county of santa clara emergency medical services system · ‐ emt’s recertification (skills...

County of Santa Clara Emergency Medical Services System Emergency Medical Care Committee (EMCC) 700 Empey Way San Jose, CA 95128 408.794.0600 voice | www.sccemsagency.org www.facebook.com/SantaClaraCountyEMS

EMERGENCY MEDICAL CARE COMMITTEE (EMCC)

Thursday, May 16, 2019 2:00 pm – 4:00 pm

Valley Specialty Center, Room BQ160,

751 South Bascom Avenue, San Jose, CA 95128

All reports and supporting material are available for review on the Santa Clara County EMS Agency website at www.sccemsagency.org and in the EMS Agency’s offices at least one week prior to the meeting. ( Indicates supporting documentation attached. Indicates committee action required). Purpose of the Emergency Medical Care Committee (EMCC) The purpose of the Emergency Medical Care Committee (EMCC) as specified in the California Health and Safety Code Section 1797.274 and 1797.276 is to review the operations of each of the following at least annually:

1. Ambulance services operating within the county.

2. Emergency medical care offered within the county, including programs for training large numbers of people in cardiopulmonary resuscitation and lifesaving first aid techniques.

3. First aid practices in the county.

The EMCC shall convene to provide the Santa Clara County EMS Agency with its observations and recommendations relative to its review of the items above in addition to providing feedback related to the EMS System Strategic Plan, policy, education and training, quality improvement, public access, and EMS system operations. The EMCC will also make recommendations related to the use of EMS Trust Fund for the funding of Category C: Stakeholder Projects consistent with Santa Clara County Prehospital Care Policy EMS Reference #812Trust Fund Guide and Application. Recommendations made by the EMCC, in the form of meeting minutes, will be provided to the Health Advisory Commission by the Chair and will be published to the EMS Agency website, and available for public review.

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AGENDA 1. Call to Order / Roll Call of Voting Members

Kenneth Horowitz, Chair and Health Advisory Commissioner 2. Introductions and Announcements

Kenneth Horowitz, Chair and Health Advisory Commissioner 3. Public Comment

Kenneth Horowitz, Chair and Health Advisory Commissioner This portion of the meeting is reserved for persons desiring to address the EMS Committee on a Committee-related matter not on the agenda. Speakers are limited to two (2) minutes. The law does not permit Committee action or extended discussion on any items not on the agenda except under special circumstances. Statements that require a response may be placed on the agenda for the next regular meeting of the Committee.

Consent Items Items 4 – 9 may be accepted as one motion. Item 4 – 9 is for informational purposes. 4. Approval of November 15, 2018 Meeting Minutes (Page 5) 5. Items Approved by the Board of Supervisors and/or Board Committees (Page 10) Copies of Board and Board Committee approved reports are provided for

reference and information purposes. 6. EMS Trust Fund Status Report

Accept written report on the financial status of the EMS Trust Fund (Page 38)

7. Santa Clara County Exclusive Operating Area Report (Page 40) 8. Non-911 Ambulance Services Report (Page 45) 9. HHS Facilities Report (Page 47) Regular Items 10. Health Advisory Commission and Items Referred by the Commission to

the EMCC Receive verbal report from Kenneth Horowitz, Chair and Health Advisory Commissioner

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11. EMS System Initiatives: Personnel

A. Receive verbal report on EMT Certification, Paramedic Accreditation, and Credentialing Daniel Peck, EMS Specialist B. Receive verbal report on EMS Investigations and Enforcement Daniel Peck, EMS Specialist C. Receive verbal report on Medical Volunteers for Disaster Response

Program (Page 49) Michael Cabano, EMS Specialist

12. EMS System Initiatives: Equipment and Supplies A. Receive verbal report Jason Weed, EMS Specialist 13. EMS System Initiatives: Data Systems

A. Receive verbal report Michael Clark, EMS Specialist 14. EMS System Initiatives: Clinical Care and Patient Outcome

A. Receive verbal report on Sobering Center Dr. Ken Miller, EMS Medical Director

B. Receive verbal report on Community Paramedicine Dr. Ken Miller, EMS Medical Director

C. Receive verbal report on Specialty Center Quality Improvement Dr. Ken Miller, EMS Medical Director

D. Receive report on Prehospital Care Policy Revision Activities

John Sampson, EMS Specialist (Page 52) 15. EMS System Initiatives: Skills Maintenance/Competency

A. Receive verbal report Daniel Franklin, EMS Specialist 16. EMS System Initiatives: Public Education

A. Receive verbal report Daniel Franklin, EMS Specialist

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17. EMS System Initiatives: Transportation/Facilities A. Receive report on Palo Alto Exclusive Operating Area (Page 53) Kevin McNally, Deputy Chief, Palo Alto Fire Department B. Receive report on Bypass (Page 65) Jackie Lowther, EMS Director 18. EMS System Initiatives: Preparedness

A. Receive verbal report on Disaster and Significant events Michael Cabano, EMS Specialist

19. EMCC Member Requests for Future Agenda Items / Announcements

Kenneth Horowitz, Chair and Health Advisory Commissioner Voting and non-voting members may request items for inclusion in future agendas or present announcements not requiring EMCC action.

20. EMS Stakeholder Requests for Future Agenda Items / Announcements

Kenneth Horowitz, Chair and Health Advisory Commissioner Members of the public or EMS System may request items for inclusion in future agenda or present announcements not requiring EMCC action.

21. Next Meeting and Adjourn

Kenneth Horowitz, Chair and Health Advisory Commissioner August 15, 2019 from 2:00-4:00 pm at Valley Specialty Center, Room BQ160, 751 South Bascom Avenue, San Jose, CA 95128

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Emergency Medical Care Committee Valley Specialty Center, 751 S. Bascom Avenue

November 15, 2018 at 1:00pm Meeting Minutes

Item Discussion Action 1. Call to Order/Roll Call Jackie Lowther called the meeting to order at

1:00 p.m. A quorum was present.

Meeting called to order

2. Introductions and Announcements

Thank you, Michael Esslinger and Max Boxel, for their time in the EMCC committee.

Voting members were requested to bring their own laptops for the next EMCC meeting, we are trying to go paperless.

3. Public Comment Danielle Johnstone from NORCAL Ambulance spoke on the following, “Trust Fund funds being used to provide High Performance stimulated manikins for privates”.

Consent Items 4. Approval of May 17, 2018 Meeting Minutes 5. Summary of Items Present to BOS and HHC 6. EMS Trust Fund

Consent items approved by: Dan Bobier / Casey Potts

7. Health Advisory Commission Updates

HAC was not present. Jackie will be presenting the EMS Annual Reports at the September HAC meeting.

8. Reports on EMS System Initiatives: Personnel.

A. EMT Certification, Paramedic Accreditation, and Credentialing (Daniel Peck)

B. EMS Investigations and Enforcement (Daniel Peck)

C. Medical Volunteers for Disaster Response Program (Michael Cabano)

A. Daniel Peck went over the pie graph provided on page 82 regarding the stats for certification and accreditations.

‐ 800 accredited paramedics. ‐ Fine tuning the new applications

which will be available soon. B. Daniel Peck announced we have a few

on probation and last quarter we did not have any denials.

C. Daniel Franklin presented the MVDR report which can be found on page 83. Some of the events that MVDR participated in where:

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Item Discussion Action ‐ San Jose Mineta Airport MCI Exercise

with 17 participants. ‐ Morgan Hill Mushroom Mardi Grass. ‐ DHV MRC User Group training.

9. Reports on EMS System Initiatives: Equipment and Supplies (Jason Weed)

‐ Private providers radios and non‐medical providers will complete the training on August 31st.

‐ $66K was spent on 20 radios to be replaced at the Hospital, County Communications will be programming them.

10. EMS System Initiatives: Data Systems (Michael Clark)

‐ Michael Clark key points: ‐ Recently launched a new online

application for EMS Provider Medical Advisors.

‐ Ted Farr is working on CEMSIS data feeds and confirming ePCR, data is coming in from our non‐911 private providers.

‐ Working on launching a new online application for EMTs.

‐ Still pending is County finance and procurement departments to establish a contract with Authorized.net so that the EMS Agency may offer online payment options for certification applicants.

11. EMS System Initiatives: Clinical Care and Patient Outcomes.

A. Receive Verbal Report from EMS Agency Medical Director (Dr. Miller)

‐ Dr. Miller key points: ‐ Review the 2018 Annual EMS Update ‐ High Performance CPR: Initial

emphasis on chest compressions, defibrillation and BLS airway management with specific crewmember functions.

‐ Introduction of video laryngoscopy and the LMA‐Supreme supraglottic airway.

‐ Introduction of two new protocols: Traumatic cardiac arrest and extremity hemorrhage control.

‐ Introduction of the Multi‐casualty Incident Plan to replace the MPMP.

‐ Trial period while working with County Communications/Jail Transports. Deciding which services to send to the call, Elmwood and County Communications interfacility transfers, etc…

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Item Discussion Action B. Receive report on Prehospital Care Policy

Revision Activities (David Sullivan)

‐ Santa Clara County Prehospital Care Policies are up for Public Comment. The Policies revision activities can be found on Page 86.

12. EMS System Initiative: Skills Maintenance/Competency (Daniel Franklin)

A. Daniel Franklin reminded everyone that the “Action Plan” is sent out every week by Michael Cabano.

‐ EMT’s recertification (skills checks) were implemented in July.

‐ Offering 9 more trainings on High Performance CPR.

‐ Train‐The‐Trainer is scheduled for October 2nd.

‐ Kaiser Santa Clara will be offering an Airway class on September 11th from 10am‐3pm, CE’s will be provided.

13. EMS System Initiatives: Transportation/Facilities

A. Receive report on SCC EOA update (John Blain)

B. Receive report on Palo Alto Service Area 911 Ambulance update (Eric Nickel)

C. Receive report on Non‐911 Ambulance Services (David Sullivan)

D. Receive report on HHS Facilities (David Sullivan)

E. Receive report on Transition of Care (Jackie Lowther)

A. Jackie Lowther provided an overview and a summary regarding the finding/variances for the current EOA ambulance and fire department compliance. Report can be found on Page 88.

‐ South County has been struggling for the last 4 months, Jackie will be working with them.

