TO: PUBLIC SAFETY, FINANCE AND FROM: Robert Sapien, Jr.
STRATEGIC SUPPORT COMMITTEE
SUBJECT: SEE BELOW DATE: March 6, 2024
Approved Date
SUBJECT: SANTA CLARA COUNTY 9-1-1 AMBULANCE SERVICES STATUS
REPORT AND FIRE DEPARTMENT EMERGENCY MEDICAL
SERVICES ANNUAL REPORT
RECOMMENDATION
1) Accept the status report on the Fire Department’s evaluation of possible service options for ambulance transport services and provide an annual report on Fire Department Emergency Medical Services delivery.
2) Refer and cross-reference this audit report to be heard by the full City Council for approval at its meeting on April 23, 2024.
SUMMARY AND OUTCOME
This report provides the Public Safety, Finance and Strategic Support Committee with a status update on the current activities centered around Santa Clara County’s 9-1-1 ambulance services, an overview of 9-1-1 ambulance services and systems revenue models, and how these systems influence and integrate with the Fire Department’s (Department) current emergency medical call volume, emergent communities, and staffing trends related to its Emergency Medical Services (EMS) delivery.
BACKGROUND
Santa Clara County 9-1-1 Ambulance Services
On October 16, 2023, the City Council conducted its Santa Clara County 9-1-1 Ambulances Services Study Session1 where the Department presented an overview of EMS operations within 1 https://sanjose.legistar.com/View.ashx?M=F&ID=12366820&GUID=CF5EDE39-4F02-44B0-88DC14F5272E9DCE PSFSS COMMITTEE AGENDA: 3/21/2024
ITEM: (d)1.
3/14/2024
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Santa Clara County (County) with a focus on the state of ambulance services in the County and impacts on Department operations. Additionally, the discussion included the status of the current 9-1-1 ambulance services provider agreement between Rural/Metro of California, Inc. (Rural/Metro) and its pending expiration of June 30, 2024, with an option to extend for one additional three-year period. The Department offered that the expiration of this agreement would present an infrequent opportunity for EMS system reforms, noting that other EMS systems have found improved performance, efficiencies through operational integration, and greater sustainability through improved cost recovery. As presented at the October 2023 study session, the Department is actively engaged in developing a service model that will provide adequate and sustainable EMS resource levels throughout the County that are operationally integrated with fire agencies and that do not compromise fire agency response to other emergencies. Among the four EMS system models introduced at the study session, including the “Alliance” model, exclusive operating area – private provider, public – third service, and public – fire based, the Department has identified the “Alliance” model as the most promising option and has initiated actions to evaluate its viability for the County. In this memorandum, the Department offers an additional analysis of those efforts and information on related concepts introduced at the study session.
Fire Department Emergency Medical Services Annual Report On April 20, 2023, the Department presented its first Annual Fire Department Emergency Medical Services Report2to the Public Safety, Finance and Strategic Support Committee which provided background on EMS services delivered by the Department’s first responders trained to provide both basic and advanced life support. The report described the Department’s EMS delivery including basic life support (BLS) and advanced life support (ALS) first responder roles, Medical Priority Dispatch Services, Fire Department Ambulance Transport, and its Public Access Defibrillator Program. Additionally, the report covered the concepts of “First Responder Funding,” contractual response time obligations, late response penalties, Fire Department ambulance transport experience data, and an analysis of increasing EMS call volume. Below, the Department offers an analysis of its EMS delivery experience in Fiscal Year 2023-2024.
ANALYSIS
Santa Clara County 9-1-1 Ambulance Services
Fiscal Year 2022-2023 9-1-1 Ambulance Services Experience The Department closely monitors performance of the contracted County ambulance provider, Rural/Metro, to determine impacts on Department response time performance. As previously reported, several factors have contributed to decreased County ambulance availability including staffing challenges, increased incident volume, and hospital ambulance patient offload delays.
