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September 12, 2023
ITEM TITLE
Agreement: Approve an Agreement with The Regents of the University of California for Medical Director Services
Report Number: 23-0212
Location: No specific geographic location
Department: Fire
Environmental Notice: The activity is not a “Project” as defined under Section 15378 of the California Environmental Quality Act State Guidelines; therefore, pursuant to State Guidelines Section 15060(c)(3) no environmental review is required.
Recommended Action
Adopt a resolution approving an agreement with The Regents of the University of California on behalf of the University of California, San Diego for Medical Director services.
SUMMARY
In order to provide 911 medical response, first responder advanced life support, and Fire Department-based ambulance transport, the Department and City must have a qualified physician to provide medical direction to emergency medical services qualified personnel. A Medical Director is required by the Local Emergency Medical Services Agency of San Diego County in order to allow Fire Department personnel to operate within the scope of practice as an emergency medical technician and/or paramedic. A Medical Director provides medical oversight, direction, and coordination of emergency medical services provided by Fire Department personnel.
ENVIRONMENTAL REVIEW
The Director of Development Services has reviewed the proposed activity for compliance with the California Environmental Quality Act (CEQA) and has determined that the activity is not a “Project” as defined under Section 15378 of the State CEQA Guidelines because it will not result in a physical change in the environment; therefore, pursuant to Section 15060(c)(3) of the State CEQA Guidelines, the activity is not subject to CEQA. Thus, no environmental review is required.
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BOARD/COMMISSION/COMMITTEE RECOMMENDATION
Not applicable.
DISCUSSION
Emergency Medical Services ( “EMS”) has become a core function of the fire service over the last 40 years .
The Chula Vista Fire Department has been a provider of Basic Life Support for the last 30 years and an Advanced Life Support provider since 2013 . The Fire Department provides EMS through a variety of positions that require an Emergency Medical Technician license for Basic Life Support and/or a Paramedic license for Advanced Life Support calls for service.
Both Emergency Medical Technician and Paramedic scopes of practice involve the delegated practice of medicine through state, county, and provider agency regulations. The California Code of Regulations, Title 22, defines the scope of practice for Emergency Medical Technicians and Paramedics. The state delegates the administration of practice to the Local EMS Agency, which determines what the local standard of medical care shall be. Standardized medical treatment protocols are developed to guide EMS personnel in their delegated practice. The Local EMS Agency (San Diego County EMS Authority) requires provider agencies to have their own Medical Director in order to perform EMS within the County of San Diego.
The Medical Director is a California Board Certified medical doctor and EMS physician who provides expertise that guides the Department’s policies and procedures, quality improvement, training activities, and medical equipment acquisition and use . The Medical Director also provides leadership in representing the City and the Fire Department within the medical community as well. The Medical Director serves as a liaison and advocate for the City of Chula Vista and its Fire Department with outside regulatory agencies such as the State of California, County of San Diego, and local groups such as the base hospital physicians and prehospital audit committees.
The University of California, San Diego, School of Medicine, Department of Emergency Medicine (“UCSD”) is the only entity in San Diego County with the ability and expertise to provide medical director services with California Board Certified EMS Physicians to meet the needs of the Fire Department . UCSD has a unique performance capability because it is the only academic medical center in San Diego County with the resources, staffing, and experience to provide medical dire ction and access to academic facilities. Because this contract is with UCSD, they have the capacity and depth to ensure there are no lapses in coverage of a Medical Director. In 2018, during our existing contract with UCSD, our assigned Medical Director b ecame unavailable, and another qualified EMS physician was immediately assigned resulting in a seamless transition with no delay in service.
UCSD is the only entity that participates in the training of paramedics, emergency medicine physicians, and emergency medical services directors. As a designated Base Hospital, they are active in the medical control of paramedic care. The City does not employ staff with the leve l of expertise in this specific area of the prehospital medical practice of emergency medicine. Given the complexity of the EMS program, this expertise is obtained in a contractual relationship for medical director services. UCSD can provide one of its doctors, Jennifer Farah, M.D., to serve as the Medical Director for the Chula Vista Fire Department.
Adoption of the proposed resolution will approve an agreement with UCSD to provide Medical Director services at a cost of $108,000 per year for an initial three-year term from October 1, 2023 through September P a g e | 3
20, 2026, with the option of two, one year additional extension terms upon mutual agreement of the City and UCSD. The City’s Procurement Agent, in consultation with the Fire Chief, has determined that selection of UCSD to perform Medical Director services, on a sole -source basis, is appropriate under the authority of Chula Vista Municipal Code Sections 2.56.110(H)(3) and 2.56.070(B)(4).
DECISION-MAKER CONFLICT
Staff has reviewed the decision contemplated by this action and has determined that it is not site-specific and consequently, the real property holdings of the City Council members do not create a disqualifying real property-related financial conflict of interest under the Political Reform Act (Cal. Gov't Code § 87100, et seq.).
Staff is not independently aware, and has not been informed by any City Council member, of any other fact that may constitute a basis for a decision-maker conflict of interest in this matter.
CURRENT-YEAR FISCAL IMPACT
Sufficient funds are budgeted and available in the current-year budget of the Advanced Life Support Program Fund, resulting in no fiscal impact to the General Fund.
ONGOING FISCAL IMPACT
The ongoing cost of services will be $108,000 per year as specified in the contract (a total of $324,000 for 36 months), funded entirely by the Advanced Life Support Program . Ongoing costs will be included in future budgets of the Advanced Life Support Program Fund, resulting in no fiscal impact to the General Fund.
ATTACHMENTS
1. Medical Director Agreement
Staff Contact: Harry Muns, Fire Chief
Raymond Smith, Deputy Fire Chief