B. Kevin McNally provided the Palo Alto Service Area 911 Ambulance report, it can be found on Page 92.

C. Daniel Franklin spoke on the report provided on Page 129.

D. Daniel Franklin presented the HHS Facilities report which can be found on Page 130.

E. Jackie Lowther presented the Transition of Care and Diversion report which can be on Page 131.

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Item Discussion Action 14. EMS System Initiatives: Public Education

A. Receive verbal report on Hands‐Only CPR Training (Daniel Franklin)

A. Daniel Franklin announced that we have a few safety campaigns that will be released soon.

‐ Materials can be found on our website.

‐ Thirty thousand “Life Files” have been distributed.

‐ Public Education in our website is currently being translated in Spanish and Vietnamese.

15. EMS System Initiatives: Preparedness

A. Receive verbal report on Disaster and Significant events (Michael Cabano)

A. Daniel Franklin spoke on the Urban Shield training that is coming up.

16. EMS Strategic Plan / EMS Annual Report (Jackie Lowther)

A. Jackie Lowther briefly spoke about the Annual Report.

‐ Submissions for Trust Fund dollars are due August 31st. Total dollar amount will be $350K.

‐ RFP update: Jackie stated that she is nonconforming to the proposal that was put out. RFP will be released early September. Contract expires June 30, 2019.

‐ Sub‐Committee that will be meeting to review the Trust Fund FY19 Category C submissions are the following voting members: Robert Jonsen Dan Bobier Heather Tannehill‐Plamondon Jo Coffaro Harry Hall

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Attachments, presentations and documents can be found at: www.sccemsagency.org

Item Discussion Action 16. EMCC Member Request for Future Agenda Items

None

Jo Coffaro requested an update regarding the Sobering Center pilot project in Gilroy.

17. EMS Stakeholder Request for Future Agenda Items

None

18. Next Meeting

February 21, 2018 from 1:00‐3:00pm at Valley Specialty Center, Room BQ160, 751 S. Bascom Ave, San Jose, CA 95128.

Meeting adjourned at 2:35pm.

VOTING MEMBERS PRESENT: David Ghilarducci, MD, Emergency Department Physician Richard Kline, MD, Specialty Care Physician Leif Juliussen, Public Sector Paramedic/EMT Douglas Petrick, County EOA Ambulance Provider Dan Bobier, Private Ambulance Service Executive Officer Casey Potts, Fire Service Executive Officer Robert Jonsen, Law Enforcement Executive Officer Kent Steffens, City Manger Heather Tannehill‐Plamondon, County Communications Jo Coffaro, Hospital Council

Voting Alternates PRESENT: Jocelyn Paulson, Private Sector Paramedic/EMT Kevin McNally, Palo Alto EAO Ambulance Provider Jeff Horner, Private Ambulance Service Executive Officer Suwanna L. Kerdkaew, SCC County Communications

EMS STAFF PRESENT: Jackie Lowther, EMS Director Dr. Ken Miller, Medical Director Ramona Aguilar, Executive Assistant Michael Clark, EMS Specialist Christopher Duncan, EMS Specialist Daniel Franklin, EMS Specialist Aaron Herrera, EMS Specialist Patricia Natividad, Sr. Management Analyst Daniel Peck, EMS Specialist John Sampson, EMS Specialist Jason Weed, EMS Specialist

Others in Attendance: Josh Markowitz, Kaiser Susan O’Neal Michael Spath, PSCMA Danielle Johnstone, NORCAL Coleen Seymour, NORCAL Dave Rose, Sunnyvale Anastasia Pieda, NORCAL Karla Costa Cunningham, CNT SCCFD Michael Baulch, Stanford Life Flight Leslie Simmons, AMR‐Sutter Maxwell Laurence, Royal

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County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 700 Empey Way San Jose, CA 95126 408.794.0600 voice | www.sccemsagency.org www.facebook.com/SantaClaraCountyEMS

Date: January 31, 2019 To: Santa Clara County EMS Committee Members From: Patricia Natividad

Senior Management Analyst

Subject: Summary of Approved or Pending Board of Supervisors and Health and Hospital Committee Items

Summary of Health and Hospital Committee Approved Items: N/A Summary of Board of Supervisors Approved Items: N/A Summary of Re-Entry Network Committee Approved Items: Gilroy Fire Emergency Medical Technician – Paramedics Pilot Project ~ December 20, 2018 Receive report from the Office of the County Executive relating to the implementation of a Gilroy Fire Emergency Medical Technician-Paramedics pilot project. This is the fulfilment of a request by Supervisor Chavez, the chair of the Re-Entry Network, for a brief update on the status of the Santa Clara County EMS/Gilroy Fire Department Behavioral Health/Sobering Center Alternate Destination Pilot Project being conducted in the City of Gilroy.

In 2017 OSHPD announced an interest in expanding the EMS HWPP Program to include new pilot project sites. Through existing Santa Clara County EMS data, the EMS Agency identified the frequency of Welfare and Institutions Code 5150 holds on 911 EMS responses in South County. The EMS Agency partnered with the Gilroy Fire Department and the Gilroy Police Department to develop a paramedic assessment protocol that would allow 911 EMS to transport selected patients on a 5150 hold directly to Emergency Psychiatric Services (EPS) or patients with uncomplicated alcohol intoxication (not on a 5150 hold) to the Mission Street

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Sobering Center (MSSC). Those patients assessed to require a medical screening examination or having a medical or trauma emergency coexistent with the behavioral crisis or alcohol intoxication would be transported to an acute care hospital emergency department. The pilot project proposal and protocol were approved by EMSA and OSHPD, education on the protocol and supporting science was conducted with the Gilroy Fire Department by the EMS Agency and patient engagement in the project began on April 23, 2018.

Data collection includes patient presentation and evaluation as documented in the prehospital electronic Patient Care Report but also includes patient demographic data as well as length of stay, any secondary emergency department transfer, discharge diagnosis (from EPS), and discharge disposition. Early data from the Pilot Project for the first 75 patients is presented in the attachment.

Ultimately the Pilot Project will characterize the 911 EMS patients with a law enforcement- placement 5150 hold and inform EMS system configuration and behavioral health referral practices to provide behavioral crisis intervention and perhaps reduce the need for field placement of 5150 holds.

See attached legislative file and presentation.

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94519

DATE: December 20, 2018

TO: Re-Entry Network

FROM: Kenneth Miller, MD, PHD, EMS Medical Director

SUBJECT: Gilroy Fire Emergency Medical Technician-Paramedics Pilot Project.

RECOMMENDED ACTION

Receive report from the Office of the County Executive relating to the implementation of a

Gilroy Fire Emergency Medical Technician-Paramedics pilot project.

FISCAL IMPLICATIONS

The recommended action to receive report has no fiscal impact, as this is an informational

report only.

REASONS FOR RECOMMENDATION

This is the fulfilment of a request by Supervisor Chavez, the chair of the Re-Entry Network,

for a brief update on the status of the Santa Clara County EMS/Gilroy Fire Department

Behavioral Health/Sobering Center Alternate Destination Pilot Project being conducted in the

City of Gilroy.

CHILD IMPACT

The recommended action will have no/neutral impact on children and youth.

SENIOR IMPACT

The recommended action will have no/neutral impact on seniors.

SUSTAINABILITY IMPLICATIONS

The recommended action will have no/neutral sustainability implications.

BACKGROUND

In 2014 the California Emergency Medical Services Authority (EMSA) and the Office of

Statewide Health Planning and Development (OSHPD) began a series of projects under the

OSHPD Health Workforce Pilot Project Program (HWPP) that allowed approved EMS

systems in California to evaluate, treat and transport selected patients to healthcare

destinations other than acute care hospital emergency departments as otherwise required by 12

Title 22 of the California Health and Safety Code. The significance of these pilot projects is

better integration of EMS systems into the greater healthcare system. Each pilot project site

has specific protocols that include patient safety monitoring and local institutional review

board approval under local medical oversight.

In 2017 OSHPD announced an interest in expanding the EMS HWPP Program to include

new pilot project sites. Through existing Santa Clara County EMS data, the EMS Agency

identified the frequency of Welfare and Institutions Code 5150 holds on 911 EMS responses

in South County. The EMS Agency partnered with the Gilroy Fire Department and the

Gilroy Police Department to develop a paramedic assessment protocol that would allow 911

EMS to transport selected patients on a 5150 hold directly to Emergency Psychiatric Services

(EPS) or patients with uncomplicated alcohol intoxication (not on a 5150 hold) to the

Mission Street Sobering Center (MSSC). Those patients assessed to require a medical

screening examination or having a medical or trauma emergency coexistent with the

behavioral crisis or alcohol intoxication would be transported to an acute care hospital

emergency department. The pilot project proposal and protocol were approved by EMSA

and OSHPD, education on the protocol and supporting science was conducted with the

Gilroy Fire Department by the EMS Agency and patient engagement in the project began on

April 23, 2018.

Data collection includes patient presentation and evaluation as documented in the prehospital

electronic Patient Care Report but also includes patient demographic data as well as length of

stay, any secondary emergency department transfer, discharge diagnosis (from EPS), and

discharge disposition. Early data from the Pilot Project for the first 75 patients is presented

in the attachment.

Ultimately the Pilot Project will characterize the 911 EMS patients with a law enforcement-

placement 5150 hold and inform EMS system configuration and behavioral health referral

practices to provide behavioral crisis intervention and perhaps reduce the need for field

placement of 5150 holds.

CONSEQUENCES OF NEGATIVE ACTION

The Re-Entry Network would not receive the update on the Santa Clara County EMS/Gilroy

Fire Department Behavioral Health/Sobering Center Alternate Destination Pilot Project.

