance service from the JPA. The City will retain its excellent ambulance service and preserve its “201” rights. By bringing the CRFA employees into the City and making the ambulance operation a separate division in the Fire Department, the ambulance service can be provided without direct merger with Monterey Fire while till having the day-to-day operational oversight by Monterey Fire as there is now and ambulance service will be provided by City of Carmel-by-the-Sea employees. Also, the fiscal support person for CRFA is already an employee of the City, and the duties of this position will not change.

Finally, the unique position classifications now in CRFA need to maintained, both for maintaining qualifications as paramedic fire fighters, but also to provide medical oversight to the ambulance service consistent with County EMS requirements. The goal is to accomplish bringing the ambulance service and its employees into the City organization by January 1, 2012.

Decision Record: N/A

Reviewed by:

______________________________ _____________________
John Goss, Interim City Administrator Date

TO: MAYOR McCLOUD AND MEMBERS OF THE CITY COUNCIL
FROM: INTERIM CITY MANAGER JOHN GOSS
DATE: OCTOBER 4, 2011
SUBJECT: INTEGRATION OF THE CARMEL REGIONAL FIRE AMBULANCE AUTHORITY INTO THE CITY OF CARMEL-BY-THE-SEA

Background
As the City Council is aware, the Carmel Regional Fire Ambulance Authority (CRFA) is a joint powers authority (JPA) initially consisting of the City of Carmel-by-the-Sea and the Carmel Valley Fire District. The District has been absorbed by the Monterey County Regional Fire District. The JPA is scheduled to dissolve in December.

In anticipation of the JPA’s dissolution, the City has taken preliminary action which would move the CRFA ambulance operation under the jurisdiction of the City, with the six CRFA’s paramedics/firefighters becoming City employees. First, among the City Council’s more recent actions, direction was given at its May meeting that the City gather
information and policy options from CRFA addressing the Health and Safety Code Section 1797.201 (201 rights), and ALS staffing. More specifically, at the June 7 Council meeting, in reviewing a proposal for CRFA employees becoming City employees, action was taken to: “approve the plan – in concept – and to have John Goss, Gerard Rose and Dave Jedinak work together to develop an action plan addressing the specific issues involved in having CRFA employees become City employees.”

At the September 13 Council meeting the City Council took action to have staff develop a draft contract with the City of Monterey to merge Carmel’s Fire Department with the Monterey Fire Department. As part of that discussion it was represented that, if the City took over the ambulance service as a direct provider, then the ambulance service would not merge with Monterey Fire, but become a separate division of the integrated Fire
Department.

Analysis
Fiscal Concerns. One of the reasons the plan to fold the ambulance service into City operations was approved only “in concept” at the June meeting was a question related to financing the ambulance service. The concern was that out of CRFA’s $1,795,854 projected Gross Revenue for 2011-12, a substantial portion of this revenue came from the unincorporated service area in which the County’s ambulance (AMR) can respond. In fact, according to CRFA’s Profit and Loss Budget for 2011-12 (see attached) presented at
the June Council meeting, only $560,417 comes from calls in Carmel-by-the-Sea.

A question was raised whether or not there might be a way to guarantee CRFA revenue especially for calls from the “Mouth of the Valley.” One thought was that if the County were reissuing an RFP to extend its ambulance contract in the near future, the City could be incorporated into this RFP to cover this nearby area.

In discussing this issue with Monterey County’s EMS Director it was first pointed out that a new RFP will not be issued in the near future. The current contract for ambulance service with AMR is valid through 2016. If AMR meets its performance standards and financial commitments, the contract could be extended through 2019.

Regarding unincorporated Pebble Beach and Carmel Valley, CRFA is considered a peripheral provider by County EMS. CRFA is, in effect, considered part of the County ambulance system by this designation. In practice, CRFA responds to these unincorporated areas and handles a good number of the AMR calls through an informal understanding with this firm. This is advantageous to AMR if one of its ambulances is not in the Cypress District or is otherwise engaged. Further, AMR has a performance standard in its County contract that requires an eight-minute response 90% of the time.

As is often the case, when AMR cannot meet this standard for a call in this area, it will ask CRFA to respond. So, in effect, CRFA benefits AMR in the unincorporated area surrounding Carmel-by-the-Sea by meeting the response time standard for AMR.

In terms of the current balance of operations between CRFA and AMR, it does not appear that there should be any major difference in the area served by CRFA and the number of calls received from these areas, both inside and outside of the City. It is not expected that this balancing of calls will change drastically in the near or intermediate future.