The Department observed a significant period of unavailability of ambulances. Inquiries with the 2 https://sanjose.legistar.com/View.ashx?M=F&ID=11900852&GUID=8035EC5B-8E51-4E17-8649- 390263F4A951
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
County EMS Agency suggested that inadequate staffing was a significant driver of ambulance shortages, reporting3that “as of November 1, 2023, AMR [Rural/Metro] needed thirty (30) additional full-time equivalent paramedics to achieve its optimal staffing level within Santa Clara County.” In the same report, the County noted that EMS responses have increased by approximately 24% since 2020, placing an extraordinary demand on all EMS providers. As of October 2023, eight of the ten hospitals in the County did not meet the California State EMS Authority’s target of 20 minutes for ambulance patient offload time – resulting in emergency department overcrowding due to a high-volume patient intake, a high acuity of patients, or the inability to move admitted patients through care and discharge remain as significant factors.
Rural/Metro has taken action to increase ambulance availability including deployment of BLS ambulances staffed with two emergency medical technician (EMT) level trained personnel. This strategy has increased the number of ambulances available to provide transport to hospital emergency rooms, however, it has resulted in only limited relief to first responder agencies.
County EMS protocols allow transfer of patient care from an ALS (paramedic) provider to a BLS (EMT) provider in limited non-emergent situations. In all other cases, first responder agency paramedics must escort the patient to the hospital in the otherwise BLS ambulance, drawing down first responder resource availability for extended periods of time. Chart 1 illustrates the impacts, showing a direct correlation between increased BLS ambulance escorts and Department EMS late responses.
Chart 1: BLS Ambulance Escorts and Department Late Responses A second action taken by Rural/Metro to improve ambulance availability was subcontracting to another provider. In December of 2023, Rural/Metro entered a Cooperative Ambulance 3 https://sccgov.iqm2.com/Citizens/FileOpen.aspx?Type=1&ID=13931&Inline=True 53 68
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PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Agreement with Royal Ambulance, another permitted non-emergency ambulance provider in Santa Clara County. This agreement allows Royal Ambulance to deploy up to two ALS ambulances within the Exclusive Operating Area to meet service demand and reduce ambulance response times. While limited, this arrangement can add critically needed resources to the County ambulance response system.
Ambulance unavailability results in delayed transport of critical patients, extended on-scene times for first responder agencies, and extended response times to subsequent emergencies. In an effort to improve ambulance availability, some fire departments in the County have increased utilization of their existing ambulances for transport and others have acquired and deployed new ambulances. The Department has increased transport frequency by its three rescue medic units.
However, when these rescue medics are tasked with transporting patients, a correlation occurs with increased late responses to EMS incidents as the units are committed during transport making them unavailable to respond to subsequent emergencies. Additionally, rescue medic transports often occur when there are no other ambulances available, straining fire agency resource availability throughout the County. Chart 2 shows a direct correlation with increased Department rescue medic transports and Department EMS late responses.
Chart 2: Department Rescue Medic Transports and EMS Late Responses 9-1-1 Ambulance Services
On September 8, 2023, the Department released an informational memorandum4to City Council informing that the Department would be releasing its own Request for Proposal (RFP) on the open-portal titled SJFD ALS Ambulance Transport Services FIRE2023-02, soliciting proposals 4 https://www.sanjoseca.gov/home/showpublisheddocument/104830/638297894315800000 55 39
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RM Transport Total Raw Late Responses
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
from qualified ambulance service providers to provide emergency and non-emergency ambulance services to the City of San José (City) as the exclusive subcontractor throughout the Exclusive Operating Area in the County of Santa Clara (County). At present, the Department is engaged with a provider, seeking to agree on terms consistent with the “Alliance” model as discussed during the October 16, 2023 study session, prior to the release of a County 9-1-1 ambulance services RFP.