ATTACHMENTS:

• EMS Re-Entry Presentation (PDF)

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SANTA CLARA COUNTY EMS/GILROY FIRE EMERGENCY MEDICAL TECHNICIAN-PARAMEDICS

PILOT PROJECTKEN MILLER, MD, PHD MEDICAL DIRECTOR

SANTA CLARA COUNTY EMS AGENCY

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© 2018 County of Santa Clara Health System

2014

• CA EMS Authority (EMSA) & CA Office of Statewide Health Planning and Development (OSHPD) established pilot programs in several EMS systems through the OSHPD Health Workforce Pilot Project (HWPP) Program

- Public health: TB medication administration

- High risk hospital discharge follow up: heart failure, diabetes, multiple chronic conditions

- Alternate destinations: urgent care centers, behavioral health facilities, sobering centers

- Frequent 911 Callers: healthcare referrals and follow ups

- Hospice: 911 calls for hospice patients

2017

• EMSA & OSHPD expand HWPP Program to additional sites & EMS systems

• Santa Clara County EMS partnered with the Gilroy Fire Department

- Alternate destination: behavioral health facility (EPS) & sobering center (MSSC)

- Patient engagement began April 2018

• Nationwide there are approximately 129 Community Paramedicine programs in 34 states

Brief History

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A defining principle in healthcare

Elements of patient safety in the Pilot Project

• Development of a patient assessment protocol based upon the medical literature and other operating behavioral health/sobering center programs and data

• SCVHHS IRB review of the Pilot Project protocol

• Education of the GFD firefighter/paramedics on behavioral crisis and uncomplicated alcohol intoxication

• 100% case review of electronic patient care reports for patients considered for inclusion in the Pilot Project

• Medical oversight by the SCC EMS Agency

• Immediate follow up on any patient transferred from EPS or MSSC to an emergency department

• Independent evaluator: Philip R. Lee Institute for Health Policy Studies and Healthforce Center at UCSF

Patient Safety

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© 2018 County of Santa Clara Health System7

Patient eligibility for engagement

• Vital sign parameters

• Not pregnant

• Comorbid factors and occult trauma

Behavioral Crisis

• Law enforcement-placed §5150

• Medical causes of abnormal behavior/psychosis; not new onset

Alcohol intoxication

• MSSC entry criteria

Pilot Project Prehospital Assessment Protocol

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Early Findings

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CA Legislature 2017 & 2018: Senate & Assembly Bills

• Inclusive of all current Pilot Projects

• Specific to behavioral crisis and sobering center

• Variable stakeholder group support and opposition

• All failed

• Legislation followed by regulations necessary to move pilot projects into broader EMS practice

AB 3115

• All current Pilot Projects

• State and local project oversight groups

• Shifting but significant stakeholder group opposition

• Veto with instruction for OSHPD to continue current Pilot Projects

Attempts at Legislation

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County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 700 Empey Way San Jose, CA 95126 408.794.0600 voice | www.sccemsagency.org www.facebook.com/SantaClaraCountyEMS

Date: May 8, 2019 To: Santa Clara County EMS Committee Members From: Patricia Natividad

Senior Management Analyst

Subject: Summary of Approved or Pending Board of Supervisors and Health and Hospital Committee Items

Summary of Health and Hospital Committee Approved Items: EMS Trust Fund Report – March 13, 2019 Receive report from Emergency Medical Services (EMS) Agency relating to the EMS Trust Fund. In 2000, the Board of Supervisors created the EMS Trust Fund and required that the EMS Agency provide an annual report on the EMS Trust Fund’s status. This annual report provides information on the activities and projected balance of the EMS Trust Fund by the end of FY19, and recommendations for expenditures for FY20, as required by the EMS Trust Fund process. Once approved by the Board of Supervisors, the expenditures for the FY20 EMS Trust Fund would be incorporated into the FY20 Budget Process. The EMS Trust Fund balance as of July 1, 2018 was $14 million. Based on projected revenues and expenditures, the estimated Trust Fund balance as of June 30, 2019 would be $12.2 million. The recommended spending plan for FY20 totals $2,192,719 and maintains $10,393,965 in the strategic reserve. FY20 estimated revenue for liquidated damages was based on straight-line projection if contracted EMS providers fail to meet response time and other agreement obligations (i.e., vehicle failure, use of non-Exclusive Operating Area ambulance providers). Revenues continue to decrease as the contracted 9-1-1 ambulance provider and first responder agencies continue to meet response times, thus decreasing penalties and revenues.

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The complete legislative file with the FY19 status and the FY20 spending plan is attached. Summary of Board of Supervisors Approved Items: Emergency Medical Services Week – May 6, 2019 Adopt Proclamation declaring the week of May 19-25, 2019 as "Emergency Medical Services Week" in Santa Clara County. (Emergency Medical Services) 2019 will mark the 45th annual EMS Week. The theme for 2019 is “Beyond the Call.” The complete legislative file and proclamation is attached.

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95480

DATE: March 13, 2019

TO: Health and Hospital Committee

FROM: Jackie Lowther, EMS Director

SUBJECT: EMS Trust Fund Report

RECOMMENDED ACTION

Receive report from Emergency Medical Services (EMS) Agency relating to the EMS Trust

Fund.

FISCAL IMPLICATIONS

The Emergency Medical Services (EMS) Agency receives revenue from liquidated damages,

which are fines and penalties paid by Rural/Metro (the contracted 9-1-1 ambulance provider)

and first responder non-performance penalties. These revenues are deposited to the EMS

Trust Fund and are intended to fund projects that provide a countywide benefit and enhance

the services provided in the Santa Clara County EMS System.

The EMS Trust Fund balance as of July 1, 2018 was $14 million. Based on projected

revenues and expenditures, the estimated Trust Fund balance as of June 30, 2019 would be

$12.2 million.

The recommended spending plan for FY20 totals $2,192,719 and maintains $10,393,965 in

the strategic reserve.

FY20 estimated revenue for liquidated damages was based on straight-line projection if

contracted EMS providers fail to meet response time and other agreement obligations (i.e.,

vehicle failure, use of non-Exclusive Operating Area ambulance providers). Revenues

continue to decrease as the contracted 9-1-1 ambulance provider and first responder agencies

continue to meet response times, thus decreasing penalties and revenues.


In 2000, the Board of Supervisors created the EMS Trust Fund and required that the EMS

Agency provide an annual report on the EMS Trust Fund’s status. This annual report

provides information on the activities and projected balance of the EMS Trust Fund by the

end of FY19, and recommendations for expenditures for FY20, as required by the EMS Trust

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Fund process. Once approved by the Board of Supervisors, the expenditures for the FY20

EMS Trust Fund would be incorporated into the FY20 Budget Process.

The FY19 EMS Trust Fund Status

The current fund balance in the EMS Trust fund, as of January 31, 2019 is $14,115,672. Of

this amount, approximately $2,614,331 will fund expenditures thru June 30, 2019. In

addition, the EMS Agency expects additional revenue in the amount of $755,343 to be

collected by June 30, 2019, leaving a balance of $12,256,684. Attachment A shows the

FY19 Projected Trust Fund Balance.

FY20 EMS Trust Fund Proposed Spending Plan

Attachment B shows the FY20 Projected Trust Fund Balance and Spending Plan. A

summary of the proposed spending plan for FY20 is as follows.

Category A: EMS System/Strategic Reserve: $10,393,965

The amount placed into the EMS System Reserve is intended for significant strategic or long-

range projects that benefit the EMS System, as approved by the Board of Supervisors. If

approved, the total Category A balance (savings) will be $10,393,965. These funds could be

used in the event the EMS system experiences an unanticipated financial burden,

extraordinary increase of cost of service, supplies, or a material decrease in system-wide

reimbursement.

In the past, Category A funds were used to make payments to the fire departments and to the

County that resulted from financial proceedings by the contracted ambulance company and

for consultant services.

Category B: EMS System Support - Training, Education & Recognition: $230,000

All Category B items are routine and requested each year. Allocation of funding areas will

focus on EMS training, information to the public and training/exercises that relate to the

Measures of Success, annual department-wide measures related to strategic planning and

multi-departmental collaboration to address system-wide opportunities and challanges.

Amounts budgeted may be transferred between any line item identified below.

(1) EMS System Information to the Public: $50,000

Authorized expenditures in this category would be allocated to promote improvements

made to the County EMS System and to inform the public about injury prevention,

safety and cardiac survivability activities. This may include community forums, video

production, written materials, and other forms of media.

(2) Training (not funded by grants or other sources): $135,000

Authorized expenditures in this category would be allocated to provide training and

training resources for EMS System providers. Courses include Ambulance Strike

Team, prehospital education, Six Sigma training, Hazardous Materials—First

Responder Operations, and Annual EMS Update.

(3) Exercises (not funded by grants or other sources): $35,000

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Authorized expenditures in this category would be allocated to design, conduct and

evaluate exercises to assess EMS System capabilities. These include Mass Casualty

Incident Plan, Standard Dispatch Orders, Ambulance Strike Team operations, and

disaster medical operations.

(4) EMS Provider Recognition and EMS Week: $10,000

Authorized expenditures in this category would be allocated for EMS System

Stakeholders and organizational recognition including plaque and awards, t-shirts

during EMS Week and throughout the year. This amount is unchanged from FY18.

Category C: Benefits to EMS System Users - $350,000

Authorized expenditures in this category are intended to assist EMS System Stakeholders

with one-time and/or short-term projects that: (1) provide a countywide benefit and that (2)

enhance the services provided in the Santa Clara County EMS System. Stakeholders will be

solicited to submit proposals in the Summer 2019. Proposals will be reviewed and selected

by the Trust Fund Advisory Group. All projects selected for funding may be started Fall

2019 and must be completed by June 30, 2020.

Category D: EMS System Strategic Initiatives - $1,612,719

Expenditures in this category are intended to support strategic initiatives of the EMS System.

(1) EMS Strategic Plan Implementation: $150,000

Funding would assist in the implementation of various projects contained within the

EMS System and EMS Agency Strategic Plans which may include, but are not limited

to, consultants, service agreements and development of various tools and resources.

Key focus areas include frequent users of EMS services, emergency medical dispatch

and quality improvement initiatives.

(2) Stroke Public Awareness Campaign: $25,000

Funding would support the development of a public education campaign aimed at

increasing public awareness of early stroke identification. In addition, the campaign

would focus on the importance of early intervention and the benefits of utilizing EMS

for faster treatment times. The EMS Agency would work in collaboration with the

Stroke Foundation and all County Stoke Center hospitals on this initiative. This is a

new line-item expenditure in EMS System Strategic Initiatives Category.