It should be noted that if demand for ambulance transport should change in the unincorporated area now primarily served by CFRA, or if there would be change in how AMR responds to this area in the future, the financial impact would be felt by the City whether the ambulance function was performed by CRFA or directly by the City. In either case, the City would need to determine what options it has in addressing a changed revenue base. Therefore, the potential future uncertainty of the current CRFA revenue base should not deter the City from taking on the provision of the ambulance service. Currently, this revenue base seems stable. In fact, as was pointed out in the June CRFA report, there will be savings by bringing the ambulance operation into the City’s organization. First, CRFA contributes to the employees’ Social Security, and the City does not. This will result in an annual savings of $35,000. Second, there will be savings related to worker’s compensation (estimate $18,000 savings) and liability insurance (estimated $10,000 savings). The City already coordinated this fiscal year with CRFA for the conduct of their audit, saving CRFA $6,000.

“201” Rights. Past discussion has focused on the City maintaining its “201” rights in order to provide ambulance service directly rather than through the County contract.

There appears to be uniform consensus that the City taking over the ambulance service will preserve its “201” rights. As the attorney, William Ross, pointed out in a letter to the City on November 9, 2009, “…the City retains the right to provide ambulance service without obtaining the County’s consent. This is regardless of whether the City is involved in a JPA, because the City itself is grandfathered under section 201.” So even if not part of the JPA the City will have direct control over ambulance service and therefore will maintain its “201” rights.

Next Steps. As indicated in previous reports and Council discussions, there are advantages to the City assuming the ambulance service from the JPA. The City will retain its excellent ambulance service and preserve its “201” rights. By bringing the CRFA employees into the City and making the ambulance operation a separate division in the Fire Department, the ambulance service can be provided without direct merger with Monterey Fire. There will still be day-to-day operational oversight by Monterey Fire as there is now. But ambulance service will be provided by City of Carmel-by-the-Sea employees. Also, the fiscal support person for CRFA is already an employee of the City, and the duties of this position will not change. Finally, the unique position classifications now in CRFA need to maintained, both for maintaining qualifications as paramedic fire fighters, but also to provide medical oversight to the ambulance service
consistent with County EMS requirements.

The goal is to accomplish bringing the ambulance service and its employees into the City organization by January 1, 2012. Steps to begin the process and recommended to be adopted at this time include:

• Adopt a resolution modifying the City’s 2011-12 budget to include the CRFA expenditures and revenues. The staff position table in the budget will need to be revised to reflect six new employees and their unique classification titles.
• Adopt a resolution adopting the Job Classification statements for the CRFA employees.
• Adopt a resolution adopting the current CRFA MOU.

In connection with modification of the City’s 2011-12 budget, several actions by the City Council are required. The first is to establish a City Ambulance Fund as shown on Exhibit “A” of this budget modification resolution. This reflects expected revenues and expenditures, which offset one another, for the last six months of the fiscal year.

In addition to creating this fund, adjustments are made to several General Fund departments resulting in total decreases in the General Fund of $10,172. This is presented in Exhibit “B”.

The Position Listing in the 2011-12 budget also is amended to reflect the addition of an Operations Manager/Paramedic Firefighter (1), Paramedic Firefighter (4) and EMT Firefighter (1). This is presented in Exhibit “C”. A revised City organization chart reflecting these changes is presented in Exhibit “D” to this Resolution.

In connection with the MOU, there are differences between the economic provisions for the paramedic/fire fighters of CRFA and the Carmel fire fighters. Instead of attempting to resolve these issues at this point, which could delay the transition date for the City assuming this ambulance service, it is recommended that these issues be resolved during a transition period beginning January 1, 2012. Both the Fire Chief and the CRFA union representatives are in agreement with this approach. Parenthetically, the CRFA union supports the 2%@50, highest three consecutive year average for all new hires.

While beginning the process for bringing the CRFA ambulance function into the City organization by adopting the three resolutions recommended in this report, there will be additional steps which will need to be taken.
These include:
• Resolving insurance issues with the current JPA. This involves the resolution of the split between the City and its JPA partner regarding their respective worker’s compensation claims.
• Resolution of Intent that the City will follow EMS policies and procedures in providing ambulance service.
• Provide notice to the CRFA Insurance Company requesting a waiver of the
timeline for cancellation.
• Employee physicals.
• Laying off and hiring the CRFA employees.

Recommendation
It is recommended that the City Council:
• Adopt a Resolution modifying the City’s 2011-12 operating budget, effective January 1, 2012, to include CRFA expenditures and revenues, and to revise the staff position table.
• Adopt a Resolution adopting the Job Classification statements for the CRFA employees, effective January 1, 2012.
• Adopt a Resolution adopting the CRFA MOU with its Association, effective
January 1, 2012.

