History of the Ambulance Service and the JPA
In The Beginning
The Western Slope of El Dorado County began with a total of two ambulances. One was Foothill Ambulance, a private provider, and the Pollock Pines Fire Protection District. In 1976 the Board of Supervisors and a couple of Fire Chiefs proposed to change the existing system to meet the population demands and the increasing needs for ambulance services on the Western Slope.
Establishment of County Service Area #7
The El Dorado County Board of Supervisors authorized a General Election to be held November 2, 1976, to determine if a County Service Area No. 7 should be established to provide ambulance service with a maximum authorized tax rate of fifteen cents per $100 assessed valuation. The affected area designated as County Service Area No. 7 is generally described as follows: "All that portion of the County of El Dorado, State of California, lying westerly of the "Great Basin and Pacific Watershed Divide," commonly known as the western slope of El Dorado County including that portion of the western slope within the boundaries of the City of Placerville."
As a result of the successful election outcome Resolution No. 316-76 of the Board of Supervisors of the County of El Dorado was passed on December 7, 1976 organizing County Service Area #7 (CSA7) pursuant to the provisions of Section 25210.1 et seg of the Government Code of the State of California.
In July 1977, the first ambulance provider contracts were negotiated and signed between Diamond Springs/El Dorado and Pollock Pines Fire Protection Districts to provide ambulances services to the citizens of CSA7. These departments replaced the private ambulance provider with the first fire-based ambulances for CSA7. The CSA7 funds were used to provide funds for the staffing and medical supplies for the ambulances.
In the following years ambulances were added to the system as the population and the medical incidents increased. In 1981 an ambulance was added to the Georgetown Fire District to cover the northeast portion of the County. In 1985 ambulances were added to Pleasant Valley and Cameron Park areas. In 1991 an ambulance was added for the City of Placerville. In 2001 an ambulance was added to the El Dorado Hills area, and in 2004 an ambulance was added to Diamond Springs/El Dorado.
This is a total of nine ambulances, most of them with backup units staged in the County at all times. These ambulances are used for the benefit of all and as they are assigned to various Districts or areas, they can be relocated, as needed, around the County.
The Joint Powers Authority
In order to provide a more comprehensive emergency medical system it was recommended that the Fire Districts develop a Joint Powers Authority. In 1996 the El Dorado County Regional Prehospital Emergency Services Operations Authority (JPA) was formed for the purpose of ensuring automatic aid between the fire agencies in the emergency medical service in El Dorado County and for the delivery of an extensive, prehospital emergency medical service in an efficient manner without regard to jurisdictional boundaries.
A joint Emergency Command Center would dispatch the closest fire unit and the simultaneous dispatch, the closest medic unit (ambulance). Prior to the JPA there were limited Advanced Life Support engines; the primary goal was to increase the number of ALS engines.
Key components of the JPA system include:
- Medical Control
- Operational Coordination
- Centralized Dispatch Center
- Countywide fee structure
- Centralized billing
- Single West Slope of the county emergency and non-emergency transport system
- Optimum ambulance placement
- Cross training of EMS Personnel
- Rescue and Extrication Expertise
- Daily Training
- Equipment Maintenance and management
- Compliance with standards
Members of the JPA include the following agencies:
- Cameron Park Community Services District
- Diamond Springs/ El Dorado Fire Protection District
- El Dorado County Fire Protection District
- El Dorado Hills Fire Protection District
- Georgetown Fire Protection District
- Garden Valley Fire Protection District
- Latrobe Fire Protection District
- Mosquito Fire Protection District
- Pioneer Fire Protection District
- Rescue Fire Protection District
Provider Member Agencies operate the medic units and receive funds from CSA7 for personnel, operating expenses, equipment and administrative overhead. Non-providers receive funds from CSA7 for medical supplies and training. Some of these member agencies operate full-time paramedic engines while others operate part-time advanced life support engines.
El Dorado County Board of Supervisors
The EL Dorado County Board of Supervisors is responsible for the fiscal management of County Service Area #7 (CSA7). Annually the JPA prepares a proposed budget for personnel, operating expenses and fixed assets to the Public Health Department. Public Health reviews and approves the proposed budget for ambulances services and consolidates the JPA's budget with the EMS Agency's request for funds from CSA7 revenues and submits the requests to the Board of Supervisors.
Public Health Department
The Public Health Department is responsible for medical oversight within the County of El Dorado. The Public Health Department is responsible for the preparation and execution of provider contracts between the County and the JPA. The contracts define the roles and responsibilities of the County and the JPA, which is considered a contractor, to provide ambulance and dispatch services within CSA7. Ambulance Billing, the Medical Director and the EMS Administrator are under the direction of the Public Health Department, These three functions report to the Emergency Medical Services Agency.
Emergency Medical Agency Administrator
The EMS Administrator is responsible for administering the master contract between the County of El Dorado and the JPA. These responsibilities include contract compliance, development of policies and procedures that affect the JPA and the County, inspection of equipment and ride-a-long with the paramedics. The position also supervises the staff in ambulance billing.
Ambulance Billing is responsible for the processing of all Patient Care Reports which includes reviewing for accuracy, billing the appropriate health insurance carrier, and following up to assure that payment has been received for services provided. If a bill is not paid in a timely manner, the bill is forwarded to the County Counsel for collection.
Emergency Medical System Medical Director
The EMS Medical Director is responsible for the overall medical direction of the JPA. These responsibilities include the development of medical protocols, policies and practices. The Medical Director is responsible for medical quality assurance programs that monitor the performance of the medical providers and system.
The responsibility of the JPA Executive Director is to interface with the Public Health Department to implement the provisions of the Master Contract and develop an annual budget to provide emergency dispatch services to the citizens of CSA7. The Executive Director coordinates with the EMS Agency to develop protocols and procedures that provide medical direction to the paramedics and other medical workers.