(3) Payment of Service to Rural/Metro: $350,000

Costs associated with the provisions of the Fifth and Sixth Amendment to the

Agreement between the County and Rural/Metro. Costs are related to training and

programs that support the EMS system previously supported by Rural/Metro. This

includes programs like First Watch, Target Solutions, 12-Lead Transmission, Image

Trend and GPS Logic.

(4) EMS Data System Costs: $300,000

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This funding would support the annual cost of maintaining the EMS System Data Hub

that collects information from all ambulance services and public safety answering

points (dispatch centers).

(5) EMResource: $38,000

EMResource is a hospital emergency department and EMS resource tracking system.

This system provides real time status of emergency department availabilities/bypass

as well as the status of multiple EMS related resources such as field treatment trailers,

radio caches and disaster support units. This system is used 24/7/365 by EMS

personnel and dispatch centers within Santa Clara County.

EMResource has been utilized by the Santa Clara County EMS system, and all of its

providers, for the last several years. This solution has been integrated within other

vital EMS solutions such as our computer aided dispatch (CAD) system as well as our

surrounding counties’ emergency department Bypass systems. The system is essential

and without it, EMS would lose a vital component of the everyday 9-1-1 response

system.

In the previous years, EMResource was fully funded through the federal Hospital

Preparedness Program (HPP) grant. The program’s emphasis shifted from the

traditional hospital-based capabilities to a broader focus on the healthcare coalitions.

As a result of the shift in the program’s focus, there will be limited funding directed

solely towards increasing hospital capabilities. EMResource is a vital tool for

redundant communications within the EMS System but it accounts for approximately

half of the total dollars allocated to hospitals for preparedness. It is recommended that

due to the federal funding decrease, the EMS Agency and Public Health Department

split the annual cost. The total yearly cost is $76,000, of which half will remain

funded with the HPP grant, the other half from the EMS trust fund.

(6) First Watch Solutions: $375,000

FirstWatch Solutions (FirstWatch) is a web-enabled system that provides near real-

time EMS System performance data analysis and operational transparency. The

system is integrated with the computer aided dispatch (CAD) systems of 9-1-1 EMS

providers operating in the County. FirstWatch is primarily utilized by the County’s

EMS Agency to monitor 9-1-1 response time performance of the ten contracted EMS

provider agencies. FirstWatch is a vital quality assurance and improvement tool used

to ensure that EMS providers are meeting EMS System performance standards.

FirstWatch has been in use since July 2011. The annual cost of the five year contract

cycle is $75,000. The total contract amount of $375,000 will be paid in FY20. This is

a new line-item expenditure in EMS System Strategic Initiatives Category.

(7) EMS Strategic Initiatives Coordinator: $193,742

Continue ongoing funding of 1.0 FTE EMS Specialist to coordinate strategic

initiative-related projects. This position was added in FY14 to support various

projects associated with the EMS System and EMS Agency Strategic Plans.

(8) EMS Building Lease Costs: $180,977

29

Continue ongoing funding to cover the annual lease costs for the EMS agency at 700

Empey Way, San Jose. This will be an ongoing expense that would be prioritized for

utilizing the EMS Trust fund on an ongoing basis.

CHILD IMPACT

The recommended action will have no/neutral impact on children and youth.

SENIOR IMPACT




BACKGROUND

On April 13, 2011, the Health and Hospital Committee reviewed the EMS Trust Fund

Strategic Funding Plan. On April 26, 2011, that plan was authorized by the Board of

Supervisors. This Strategic Funding Plan created four categories to which EMS Trust Fund

revenue would be assigned. The categories, and their intended use, are summarized below:

Category A: EMS System Reserve Investment

Each year, at least 20% of the EMS Trust Fund revenue is generated in the previous fiscal

year. This revenue is retained and used for significant and long-term strategic projects that

benefit the EMS System, as approved by the Board of Supervisors. These funds could also be

used should the EMS System experience an unanticipated financial burden, such as

extraordinary increase of cost of service or supplies, or a material decrease in system-wide

third-party payer reimbursement.

Category B: EMS System Support-Training, Education and Recognition

Funding authorized in this category would be primarily used for annual training, education,

exercises, an annual EMS conference, and recognitions. Funds would be used in the

following subcategories:

• EMS System Information to the Public

• Training (which is not funded by grants or other sources)

• Exercises (which are not funded by grants or other sources)

• EMS Provider and committee member recognition, and EMS Week

Category C: Benefits to EMS System Providers

Projects in this category are requested from County of Santa Clara (County) EMS System

Stakeholders, such as fire departments, County Communications, ambulance services,

dispatch centers, and the EMS Agency. Projects in this category would continue to focus on

one-time or shorter-term focused projects that benefit EMS System providers.

For Category C expenditures, the EMS Trust Fund Advisory Group, a subcommittee of the

Emergency Medical Care Committee (EMCC), reviews proposals and makes

recommendations to the EMS Agency for funding. After review by EMS Agency staff, the

30

EMS Director includes recommended projects in the annual EMS Trust Fund budget

proposal to the Board of Supervisors.

Category D: EMS System Strategic Initiatives

Projects in this category emphasize the development of initiatives that strategically advance

the County EMS System, often in the longer term. Projects in this category may take more

than one fiscal year and involve numerous parties.


The Committee would not receive the information requested and the proposed FY20 EMS

Trust Fund spending request could be delayed.

STEPS FOLLOWING APPROVAL

ATTACHMENTS:

• Attachment A FY19 EMS Trust Fund Status (PDF)

• Attachment B FY20 EMS TF Balance and Spending Plan (PDF)

31

Attachment A

Trust Fund Balance as of July 1, 2018 14,033,130$

Revenues:FY18‐ Rural Metro liquidated damages, May to June 18 189,000$ FY19‐ Rural Metro liquidated damages July to October 18 37,000$ 226,000First Responder Fees FY19 Q1Interests 62,874$ Total Revenues 288,874$

Expenditures:Category B: EMS System Support

EMS System Public Information 19,933$ Training 1,090 Exercises ‐ EMS Provider Recognition 576 21,599$

Category C: Stakeholder RequestsBenefits to EMS System Providers ‐$ Data Project Funding for Fire Departments (EMCC) 25,300 25,300

Category D: Strategic InitiativesEMS System Strategic Plan Implementation 2,998$ Inventory Item #25‐ CPR in Schools Initiative ‐ EMS Data System Costs 10,088 EMResource ‐ AED/Racing Hearts (misc. adjustment) (6,032) EMS Strategic Initiatives Coordinator 78,401 EMS Lease Cost 73,978 159,434

Total Expenditures (for July 2018 to January 2019) 206,332$

Trust Fund Balance as of January 31, 2019 14,115,672$

Projections‐ February thru June 2019Revenues

FY19‐ Rural Metro liquidated damages November 18 to April 19 60,000$ First Responder Fees FY18 Q3‐Q4, FY19 Q1‐Q2 695,343

Total Projected Revenues 755,343 Expenditures:

Category B: EMS System SupportEMS System Public Information 30,067$ Training 133,910 Exercises 35,000 EMS Provider Recognition 9,424 208,401

Category C: Stakeholder RequestsBenefits to EMS System Providers 350,000$ Data Project Funding for Fire Departments (EMCC) ‐ Rollover 724,700 1,074,700

Category D: Strategic InitiativesEMS System Strategic Plan Implemnetation 147,002$ Inventory Item #25‐ CPR in Schools Initiative 51,164 Rural Metro Amendment 5 & 6 Programs 350,000 EMS Data System Costs 289,912 EMResource 34,784 AED/Racing Hearts 72,760 Inventory Item #64‐ AEDs in Jails 120,000 EMS Stategic Initiatives Coordinator 107,587 EMS Lease Cost (based on FY19 FAF budget) 158,022 1,331,230

Total Projected Expenditures 2,614,331$

Projected Trust Fund Balance as of June 30, 2019 12,256,684$

FY19 EMS Trust Fund StatusFund 0363 CC 9854

32

Attachment B

Projected Fund Balance as of July 1, 2019 12,256,684$

Projected Revenues:

Rural Metro Liquidated damages 50,000$ First Responder Fees 280,000

Total FY20 Projected Revenues 330,000$

Proposed Expenditures:

Category B: EMS System SupportEMS System Public Information 50,000$ Training 135,000 Exercises 35,000 EMS Provider Recognition 10,000

Sub‐total 230,000$ Category C: Stakeholder Requests

Benefits to EMS System Providers 350,000$ Category D: Strategic Initiatives

EMS System Strategic Plan Implementation 150,000$ Stroke Awareness Campaign 25,000 Rural Metro Amendment 5 & 6 Programs 350,000 EMS Data System Costs 300,000 Emergency Management Resource System 38,000 First Watch Solutions 375,000 EMS Strategic Initiatives Coordinator 193,742 EMS Lease Cost (FY20 FAF budget) 180,977

Sub‐total 1,612,719$

Total FY20 Proposed Expenditures 2,192,719$

Category A ‐ EMS System Reserve: (Funds to be held in Trust Fund) 10,393,965$

Total Projected Fund Balance (excluding Reserves) as of June 30, 2020 0

FY20 EMS Trust Fund Projected Balance and Spending PlanFund 0363 CC 9854

33

96339

DATE: May 6, 2019

TO: Board of Supervisors

FROM: Jackie Lowther, EMS Director

SUBJECT: Emergency Medical Services Week

RECOMMENDED ACTION

Adopt Proclamation declaring the week of May 19-25, 2019 as "Emergency Medical

Services Week" in Santa Clara County. (Emergency Medical Services)

FISCAL IMPLICATIONS

There are no fiscal implications resulting from this action.


National Emergency Medical Services Week brings together local communities and medical

personnel to publicize safety and honor the dedication of those who provide the day-to-day

lifesaving services of medicine's "front line."

CHILD IMPACT

The recommended action will have no/neutral impact on children or youth.

SENIOR IMPACT




BACKGROUND

2019 will mark the 45th annual EMS Week. The theme for 2019 is “Beyond the Call.”


Failure to approve this recommendation and proclaim May 19-25, 2019 as “National

34

Emergency Services Week” in Santa Clara County would result in a lost opportunity to

recognize the many contributions and lifesaving efforts made by emergency medical

professionals.