The purpose of this action was to determine the viability of an EMS service model where the City of San José would be the countywide ambulance provider, subcontracting ambulance services to a private provider. This model has become known as the “Alliance” model in California, and is currently in place in Contra Costa County, the City of San Diego, and Sonoma County; has been awarded in Santa Barbara County and San Bernardino County; and is being evaluated by several agencies in other counties. The “Alliance” model offers greater integration between first responder agencies and the private ambulance provider, leveraging the high level of cooperation and coordination that exists between regional fire agencies. Additionally, this model can result in greater system sustainability that is improved because public providers can achieve greater cost recovery, availing funding for reinvestment into the local EMS system. This point will be discussed further below.
Contra Costa County awarded ambulance services to the Contra Costa County Fire Protection District in November 2015. The Contra Costa County Fire Protection District bid the County’s RFP jointly with American Medical Response as a subcontracted provider and began providing ambulance transport services on January 1, 2016. In its eighth year, the first “Alliance” model has proven beneficial in several ways:
• Enhances ambulance deployment beyond levels to ensure compliance with response times as required by existing County policy.
• Leverages all funding sources that are not accessible to a private provider (PP-GEMT) independently, securing long-term financial stability for the provision of all contracted services.
• Covers all mandated costs, fees, and first responder allocations stipulated by the County. • Expands the number of positions dedicated to overseeing and managing the subcontractor and County EMS agreements.
• Establishes a long-term reserve account, funded annually, to address any service contingencies or emerging needs.
• Employs the services of a third-party ambulance billing provider to manage billing processes.
• Generates revenues to support future system enhancements, including the implementation of a nurse navigation line, mental health crisis units, or alternative destination transportation options.
With the anticipated release of a County of Santa Clara Advanced Life Support First Response and Paramedic Ambulance Transportation RFP, the Department initiated steps to evaluate the feasibility of entering fully into the provision of ambulance services in the County, under an
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
“Alliance” type model. Utilizing funding allocated for this purpose, the Department engaged a consulting firm, AP Triton, LLC to support the City in the design and development of an RFP for an ambulance services provider and assist during contract negotiations.
The combination of pay centers and the proportion of system users in each pay center, or payer mix, determines the financial sustainability of the healthcare system. This is true for the ambulance transport services as well, where analysis of payer mix and ambulance transport volume can determine system revenue potential. Major pay centers to be considered include Medicare, Medi-Cal, commercial insurance, and private pay.
Medicare
Medicare typically makes up the most significant portion of a systems payer mix because it covers everyone over age 65, estimated to apply to 43% of ambulance transports in San José.
Medicare caps payment for transports at $652.00, and usually pays 80% or $521.60. An additional co-pay is collected at an estimated 30% rate. This means that if a system average charge for service is $2,000, Medicare will pay $521.60, and the patient will have a small co-pay of about $130, depending on the coverage. If the system were to charge $3,000, the payments and co-pays for the patient would remain the same, so most rate increases by the City do not affect this payer category.
Medi-Cal
Medi-Cal, California’s Medicaid program, is the insurance designed for those who live under the poverty line or with significant disabilities, and some in the elderly population can have Medicare and Medi-Cal insurance, called Medi-Medi. Like Medicare, there is a cap on what Medi-Cal will pay regardless of what is charged; that amount is about $118. Medi-Cal is the second most significant portion of the patients transported in San José, with a percentage of 29%.
Commercial Insurance
The commercial insurance payer category comprises those with medical insurance through employment, private purchase, or other means. Reimbursement from this category is estimated at 80%. Commercial insurance pays a usual and customary payment based on what is charged. For instance, for an ALS transport charge of $4,200, the commercial insurance payment would be an estimated 80%, or $3,360.
