City Council
Report
City Council Meeting: April 14, 2026
Agenda Item: 4.D
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To: Mayor and City Council
From: Oscar Santiago, Director, Finance Department, Risk Management Subject: Adoption of a Resolution to Join Public Risk Innovation, Solutions, and Management (PRISM), a Joint Powers Authority for City's Advanced Provider Unit (APU) Program
Recommended Action
Staff recommends that the City Council:
1. Adopt a finding of no possibility of significant effect pursuant to Section 15061(b)(3) (Common Sense Exemption) of the California Environmental Quality Act (CEQA) Guidelines; and
2. Adopt the attached resolution approving the City of Santa Monica’s membership with Public Risk Innovation, Solutions, and Management (PRISM), a Joint Powers Authority, for the City’s Advanced Provider Unit (APU) Program.
Summary
The City’s Advanced Provider Unit (APU) program utilizes contracted Nurse Practitioners paired with Firefighter Paramedics to provide field-based clinical care, resulting in a medical malpractice exposure that is not covered under existing City insurance policies. Although Nurse Practitioners maintain individual professional liability insurance, these policies do not adequately protect the City from related malpractice claims.
PRISM is a statewide Joint Powers Authority (JPA) and the nation’s largest memberdirected risk-sharing pool for public entities. It offers broad, cost-effective medical malpractice coverage. The cost of PRISM coverage is approximately equal to the combined cost of the two medical malpractice policies the City currently maintains.
Membership will provide high-limit malpractice coverage for APU operations and 2 of 3
eliminate the need for these separate policies. It will also position the City to obtain appropriate, scalable coverage for any future programs involving medical or other specialized operational risks. Coverage has been placed retroactively to November 3, 2025, to match the start of the APU program, pending Council approval of PRISM membership.
Discussion
The City incurs malpractice exposure whenever APU personnel perform clinical assessments, make treatment or medical-clearance decisions, or provide follow-up care in the field. Nurse Practitioners carry individual professional liability insurance with limits of $1 million per occurrence. However, those policies do not extend to the City’s broader malpractice exposure. PRISM coverage would close this gap. It would provide the City with malpractice limits of $21,475,000 per occurrence, subject to certain exclusions and a $25,000 deductible.
PRISM’s statewide public-agency structure, financial strength, and long-term rate stability make it an appropriate and reliable mechanism for insuring the City’s APUrelated risk. Membership would also remove the need to buy separate malpractice coverage for the Fire Department’s Medical Director and EMS Coordinator. The total annual cost of these existing policies is about equal to the cost of getting comprehensive, high-limit coverage through PRISM.
Environmental Review
This contract is exempt from CEQA pursuant to Section 15061(b)(3) of the CEQA Guidelines. The agreement is covered by the common sense exemption, which states that CEQA does not apply, “where it can be seen with certainty that there is no possibility that the activity in question may have a significant effect on the environment.” The action involves approval of the City’s membership with a JPA and does not entail any physical change to the environment. Therefore, it can be stated with certainty that the action will not result in adverse physical environmental impacts and is consequently exempt from CEQA.
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Financial Impacts and Budget Actions
There is no immediate financial impact or budget action necessary as a result of the recommended action. Staff will return to Council if specific budget actions are required in the future. The estimated premium costs are $7,838 for FY 2025-26 and $11,912 for FY 2026-27. Funding has already been allocated in the Self-Insurance, Liability and Auto Fund within the FY 2025-27 Biennial Budget.
Prepared By: Oles Gordeev, Risk Manager
Approved Forwarded to Council
Attachments:
A. Attachment A - PRISM Resolution 4.14.26
B. Attachment B - PRISM Joint Powers Agreement