ATTACHMENTS:

• EMS Week Proclamation Signed (PDF)

35

Month / Year Amount

January-18

$265,000.00

February-18 $64,500.00

March-18 $4,000.00

April-18 $6,000.00

May-18 $175,000.00

June-18 $14,000.00

July-18 $10,000.00

August-18 $5,000.00

September-18 $12,000.00

October-18 $10,000.00

November-18 $9,000.00

December-18 $7,000.00

Total for CY18 $581,500.00

Average Monthly Total In Period $48,458.00

County of Santa Clara Emergency Medical Services System

Emergency Medical Services Agency 700 Empey Way San Jose, CA 95128 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org

Date: January 31, 2019 To: Santa Clara County EMS Committee Members From: Patricia Natividad Senior Management Analyst Subject: EMS Trust Fund – Liquidated Damages for Calendar Year 2018

Monthly Liquidated Damages for Response Time

January 1, 2018 – December 31, 2018

.

38

Month / Year Amount

July-18 $10,000.00

August-18 $5,000.00

September-18 $12,000.00

October-18 $10,000.00

November-18 $9,000.00

December-18 $7,000.00

January-19 $14,000.00

February-19 $93,250.00

March-19

April-19

May-19

June-19

Total for FY19 $160,250.00

Average Monthly Total In Period $20,031.00

County of Santa Clara Emergency Medical Services System

Emergency Medical Services Agency 700 Empey Way San Jose, CA 95128 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org

Date: May 8, 2019 To: Santa Clara County EMS Committee Members From: Patricia Natividad Senior Management Analyst Subject: EMS Trust Fund – Liquidated Damages for Fiscal Year 2019

Monthly Liquidated Damages for Response Time

July 1, 2018 – June 30, 2019

.

39

Date: February 21, 2019 To: Santa Clara County Emergency Medical Care Committee From: John Blain, EMS Specialist, EOA Contract Management Subject: County EOA Service Area Response Time Performance Reports History and Issue The County has entered into agreements with private and public entities to provide emergency medical response and advanced life support ambulance transportation services. Periodic response time compliance reports have been provided to the Emergency Medical Care Committee for the purpose of providing public review of those entities’ performance and compliance with contractual response time requirements. The County has performance based contracts with the following entities: 1. County Ambulance Contracted Provider (Rural/Metro of California-AMR) 2. Gilroy, City of 3. Milpitas, City of 4. Morgan Hill, City of 5. Mountain View, City of 6. San Jose, City of 7. Santa Clara, City of 8. Santa Clara County Central Fire Protection District 9. South Santa Clara County Fire District 10. Sunnyvale, City of Context Compliance is measured by several key performance indicators that include; response time requirements based on population density; designated response areas; type of response priority (red lights & siren or non-red lights & siren); total number of responses; total number of late responses; and total number of responses exempted (removed) from compliance calculations. Compliance is achieved when ninety (90.00%) percent or more of the responses meet the specified response time requirement in each response priority within each designated response area.

40

80.00%

85.00%

90.00%

95.00%

100.00%

Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18

County Ambulance: Code 3 Response Compliance

Zone 1 Zone 2 Zone 3 Zone 4 Zone 5

103,624109,253 111,635

118,343 121,599 126,019 123,478

283

299306

324332

345338

260

310

360

410

20,000

60,000

100,000

140,000

2012 2013 2014 2015 2016 2017 2018

County EOA Emergency Ambulance Service Responses

County Ambulance Responses Average responses per day

70,574 72,054 73,56578,045 79,896 82,042 81,721

193 197 202

214 218225 224

170

200

230

260

290

0

20,000

40,000

60,000

80,000

100,000

2012 2013 2014 2015 2016 2017 2018

County EOA Emergency Ambulance Service Transports

County Ambulance Patients Transported Average patient transports per day

41

97.9

7%

98.6

3%

97.4

7%

97.5

0%

97.4

4%

97.2

7%

95.1

8% 97.0

9%

96.6

2%

95.5

3% 97.3

7%

95.9

0%

80.00%

85.00%

90.00%

95.00%

100.00%


Gilroy, City of

Code 3 Compliance [%]

98.5

0%

97.2

3%

93.5

4%

98.4

7%

97.6

4%

97.3

2%

97.6

5%

97.0

2%

98.0

0%

97.6

8%

96.9

1%

95.0

0%

80.00%

85.00%

90.00%

95.00%

100.00%


Milpitas, City of


94.6

7% 96.7

6%

96.3

9%

93.6

9% 95.2

2%

96.1

2%

93.9

7% 95.4

8%

96.1

2% 98.0

2%

98.3

1%

98.5

8%

80.00%

85.00%

90.00%

95.00%

100.00%


Morgan Hill, City of


42

96.3

7% 98.2

1%

97.6

6%

97.9

5%

98.9

0%

99.6

6%

96.7

0% 98.3

4%

96.5

3%

96.9

7%

96.2

2%

96.2

1%

80.00%

85.00%

90.00%

95.00%

100.00%


Mountain View, City of


89.9

1%

89.5

7%

89.3

9%

88.3

2% 90.3

1%

90.9

5%

91.4

3%

91.6

0%

90.4

3%

91.0

0%

91.2

7%

91.6

9%

80.00%

85.00%

90.00%

95.00%

100.00%

Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18

San Jose, City of


95.7

3%

95.7

4%

95.4

3%

95.1

4% 97.2

0%

97.1

4%

97.5

0%

93.5

3%

96.1

9%

91.6

2% 93.7

1%

94.0

2%

80.00%

85.00%

90.00%

95.00%

100.00%

Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18

Santa Clara, City of


43

97.1

2%

96.4

9%

96.8

2%

97.2

2%

97.2

9%

96.3

1%

96.4

0%

96.7

6%

96.2

3%

97.4

1%

96.5

4%

97.3

2%

80.00%

85.00%

90.00%

95.00%

100.00%


Santa Clara County Central Fire District


93.8

1%

92.6

3%

87.3

0%

94.7

4%

91.3

3%

89.3

6%

92.2

5%

88.1

4%

96.1

5%

96.8

8%

97.8

3%

96.4

9%

80.00%

85.00%

90.00%

95.00%

100.00%


South Santa Clara County Fire District


98.4

3%

98.0

4%

97.1

7% 99.7

4%

98.8

0%

99.4

8%

98.4

7%

98.1

3%

98.5

8%

98.1

1%

95.6

3%

98.3

1%

80.00%

85.00%

90.00%

95.00%

100.00%


Sunnyvale, City of


44

County of Santa Clara EMS Agency

NON-911 AMBULANCE SERVICES/PERMITTED VEHICLES – As of January 22, 2019

Current Non-911 Private Ambulance Providers:

Provider Levels of Service American Medical Response - Sutter CCT, BLS Bayshore Ambulance CCT, BLS Falck North America CCT, ALS, BLS Falcon Critical Care Transport CCT, BLS Norcal Ambulance CCT, BLS Pro Transport-1 CCT, ALS, BLS Royal Ambulance CCT, BLS Silicon Valley Ambulance ALS, BLS Westmed Ambulance CCT, ALS, BLS

Number of Non-911 resources (as of 01/22/19):

Provider Santa Clara County Resources

American Medical Response - Sutter 7 Bayshore Ambulance 5 Falck North America 13 Falcon Critical Care Transport 8 Norcal Ambulance 6 Pro Transport-1 31 Royal Ambulance 27 Silicon Valley Ambulance 9 Westmed Ambulance 26 Total 132

Number of field inspections of ambulances and fire apparatus during CY2018:

Resource Type Inspections

Ambulances (Fire, EOA, and Non-911) 55 Fire Apparatus (Non-Transport) 7

45


NON-911 AMBULANCE SERVICES/PERMITTED VEHICLES – As of April 29, 2019

Current Non-911 Private Ambulance Providers:

Provider Levels of Service American Medical Response - Sutter CCT, BLS Falck North America CCT, ALS, BLS Falcon Critical Care Transport CCT, BLS NORCAL Ambulance CCT, BLS ProTransport-1 CCT, ALS, BLS Royal Ambulance CCT, BLS Silicon Valley Ambulance ALS, BLS Westmed Ambulance CCT, ALS, BLS

*Bayshore Ambulance ceased ambulance operations in the San Francisco Bay Area effective Sunday April 28th at 17:00 hours Number of Non-911 resources (as of 04/29/19):

Provider Santa Clara County Resources

American Medical Response - Sutter 7 Falck North America 14 Falcon Critical Care Transport 8 NORCAL Ambulance 6 ProTransport-1 31 Royal Ambulance 30 Silicon Valley Ambulance 9 Westmed Ambulance 26 Total 131

Number of field inspections of ambulances and fire apparatus, so far, during CY2019:

Resource Type Inspections

Ambulances (Fire, EOA, and Non-911) 26 Fire Apparatus (Non-Transport) 4

46


ADDITIONAL 911 AMBULANCE (COUNTY AMBULANCE) DATA

28 3033

24

18

34 34

21

27 29

1821

26

33

42

3330

38 38

31 29

41

2924

0 1 0 2 0 0 0 0 0 0 1 02 1 0 0 1 1 3 1 0 1 0 005

1015202530354045

Jan‐18 Feb‐18 Mar‐18 Apr‐18 May‐18 Jun‐18 Jul‐18 Aug‐18 Sep‐18 Oct‐18 Nov‐18 Dec‐18

911 Ambulance Responses to County Custody Facilities

Elmwood (MLP) Main Jail (SJS) Ranches for Boys (MRG)

Juvenile Hall (SJS) Linear (Elmwood (MLP)) Linear (Main Jail (SJS))

3

13

8

18

7

18

12

3

8

2

8

3

1110

2

13

3

11

1

17

8

5

11

1

17

8

18

10

6

8

1

13

5

16

11

4

21

14

32

16

2

6

0

12

3

15

10

3

6 6

9

5

7

5

2

7

5

12

5

10

14

3

7

2

8

3

11

20

2

5

8

13

5

11

16

2

54

15

2

9

13

0

5

10

15

20

25

Milpitas East Valley (SJS) Renal Care (SJS) Moorpark (SJS) Tully (SJS) VMC (SJS) Downtown (SJS)

911 Ambulance Responses to SCVMC Clinics

Jan‐18 Feb‐18 Mar‐18 Apr‐18 May‐18 Jun‐18 Jul‐18 Aug‐18 Sep‐18 Oct‐18 Nov‐18 Dec‐18