CITY OF CARMEL-BY-THE-SEA
CITY COUNCIL
RESOLUTION 2011-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CARMEL-BY-THE-SEA MODIFYING THE CITY’S 2011-12 OPERATING BUDGET, EFFECTIVE JANUARY 1, 2012, TO INCLUDE CRFA EXPENDITURES AND REVENUES, AND REVISING THE STAFF POSITION TABLE_____________________________________________________________

WHEREAS, the City Council approved the Budget for Fiscal Years 2011/12 of the Triennial Budget 2011/12 through 2013/14 by Resolution 2011-32 dated June 21, 2011; and

WHEREAS, the Carmel Regional Fire and Ambulance Joint Powers Authority
consisting of the City of Carmel-by-the Sea and the Carmel Valley Fire District which was later absorbed by the Monterey County Regional Fire District is dissolving effective December 31, 2011; and

WHEREAS, City staff has taken preliminary action to move the ambulance service now operating under the Joint Powers Authority under the jurisdiction of the City upon dissolution of the Authority, and

WHEREAS, a City Ambulance Fund is to be established for fiscal accounting of the City Ambulance Department to be operational as a division of the City Fire Department beginning January 1, 2012 as per the attached schedule, Exhibit “A”; and

WHEREAS, expenditure adjustments are needed for the Fiscal Year 2011/12 General Fund budget as of January 1, 2012 to accommodate establishment of a City Ambulance Department as a division of the City Fire Department; and

WHEREAS, the 2011/12 General Fund budget adjustments include decreases totaling $10,172 per the attached schedule, Exhibit “B” and

WHEREAS, amendments are needed as of January 1, 2012 to the City’s Position Listing provided in the adopted 2011/12 Budget as per the attached schedule, Exhibit “C”; and

WHEREAS, adjustments are needed as of January 1, 2012 to the City’s
Organizational Chart provided in the adopted 2011/12 Budget as per the attached schedule, Exhibit “D”.

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

1. Approve establishment of an Ambulance Fund containing an Ambulance
Department budget at mid-year, as per the attached schedule, Exhibit “A”.

2. Approve mid-year budget adjustments to the Fiscal Year 2011/12 General Fund budgeted expenditures for a total decrease of $10,172, per the attached schedule, Exhibit “B”.
3. Approve mid-year amendments to the Position Listing provided in the 2011/12 adopted budget, as per the attached schedule, Exhibit “C”.
4. Approve mid-year amendments to the annual Organizational Chart provided in the adopted 2011/12 budget, as per the attached schedule, Exhibit “D”.

PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-
SEA, this 4th day of October 2011 by the following roll call vote:

AYES: COUNCIL MEMBERS:
NOES: COUNCIL MEMBERS:
ABSENT: COUNCIL MEMBERS:

SIGNED:

_________________________________
MAYOR SUE McCLOUD

ATTEST:

______________________________
Heidi Burch, City Clerk

Exhibit "A"
Exhibit "B"

CITY OF CARMEL-BY-THE-SEA
CITY COUNCIL
RESOLUTION 2011-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA
ESTABLISHING THE JOB DESCRIPTIONS FOR THE POSITIONS OF PARAMEDIC FIRE FIGHTER, EMT FIRE FIGHTER, PER DIEM EMT PARAMEDIC FIRE FIGHTER, AND OPERATIONS OFFICER

WHEREAS, the City Administrator has the responsibility for the administration of the Position Classification Plan, in accordance with Carmel Municipal Code (CMC), Article II, Section 2.52.040 (A); and,

WHEREAS, the City Administrator may determine the need for new classifications or the revision of existing classifications in accordance with CMC, Article II, Section 2.52.040 (C); and,

WHEREAS, the City Administrator may propose revised class specifications to the City Council in accordance with CMC, Article II Section 2.52.040 (D),

NOW THEREFORE BE IT RESOLVED that the City Council of the City of Carmel-by-the-Sea does:

1. Establish the following job classifications (job descriptions attached hereto as Exhibit A, B, and C) as follows:
a. Paramedic Fire Fighter & EMT Fire Fighter
b. Per Diem On-Call EMT Paramedic/FF
c. Operations Officer

PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA, this 4th day of October 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

CITY OF CARMEL-BY-THE-SEA
CITY COUNCIL
RESOLUTION 2011-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CARMEL-BY-THE-SEA ADOPTING THE CARMEL REGIONAL AMBULANCE AUTHORITY (CRFA) FIREFIGHTERS MEMORANDUM OF UNDERSTANDING
WHEREAS, the CRFA employees are represented by the Carmel Regional Ambulance Employees Association (Association); and

WHEREAS, the Association negotiated a Memorandum of Understanding with CRFA; and

WHEREAS, the employees of the Association will become City employees on January 1, 2012; and

WHEREAS, it is the desire to recognize the Association’s present MOU with CRFA on January 1, 2012.

THE CITY COUNCIL OF THE CITY OF CARMEL-BY-THE-SEA DOES RESOLVE AS FOLLOWS:
1. Recognize and approve the Association’s Memorandum of Understanding with CRFA.

PASSED AND ADOPTED by the City Council of the City of Carmel-by-the-Sea this 4th day of October 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