Private Pay
This payer mix category comprises those who do not meet the threshold needed for receiving Medi-Cal or who have failed to apply and do not have commercial insurance. Because this group includes a wide population range, it will include those with minimal and above-average income levels. In the past, the most common demographic was those employed by smaller companies that did not provide insurance to their workers or those who were self-employed. As a result, this
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
payer mix comprises those who can afford the total ambulance transportation costs and those who cannot afford to pay any part of the fee. Within those parameters are those who can afford to make payments and agreements to take a settlement for a partial amount. Because this group comprises such economic diversity as a combined group, it is typical to see an aggregate reimbursement rate of 5% of the complete collection for this payer mix. However, with the implementation of the Affordable Care Act for California and Covered California, this demographic is continuing to transition to the insured category. The impact on the overall collection rate is still unknown as many of the plans through Covered California have higher deductibles.
Public Provider Ground Emergency Medical Transport (PP-GEMT) Specifically, public agencies can participate in the California Department of Health Care Services Public Provider Ground Emergency Medical Transport (PP-GEMT) Intergovernmental Transfer (IGT) Program which was implemented effective January 1, 2023 (AB-1705)5. Public providers participating in the PP-GEMT Program receive supplemental reimbursement through an add-on payment. The PP-GEMT Program allows public providers to draw down Federal matching funds after initially paying into a state fund on a quarterly basis. Participating public providers receive enhanced reimbursement for transports of Medi-Cal patients which make up approximately 29% of the payer mix. Given the last reported County Ambulance transport data of 89,238 transports in Calendar Year 20226, this would equate to approximately 25,879 MediCal patient transports. A typical PP-GEMT enhancement offers up to $400 of additional reimbursement on a Medi-Cal patient transport when compared to a private provider. Collection rates have an impact on the total amounts received. Figure 1 identifies the breakdown of the estimated payer mix in Santa Clara County.
5 https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201920200AB1705 6 https://emsagency.sccgov.org/sites/g/files/exjcpb266/files/general/Annual%20Report%202022.pdf
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Figure 1: Estimated Payer Mix Percentages in Santa Clara County Fire Department Emergency Medical Services Annual Report Call Volume
Fiscal Year 2022-2023 Department incident volume was 109,136 with 63%, or 68,212, classified as medical-only service requests, an increase of 6% from the previous year. Chart 3, below, provides a five-year period of incident volume from Fiscal Year 2017-2018 through Fiscal Year 2022-2023. Chart 4 reflects annual incident volumes compared with the annual City population over the ten-year period from Fiscal Year 2012-2013 to Fiscal Year 2022-2023.
Medicare 43%
Medi-Cal 29%
Commercial
Insurance 15%
Private Pay 13%
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Chart 3: Incident Volume and County Ambulance Responses (FY 2017-2018 - FY 2022-2023) Chart 4: Incident Volume and City Population (FY 2012-2013 - FY 2022-2023) 92,587 91,900 91,595 94,784
103,145
109,136
57,935 57,800 56,454 57,125
63,997 68,212
123,478 124,394 125,394 126,394
133,354 131,532
0 20,000
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2017-2018 2018-2019 2019-2020 2020-2021 2021-2022 2022-2023 SJFD Total Incidents SJFD Medical Only Incidents County Ambulance EMS Responses 78,957 83,632 87,033 90,869 92,587 91,900 91,595
94,784 103,145
109,136
51,667 51,667 53,704 56,025 57,935 57,800 56,454 57,125 63,997 68,212
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PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Community Demographics
According to the California State Plan on Aging72017-2021, the number of County residents above age 65 will increase 99% from 277,700 in 2010 to 553,409 in 2030, and County residents aged 85 and older are estimated to increase 85% from 28,039 in 2010 to 51,772 in 2030. Those 85 and older have a significantly higher rate of severe chronic health conditions and functional limitations that result in the need for more health and supportive services. The rapid growth of this age group has many implications for the healthcare sector. Chart 5 reflects Department EMS dispatches based upon reported ages of the patient based upon caller information with almost 65% of responses attributable to the ages of 50 and over.