47


ADDITIONAL 911 AMBULANCE (COUNTY AMBULANCE) DATA

37

18

23

36

27 26

1 0 02 2

00

5

10

15

20

25

30

35

40

Jan‐19 Feb‐19 Mar‐19

911 Ambulance Responses to County Custody Facilities

Elmwood (MLP) Main Jail (SJS) Ranches for Boys (MRG)

Juvenile Hall (SJS) Linear (Elmwood (MLP)) Linear (Main Jail (SJS))

6

10

5

15

20

11

3

10

56

24

11

2

9

3

27

1210

0

5

10

15

20

25

30

Milpitas East Valley (SJS) Renal Care (SJS) Moorpark (SJS) Downtown (SJS) VSC (SJS)

911 Ambulance Responses to SCVMC Clinics

Jan‐19 Feb‐19 Mar‐19

48

MVDR MEMBERSHIP REPORT MAY 2019

Current Membership:

Type of License Level 1 Level 2 Level 3 Level 4 Total

Physician 57 34 13 104

Registered Nurse 159 96 36 291

Physician’s Assistant 16 5 0 21

Nurse Practitioner 8 3 1 12

Paramedic 20 1 4 25

EMT 91 39 28 158

Pharmacist 14 3 2 19

Social worker 4 1 0 5

Psychologist 4 2 0 6

Dentist 3 7 0 10

Veterinarian 4 4 0 8

Other (Medical) 147 31 10 188

Other (Non-Medical) 92 33 8 129

Total 619 259 102 980

Membership by Level:

Level JANUARY FEBRUARY MARCH APRIL MAY Level 1 0 0 0 0 0 Level 2 619 619 619 619 619 Level 3 259 259 259 259 259 Level 4 102 102 102 102 102 Total Membership

980 980 980 980 980

49

Withdrawals:

Membership Withdrawals

JANUARY FEBRUARY MARCH APRIL MAY

Withdrawn 0 0 0 0 0 Reason N/A N/A N/A N/A N/A Total Withdrawals:

0 0 0 0 0

Event Participation:

MONTH JANUARY FEBRUARY MARCH APRIL MAY EVENT DHV MRC

User Group Training

NACCHO MRC

Technical Readiness Workshop

- DHV Quarterly

Drill

Statewide MRC

Coordinators Workshop

- - - - - PARTICIPANTS 1 1 - 1 1

- - - - - TOTAL MONTHLY PARTICIPANTS

1 1 - 1 1

Event Summary:

The MVDR Program is currently going through a volunteer reconciliation process that will gather appropriate staffing numbers and update current member notification information. This process will conclude its reporting period on May 30, 2019.

Since the last membership report the MVDR Program Administrator has participated in several workshops and drills to enhance program readiness and coordinate with state resources. The Program Administrator is scheduled to attend the two-day Statewide MRC Coordinators Workshop in Sacramento on May 29th and 30th.

Membership Summary:

There was no documented increase in membership from the last report through August 2018.

Membership Level Definitions:

Level I: the program has little or no advanced knowledge of member or prior training. Level I members require emergency credentialing and are last to be utilized to fill resource needs. Level I members and are ineligible to deploy unless sworn in as Disaster Service Workers (DSW)

Level II: Basic volunteers who have expressed some level of interest in the program prior to attendance. These members have registered with the DHV but have yet to participate in a new

50

member orientation. These members are used to fill resource needs after Level III and Level IV volunteers. Level II members and are ineligible to deploy unless sworn in as Disaster Service Workers (DSW).

Level III: Intermediate volunteers are primarily called into service in disaster events and will be attached to existing infrastructure. These individuals regularly participate in training and exercises. They have completed the core competencies and have been issued an MVDR ID.

Level IV: Level 4 members are first call for deployments and are deployable with little or no advanced notice. They have completed advanced training classes in addition to frequent participation in training and exercises.

51


POLICY DEVELOPMENT REPORT

The following policies and protocols were released or updated by the County of Santa Clara EMS Agency in the first quarter of calendar year 2019.

Policy # Policy Name Effective Date Change 301 Supplemental EMS System Resources 2/12/2019 Updated 302 Prehospital Care Asset ‐ Minimum Inventory Requirements 2/12/2019 Updated 313 Public Safety First Aid Providers Scope of Practice and Optional Skills 2/12/2019 Updated 700‐A07 Cardiac Arrest 2/12/2019 Updated 700‐A17 Traumatic Cardiac Arrest 2/12/2019 New Policy 700‐M01 Airway Management 2/12/2019 Updated 700‐M11 Spinal Motion Restriction 2/12/2019 Updated 700‐M17 Extremity Hemorrhage Control 2/12/2019 New Policy 700‐P07 Pediatric Cardiac Arrest 2/12/2019 Updated 700‐S01 Continuous Cardiopulmonary Resuscitation 2/12/2019 Updated 700‐S13 Use of Physical Restraints 2/12/2019 New Policy 700‐X01 Airway Management (BLS Optional Scope) 2/12/2019 Updated 700‐X06 Pain Management (ALS Optional Scope) 2/12/2019 New Policy 811 Multiple Casualty Incident Plan 2/12/2019 Updated 811A MCI Documents/Tools 2/12/2019 Updated

52

City of Palo Alto (ID # 10165) City Council Staff Report

Report Type: Informational Report Meeting Date: 3/18/2019

City of Palo Alto Page 1

Summary Title: PAFD Semi-Annual Performance Report FY19

Title: Palo Alto Fire Department Semi-Annual Performance Report for the First Half of Fiscal Year 2018

From: City Manager

Lead Department: Fire

Recommendation Staff recommends the City Council review the First Palo Alto Fire Department Semi-Annual Performance Report for Fiscal Year 2019. Background and Discussion In Fiscal Year 2015 the Palo Alto Fire Department (PAFD) identified performance reporting as a key initiative, and began reporting on key performance measures quarterly. In Fiscal Year 2018 the Department began submitting reports twice each year. The report provides overall calls for service information, as well as more detailed information on the key service areas, including Emergency Medical Services, Fire Suppression, Rescue and Hazardous Materials Response, and Fire Prevention. The report also provides information on mutual and automatic aid with our regional public safety partners and internal workforce planning efforts. Performance measures include the following:

Calls for Service: This data provides information on the final outcome of all emergency response calls. The data is tracked in the Fire Department’s Record Management System, and uses standardized call type codes, which are defined by the National Fire Incident Reporting System (NFIRS). The report includes overall call volume by primary category, and a detailed listing of call type in the service type sections.

Response Times: The time that a call is received by the emergency dispatchers to the arrival of the fire resources at the scene of the emergency. This

53


information is tracked in the Computer Aided Dispatch (CAD) System, and the performance goals, or service levels, are set by Council in accordance with county and national standards.

Ambulance Transports: The report provides the number of ambulatory transports to hospitals or other medical care facilities, and the proportion of Emergency Medical Calls that included transports. This information is tracked in the Fire Department’s Emergency Medical Record Management System.

Fire Containment: This measures the proportion of building and structure fires that are contained to the area or room of origin within Palo Alto and Stanford Campus.

Mutual and Automatic Aid: This includes the number and proportion of all incidents that the PAFD provided aid to neighboring communities, as well as the aid received from neighboring Fire Departments. This information is tracked in the CAD System.

Permits: This provides the total count of facility, electric vehicle, and solar permits issued by the Fire Prevention Bureau. This information is currently tracked in the Development Center’s Records Management System.

Inspections: A count of the total number of Hazardous Materials and State Mandated inspections is provided. In addition, an estimated number of inspections to be completed for the year is also provided to assess overall workload performance to date.

Fire and Life Safety Plans Reviewed: This provides a total count of all plans reviewed, as well as the proportion of plans that were reviewed within the time guidelines.

Vacancies and Off-Line Employees: This section provides the total number of budgeted full-time equivalent shift personnel, current vacancies, and employees that are off line due to workers compensation or light duty. This information is obtained from the Fire Department’s Staffing and Scheduling System (TeleStaff), as well as the City’s Personnel Management System.

Succession Planning Metrics: This provides the number and proportion of shift personnel that are eligible to retire, or will be eligible within the next five years. This information is tracked in the City’s Personnel Management System. This report also provides the total number of hours that shift personnel spent in an acting capacity. Personnel serving in an acting capacity are a key component of the Department’s overall succession planning efforts. Acting capacity allows junior officers to learn the responsibilities of higher ranks with guidance from

54


senior officers. This information is tracked in TeleStaff.

Training hours: The total number of training hours completed by all shift personnel is provided, as well as the average number of hours per each shift personnel on staff. This information is tracked in the Fire Department’s Record Management System. Local, State and Federal mandates require fire personnel to train a minimum of 20 hours per month.

Attachments:

ATTACHMENT A_Coverletter FINAL

ATTACHMENT B_Semi Annual Performance Report FY19.1 DRAFT_030419

ATTACHMENT C_EMS Customer Report

ATTACHMENT D_Kudos FY19.1

55

P.O Box 10250 Palo Alto, CA 94303 650.329.2184 650.327.6951 fax

City of Palo Alto

Fire Department

Honorable Councilmembers,

I am pleased to provide the enclosed performance report for the first half of Fiscal Year 2019. This

period saw an eight percent (8%) reduction in overall call volume. This is primarily from a reduction in

false alarms and good intent calls.

With the beginning of the new contract with Stanford University, the terms outline changes and

proactive work to reduce the instance of false alarms. The initial decrease seen this period is from the

Department no longer providing response to supervisory fire alarms. Supervisory alarms are merely

advisory alarms and do not indicate that there is an emergency. Over the next year, we can expect a

continued decrease in false alarms as the contract also requires that the Department and Stanford

collaborate to implement a false alarm reduction program.

This period also marked the deadliest and most destructive wildfire in California history. The Camp Fire

in Butte County spanning almost 240 square miles took seventeen days to contain. The Department

deployed a strike team for eleven days from November 11th through the 22nd to aide in the firefighting

efforts. The strike team crew included Fire Captain Sean MacDonald, Apparatus Operator Sarah Wallace,

Firefighter Antoine Trader, and Firefighter Jesse Wooton. Apparatus Operator, Chris Mosko, responded

to the Camp Fire with FEMA’s Task Force 3 for recovery efforts. I give my heartfelt gratitude and

acknowledgement to these firefighters and their families that stepped up to serve in the most significant

fire in California history.

Sincerely,

Geo Blackshire Interim Fire Chief

56

Palo Alto Fire Department First Semi-Annual Performance Report Fiscal Year 2019

Calls for Service The Palo Alto Fire Department (PAFD) responded to a total of 4,264 calls for service in the first six-month period of Fiscal Year 2019. This includes responses within Palo Alto, Stanford, and neighboring cities to provide Auto and Mutual Aid. Approximately eighty-three percent (83%) of calls are generated from Palo Alto, fifteen percent (15%) from Stanford, and the remainder from neighboring cities or requests for regional fire deployment.

The majority of calls were for Rescue and Emergency Medical Services, making up sixty-two percent (62%) of the responses. Table 1 below shows the main categories of the calls to which PAFD responded. Calls are classified based on the actual event occurred, rather than the initial call request.

Call Type FY18 JUL-DEC FY19 JUL-DEC

Rescue and Emergency Medical Services Incidents 2,692 2,632 Good Intent 804 620 False Alarm and False Call 695 620 Service Call 264 231 Fire 105 85 Hazardous Condition, No Fire 77 76 Grand Total 4,637 4,264

Good Intent and False Alarm calls make up the second largest types of responses. Most calls for service that may be a true threat of fire, gas or other emergency hazard are actually found to be something else after Firefighters investigate the situation. These calls are coded as Good Intent calls. As well, many fire alarm activations are from causes other than fire or emergency hazard. These situations are categorized as False Alarm calls.

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PAFD FY19 Bi-Annual Performance Report

2 | P a g e

Emergency Medical Services and Rescue Emergency Medical Service (EMS) is the primary service that the Palo Alto Fire Department provides to Palo Alto and Stanford. While this shift toward EMS is being seen across the region, the Palo Alto Fire Department is the only Fire Department in the County that provides ambulance and transport services.

Of the 2,632 Emergency Medical Service calls the PAFD responded to in the first period of Fiscal Year 2019, the overwhelming majority were for medical, trauma and cardiac calls that did not involve a vehicle accident.

Rescue and EMS Performance Measures FY18 JUL-DEC FY19 JUL-DEC

Emergency Medical Service Incident 2,643 2,577 Lock-In 13 10 Extrication, Rescue 32 41

Rescue or EMS Standby 3 2 Water and Ice-Related Rescue 1 1 Search for Lost Person 0 1

Total 2,692 2,632 Transports

Number of Transports 1,703 1,774 Percent of EMS Calls resulting in transport 63% 67%

Response Times Percent of first responder arriving on scene to EMS calls within 8 minutes

95% 93%

Percent of paramedic responder arriving on scene to EMS calls within 12 minutes

99% 99%

Average response time for first responder arriving on scene to EMS calls

4:48 5:06

This period reflects a slight dip in the number of Rescue and EMS Incident calls. The number of EMS calls that resulted in an ambulance transport to a local hospital or care facility, accounted for sixty seven percent (67%) of all EMS calls. This is the primary source of revenue generated from emergency medical services, and the Department has seen the revenue flatten out over the last period.

Response Time Goal Met: At least 90% of first responder arriving on scene to EMS calls within eight minutes.

This period the PAFD first responder arrived on scene to EMS calls within eight minutes ninety-three percent (93%) of the time.

Response Time Goal Met: At least 99% of paramedic responder arriving on scene to EMS calls within 12 minutes.

This quarter the PAFD paramedic responder arrived on scene to EMS calls within 12 minutes ninety-nine percent (99%) of the time.

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3 | P a g e

Fire Suppression Very few of the potential fire calls coming into dispatch turn out to be a real fire once PAFD investigates the scene and cause of the concerning elements. This period PAFD responded to 85 calls where fire was present, with 74 in Palo Alto or Stanford. There were seven building fires that the Department responded to in Palo Alto and Stanford, five of which were contained to the area of origin. Here are the descriptions of the significant fires for this period: July 20, 2018 Fire Units responded to the report of a fire in the bathroom of a single family residence. Units arrived to find light smoke in the house. The fire investigator found that the fire was caused by a bathroom fan that burned into the attic, where the fire was extinguished. August 14, 2018 There was a report of smoke and flames seen inside of a single family residence. There was also a report that a child may still be in the house. The fire was in one of the bedrooms and quickly extinguished. The child was found outside of the house. Based on the investigation, the fire was caused by a furnace that was recently serviced, located in the attic. The extent of the damage was limited to the attic and the bedroom. October 21, 2018 Fire units were dispatched to a water flow alarm at a multiple unit student housing occupancy. There were reports of water flowing out of a room, typically indicative of a fire sprinkler activation. The first due engine arrived to find the building being evacuated and smoke rolling down the hallway. The fire crews, with the assistance of the fire sprinkler, were able to fully extinguish the fire and confine the damage to the room of origin. The fire was caused by a pot that was left on the stove. November 11, 2018 Palo Alto Fire Engine 65 was dispatched to join a Santa Clara County strike team to assist with the Camp Fire in Butte County, the deadliest and most destructive fire in California history. For 11 days, fire crews were responsible for constructing fire lines, structure preparation and defense, and overhaul. The crew returned safely without any injuries. November 16, 2018 Fire crews were dispatched to smoke coming from a single family residence. When the crews made entry, the house was full of smoke with zero visibility, and a fire sprinkler was activated. Eventually, the crews made it to the bathroom and quickly extinguished the fire. Based on the investigation, the fire was caused by a faulty exhaust fan in the bathroom.

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4 | P a g e

Fire Suppression Measures FY18 JUL-DEC FY19 JUL-DEC

Structure Fire 46 32 Outside rubbish fire 22 19 Mobile property (vehicle) fire 12 12 Natural vegetation on fire 20 10 Fire, Other 0 10 Special outside fire 4 2 Fire in mobile property used as a fixed structure 1 0

Total 105 85 Response Times

Percent of first responder arriving on scene to Fire calls within 8 minutes 90% 87% Average response time for first responder arriving on scene to Fire calls 5:27 5:46

Fire Containment Percent of building and structure fires contained to the room or area of origin 83% 71%

Response Time Not Goal Met: At least 90% of first responder arriving on scene to Fire calls within eight minutes.

This period the PAFD first responder arrived on scene to Fire calls within eight minutes eighty seven percent (87%) of the time.

Fire Containment Goal Not Met: At least 90% of building and structure fires contained to the room or area of origin.

This period there were seven building or structure fires within Palo Alto or Stanford, of which five were contained to the room or area of origin. In both cases the fire had spread beyond the original area despite a response time under eight minutes.

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5 | P a g e

Hazardous Materials The Fire Department responded to a total of 76 calls related to hazardous material incidents. The most common Hazardous Material call is spills and leaks of either natural or liquid petroleum gas (LPG) which totaled 36. This number accounted for forty-seven (47%) percent of all Hazardous Material calls.

The second highest Hazardous Material calls were related to electrical wiring or equipment problems. fifteen (15) of these calls account for twenty (20%) percent of all Hazardous Material calls.

Hazardous Materials Response Measures FY18 JUL-DEC FY19 JUL-DEC

Combustible/Flammable spills and leaks 42 36 Electrical wiring/Equipment problem 26 15 Hazardous Condition, Other 0 10 Biological hazard 4 8 Chemical release, reaction, or toxic condition 1 4 Accident, potential accident 3 3 Attempted burning, illegal action 1 0

Total 77 76 Response Times

Average response time for first responder arriving on scene to Rescue & Hazardous Materials calls

5:50 6:42

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6 | P a g e

Mutual and Automatic Aid The Fire Department previously held automatic aid agreements with five regional Fire Departments, including Mountain View, Menlo Park, and Santa Clara County Fire. At the request of the City of Mountain View, the automatic aid agreement was modified at the beginning of January 2018 resulting in a significant decrease in the number of calls compared to the prior fiscal year. The Palo Alto Fire Department continues to advocate for the closest unit response and collects objective data to support improved services to all of our communities under the previous automatic aid agreement.

Santa Clara County received the highest amount of aid from the department this period accounting for fifty-six (56%) of all mutual and auto aid provided. The Department received the most aid from Mountain View with a total of 28 incidents.

Mutual Aid Performances FY18 JUL-DEC FY19 JUL-DEC

Mutual and Auto Aid Provided Agency

Santa Clara County Fire 37 34 Mountain View Fire 221 21 Menlo Park Fire 7 5 San Mateo City 1 0 San Mateo County 2 1 Out of Area 3 0

All Mutual and Auto Aid Provided 271 61

Mutual and Auto Aid Received Agency

Mountain View Fire 147 28

Menlo Park Fire 27 16

Santa Clara County Fire 13 4

Woodside Fire 15 0

Moffett Fire 2 0

Sunnyvale 2 0

Cal-Fire 2 0 All Mutual and Auto Aid Received 208 48

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7 | P a g e

Fire Prevention The Fire Prevention Bureau ensures compliance with the Fire Code for the safety of occupants and protection of property. Fire Inspectors perform fire sprinkler and fire alarm plan checks, permitting, and field inspections with the goal of ensuring all construction complies with local and national codes.

This period saw a decrease in the number of electric vehicle permits issued compared the same period in the prior year. The number of Fire Inspections and Hazardous Material inspections increased, and the number of plans to review remained steady.

Prevention Bureau Performance Measures FY18 JUL-DEC FY19 JUL-DEC

Permits Fire Permits Issued 230 225

Sprinkler Permits Issued 114 136 Solar Permits Issued 26 46 Electric Vehicle Permits Issued 7 0

Inspections Fire Inspections 4,617 5,046 Hazardous Material Inspections Completed 219 241 Number of Hazardous Material Inspections for the year 563 565 Percent of Hazardous Material Facilities Inspections Complete 39% 43% State Mandated Inspections Completed 137 228 Number of State Mandated Inspections for the year 397 574 Percent of State Mandated Facilities Inspections Complete 35% 40%

Fire and Life Safety Plan Review Plans Reviewed 853 860 Percent of Reviews Completed On-Time 94% 95%

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8 | P a g e

Workforce Planning The Department operates daily emergency response operations with a total of 86.00 FTE line personnel. This includes three battalions of crews that staff six stations in the City and Stanford 24 hours each day. Over the last period, the department has operated with 7.0 positions vacant and 10.0 employees off-line creating a total of 17.00 FTE positions that require backfill.