Chart 5: Department EMS Patient Age Distribution
Responding fire personnel are asked to capture data to aid the Department in understanding its services to unhoused residents. In Fiscal Year 2022-2023, the Department responded to 6,302 EMS incidents for unhoused individuals. The 2023 Homeless Census8conducted on January 24 and 25, 2023 concluded that the homeless population in San José continues to hover around 6,266 individuals experiencing homelessness. Once again, this survey polled individuals experiencing homelessness to capture their experiences and characteristics. Individuals surveyed reported conditions that affect the ability to maintain housing and/or employment and lead to activation of EMS due to lack of reliable healthcare and health insurance including psychiatric or emotional conditions (34%), post-traumatic stress disorder (32%), drug or alcohol abuse (31%), chronic health problem (25%), physical disability (20%), and traumatic brain injury (10%). 7 https://aging.ca.gov/download.ashx?lE0rcNUV0zbUy1iwYmWKng%3d%3d 8 https://www.sanjoseca.gov/your-government/departments-offices/housing/resource-library/homelessreports/homeless-reports-executive-summary 348
1,326
2,104
3,959
5,488 5,489
7,528
9,207 9,308 9,168
4,234
3,336
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PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
The Department’s Bureau of EMS and Training - EMS Division reviews electronic patient care reports that are completed after each patient contact. This data is used to track trends that could better define the sudden increase in EMS call volume and can be seen in Table 1.
Table 1: Major Observations on Patient Primary Impressions Department Provider's Primary
Patient Impression
Fiscal Year
18-19
Fiscal Year
19-20
Fiscal Year
20-21
Fiscal Year
21-22
Fiscal Year
22-23
1 Traumatic Injury 8,978 8,252 7,701 9,259 9,746
2 General Weakness 3,545 3,355 3,886 4,387 4,914
3 Respiratory Distress 3,291 3,476 3,807 4,201 4,651
4 Abdominal Pain / Problems 2,776 2,743 3,156 3,521 3,978 5 No Medical Complaint / Findings 3,839 3,648 3,194 3,171 3,463 6 Behavioral/Psychiatric Crisis /
Excited Delirium 2,395 2,282 2,564 2,785 3,064
7 Altered Level of Consciousness
(Not Hypoglycemia or Seizure) 2,082 2,274 2,591 2,617 2,894 8 Alcohol Intoxication / Overdose 2,436 2,411 2,274 2,488 2,583 9 Non-Traumatic Body Pain 2,234 2,132 2,315 2,473 3,015 10 Chest Pain / Dysrhythmia /
Hypertension 2,027 1,965 1,861 2,210 2,431
In Fiscal Year 2022-2023, the Department advanced mandatory trainings to address challenges and meet increasing service demand:
Training Description Completion
Law Enforcement
Disengagement
Sworn personnel received training on new County EMS
protocols9that directed first responders on how to
simultaneously disengage from a scene once law
enforcement made the determination that “de-escalation” was the appropriate tactic rather than a “hands-on”
approach that could lead to use-of-force resulting in
injury or death to the subject. Law enforcement officers could then request a crisis intervention team to respond with a licensed social worker, engage in verbal deescalation, and/or choose to leave the scene and reengage later.
August 2022
Controlled Substance
Inventory Control
Sworn personnel received training on Operative IQ, the
Department’s new cloud-based Drug Enforcement
Agency compliant inventory control system for
controlled substances, providing greater cost efficiency and control by improving inventory tracking, expiration monitoring, usage, disposal, and procurement.
December
2022
9 https://emsagency.sccgov.org/sites/g/files/exjcpb266/files/prehospital-care-policy-600/Policy%20618.pdf
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
Training Description Completion
Geriatric EMS Patients Sworn personnel received training focusing on how to conduct patient assessments for older adults, age-related changes to body systems, and transport/movement
considerations.
December
2022
Health Insurance
Portability and
Accountability Act of
199610 (HIPAA)
Sworn personnel received refresher training focused on
protecting sensitive patient health information from being disclosed without the patient’s consent or knowledge as required by law.
December
2022
Trauma Care Sworn personnel received training on administration of pain medications, suspected spinal injury care, and
patient triage for vehicle accident victims.
December
2022
Active Assailant/
Shooter
Fire and Police Department personnel conducted joint
scenario-based training to support safe and efficient
response to active shooter events, providing for rapid
rescue, triage, treatment, and transport of trauma victims.
June 2023
In Fiscal Year 2022-2023, the Department worked to address critical equipment procurement and replacement needs to continue to meet EMS care protocols and standardization across all response units. In Fiscal Year 2022-2023, the Department procured the following:
Equipment Description
LifePak 1000
Automatic External
Defibrillators
These devices are used by BLS providers (EMT) and deployed on satellite apparatus that are typically staffed by EMTs (i.e., water tenders, Type 6 engines, battalion chief, or overhead vehicles). In Fiscal Year 2022-2023, the Department replaced 12 LifePak 1000 units that were expiring and at their end of service date.
LifePak 15 V4+
Cardiac Monitor &
Defibrillator
These units are used by ALS providers (paramedic) and are deployed on all front-line ALS companies (i.e. engines, trucks, and rescue medics). These highly versatile units are employed at almost all EMS responses and can stream patient data to downstream care providers. In Fiscal Year 2022- 2023, the Department replaced 20 units.
LUCAS 3 Mechanical
Chest Compression
Device
In Fiscal Year 2022-2023, the Department was able to deploy these devices on all front-line ALS response units. Once applied, these devices provide hands-free consistent/high-quality chest compressions, freeing responders to initiate other life-saving therapies.
Department Staffing
As COVID-19 lockdown actions persisted in 2020 and 2021, paramedic development slowed dramatically. Students at that time were unable to initiate or resume education and training toward licensure at all phases of development including initial classroom, clinical, and internship. As a result, ALS providers across the state struggled to maintain staffing levels. The Department experienced the impacts of the shortage, finding few licensed paramedics in 10 https://www.cdc.gov/phlp/publications/topic/hipaa.html
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
applicant pools amidst increasing vacancies created by attrition. The result was increased and excessive demand for overtime on Firefighter/Paramedics. In response, the Department asked former paramedics in the ranks of Fire Engineer and Fire Captain to reactivate their paramedic licensure and accreditation to ease pressure on the Firefighter/Paramedics. This strategy proved successful. In December of 2022, Firefighter/Paramedic mandatory overtime hours peaked to approximately 9,000 hours and was reduced to less than 2,000 hours in July of 2023 as reflected in Chart 6 below.
Chart 6: Firefighter Paramedic Mandatory Call Back Hours and Support Paramedics
EVALUATION AND FOLLOW-UP
The Department will return to the Public Safety, Finance and Strategic Support Committee in Fiscal Year 2024-2025 with its next annual report regarding EMS activity and delivery.
COORDINATION
This memorandum has been coordinated with the City Attorney’s Office and the City Manager’s Budget Office.
24 28
34 42
54 58 61 63 66
0 20
40 60
80 -
2,000
4,000
6,000
8,000
10,000
Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Personnel
Hours
Support Paramedics FF/PM-MCB Hours
PUBLIC SAFETY, FINANCE AND STRATEGIC SUPPORT COMMITTEE
March 6, 2024
Subject: Santa Clara County 9-1-1 Ambulance Services Status Report and Fire Department Emergency Medical Services Annual Report
PUBLIC OUTREACH
This memorandum will be posted on the City’s Council Agenda website for the April 23, 2024 City Council meeting.
COMMISSION RECOMMENDATION AND INPUT
No commission recommendation or input is associated with this action.
CEQA
Not a Project, File No. PP17-009, Staff Reports, Assessments, Annual Reports, and Informational Memos that involve no approvals of any City action
PUBLIC SUBSIDY REPORTING
This item does not include a public subsidy as defined in section 53083 or 53083.1 of the California Government Code or the City’s Open Government Resolution.
ROBERT SAPIEN, JR.
Fire Chief, Fire Department
For questions, please contact Robert Sapien, Jr., Fire Chief, at [email protected] or (408) 794-6952.