The vacant positions are primarily within the Firefighter and Apparatus Operator Classifications, since a promotional process for Fire Captain was conducted last fiscal year there are no permanent vacant Fire Captain positions.

The proportion of shift staff eligible to retire within the next five years continues to remain steady, currently making up more than half of all shift staff. The Department hired 9.0 FTE Entry Level Firefighters in November in order to fill these vacancies after receiving approval to over-hire in anticipation of future retirements. These new hires are currently in a Fire Academy and are anticipated to graduate in March.

The Department will be focusing on succession planning efforts to fill the current Battalion Chief vacancy. The Department will hold a promotional exam, and those that pass will be given the opportunity to serve as Acting Battalion Chiefs.

Vacancies and Off-Line Employees FY19 JUL-DEC

Classification Budgeted

FTE Vacancies

Off-Line Employees (Workers Comp/Light

Duty)

Personnel On Line

Percent of Personnel

On Line

Battalion Chief 4 1 0 3 75%

Fire Captain 22 0 2 20 90%

Fire Apparatus Operator & Fire Fighters

60 6 8 46 76%

TOTAL 86 7 10 69 80%

Succession Planning FY18 JUL-DEC FY19 JUL-DEC

Personnel

Number of Shift Staff Currently Eligible to Retire 24 25

Number of Shift Staff Eligible to Retire in Five Years 19 18

Percent of all Shift Staff Eligible to Retire within Five Years 51% 51%

Number of Acting Battalion Chief Hours 0 48

Number of Acting Captain Hours 3,045 1,681

Number of Acting Apparatus Operator Hours 7,053 8,107

Training

Hours of Training Completed 14,748 17,464

Average Hours Per Line Personnel 202 253

64

County of Santa ClaraEmergency Medical Services System

Monthly Hospital Destination, Diversion and Advisory Status Report

Report for Time Period: February 2019

Table 1: Number of Patients Transported to Hospital ED from 9-1-1 System*

Hospital (Diversion Zone) Oct-18 Nov-18 Dec-18 Jan-18 Feb-19 Mar-19 Total

Stanford (North) 419 426 439 465 455 497 2,701

El Camino - Mt. View (North) 780 727 858 823 728 819 4,735

Kaiser - Santa Clara (North) 699 680 732 788 708 859 4,466

Regional - San Jose (Central) 1,313 1,372 1,404 1,382 1,206 1,347 8,024

O'Connor (Central) 499 508 646 566 480 643 3,342

VMC (Central) 1,424 1,430 1,473 1,408 1,266 1,415 8,416

Good Samaritan (South) 717 753 786 788 765 788 4,597

Kaiser - San Jose (South) 717 724 741 742 633 752 4,309

Saint Louise (South) 289 301 327 281 253 275 1,726

El Camino - Los Gatos (N/A) 92 96 99 102 109 136 634

VA - Palo Alto (N/A) 91 70 91 85 61 85 483

Total 7,040 7,087 7,596 7,430 6,664 7,616 43,433

Hospital (Diversion Zone) Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 6 Mth Avg

Stanford (North) 14 14 14 16 15 16 15

El Camino - Mt. View (North) 25 24 28 27 23 26 26

Kaiser - Santa Clara (North) 23 23 24 26 23 28 24

Regional - San Jose (Central) 42 46 45 46 39 43 44

O'Connor (Central) 16 17 21 19 15 21 18

VMC (Central) 46 48 48 47 41 46 46

Good Samaritan (South) 23 25 25 26 25 25 25

Kaiser - San Jose (South) 23 24 24 25 20 24 23

Saint Louise (South) 9 10 11 9 8 9 9

El Camino - Los Gatos (N/A) 3 3 3 3 4 4 3

VA - Palo Alto (N/A) 3 2 3 3 2 3 3

Total Daily Average 227 236 245 248 215 246

Source: Santa Clara County Communications & Palo Alto Fire Department

*Notes for Tables 1 and 2: These numbers only reflect patients that originated in Santa Clara County and were transported by

the County's EOA Ambulance Provider and Palo Alto Fire Department. Data for Stanford does not include patients from San Mateo

County. The data includes but, does not differentiate specialty center status (TRAUMA, STROKE, STEMI, BURN) Page 1 of 2

Source: Santa Clara County Communications & Palo Alto Fire Department

Table 2: Daily Average of 9-1-1 Patients Transported By Hospital*

County of Santa ClaraEmergency Medical Services System

Monthly Hospital Destination & Bypass Status Report

65

Table 3: Total Monthly Hours of Emergency Department on "AMBULANCE" Bypass


Stanford (North) 0.00 1.30 2.00 1.00 2.01 5.75 12.06

El Camino - Mt. View (North) 6.05 6.01 3.01 10.02 8.19 18.12 51.40

Kaiser - Santa Clara (North) 4.04 4.01 4.01 8.02 11.04 22.05 53.17

Regional - San Jose (Central) 0.00 0.91 5.01 5.90 5.48 1.01 18.31

O'Connor (Central) 0.00 0.00 2.00 1.00 1.14 0.00 4.14

VMC (Central) 34.83 52.34 45.09 60.13 44.74 36.06 273.19

Good Samaritan (South) 1.00 0.37 0.00 1.37 13.03 13.03 28.80

Kaiser - San Jose (South) 0.00 0.00 7.53 0.00 8.43 6.14 22.10

Saint Louise (South) 1.01 2.00 3.01 4.00 2.00 9.02 21.04

El Camino - Los Gatos (N/A) 0.00 0.00 1.46 2.00 1.00 2.00 6.46

Total 46.93 66.94 73.12 93.44 97.06 113.18 490.67

Color Legend for ED Ambulance Bypass Only Above 37hrs Above 30hrs Below 30hrs

Table 4: Total Monthly Hours of Stroke Center on "STROKE" Bypass*


Stanford (North) 0.00 0.00 0.00 0.00 0.00 0.00 0.00




O'Connor (Central) 0.00 0.00 0.00 0.00 0.00 0.00 0.00

VMC (Central) 0.00 0.00 0.00 0.00 0.09 0.00 0.09



Saint Louise (South) 6.38 20.93 0.00 3.18 32.74 31.13 94.36

El Camino - Los Gatos (N/A) 0.38 0.28 4.74 0.56 0.90 0.00 6.86

Total 6.76 21.21 35.38 12.22 81.04 175.68 332.29

Table 5: Total Monthly Hours of STEMI Center on "STEMI" Bypass*


Stanford (North) 0.00 0.00 0.00 0.00 0.00 0.00 0.00




O'Connor (Central) 0.00 0.00 0.00 0.00 4.94 0.00 4.94

VMC (Central) 19.07 0.00 0.00 0.00 0.09 0.00 19.16



Total 19.28 0.37 1.97 1.56 48.41 15.55 87.14

Table 6: Total Monthly Hours of Trauma Center on "TRAUMA" Bypass


Stanford (North) 0.00 0.00 0.00 0.00 0.00 0.00 0.00


VMC (Central) 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total 0.00 0.53 0.00 1.21 0.00 0.00 1.74Page 2 of 2

66

SHC ECH KSC RMC OCH VMC GSH KSJ SLH LGH

Oct-18 0:10:53 0:13:56 0:19:19 0:16:14 0:17:16 0:32:01 0:22:41 0:19:59 0:19:44 0:08:56

Nov-18 0:11:26 0:13:58 0:21:55 0:19:56 0:17:59 0:35:22 0:25:53 0:19:00 0:16:28 0:09:20

Dec-18 0:10:55 0:14:39 0:20:18 0:23:42 0:18:29 0:37:04 0:23:36 0:20:21 0:18:40 0:09:52

Jan-19 0:12:20 0:15:28 0:24:00 0:32:32 0:20:10 0:40:08 0:25:07 0:21:56 0:20:00 0:09:35

Feb-19 0:12:47 0:18:30 0:24:15 0:34:59 0:20:42 0:49:48 0:28:23 0:22:07 0:19:33 0:10:37

Mar-19 0:14:53 0:18:50 0:28:38 0:27:13 0:21:06 0:49:48 0:33:18 0:24:39 0:16:32 0:10:06

0:00:00

0:07:12

0:14:24

0:21:36

0:28:48

0:36:00

0:43:12

0:50:24

0:57:36

Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

H:M

M:S

S

Ambulance Patient Offload Time (APOT) - 90th Percentile

SHC ECH KSC RMC OCH VMC GSH KSJ SLH LGH

67

APOT 2 - March 2019

< 20 minutes

21-60 minutes

61-120 minutes

121-180 minutes

>180 minutes

Total Patients

<25

minutes

SHC 201 11 0 0 0

212

SHC 208

94.8% 5.2% 0.0% 0.0% 0.0% 98.1%

ECH 750 53 1 0 0

804

ECH 774

93.3% 6.6% 0.1% 0.0% 0.0% 96.3%

KSC 680 160 6 0 0

846

KSC 738

80.4% 18.9% 0.7% 0.0% 0.0% 87.2%

RMC 1124 162 32 5 2

1325

RMC 1181

84.8% 12.2% 2.4% 0.4% 0.2% 89.1%

OCH 560 62 1 0 0

623

OCH 582

89.9% 10.0% 0.2% 0.0% 0.0% 93.4%

VMC 982 338 78 8 2

1408

VMC 1074

69.7% 24.0% 5.5% 0.6% 0.1% 76.3%

GSH 601 176 7 0 0

784

GSH 654

76.7% 22.4% 0.9% 0.0% 0.0% 83.4%

KSJ 634 113 4 0 0

751

KSJ 684

84.4% 15.0% 0.5% 0.0% 0.0% 91.1%

SLH 253 16 1 0 0

270

SLH 261

93.7% 5.9% 0.4% 0.0% 0.0% 96.7%

LGH 134 3 0 0 0

137

LGH 134

97.8% 2.2% 0.0% 0.0% 0.0% 97.8%

TOTAL 5919 1094 130 13 4

7160

TOTAL 6290

82.7% 15.3% 1.8% 0.2% 0.1% 87.8%

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