EXCELLENCE IN SERVICE
• Every individual, regardless of nationality, race, creed, religion, sex, or status has intrinsic value and should be treated with dignity and respect
• Each professional encounter should reflect courtesy, compassion, and concern
• Each patient should receive the highest quality service possible based on accepted prehospital standards
• We must refrain from behaviors which impair our professional judgment or our ability to practice competently
• Patient confidentiality and privacy should be preserved and respected at all times
• Meeting the needs of the public and other customers should always be our first priority
• Each of us has a responsibility to contribute toward an improved community
EXCELLENCE IN PRACTICE
• Prehospital care is both a science and an art
• We should support collaboration with other health care team members to meet the needs of our patients
• We should promote public education to prevent illness and injury and encourage appropriate system use
• We are accountable to our patients, as well as to our colleagues and peers for our professional practice
• Monitoring and evaluating the services we provide is our responsibility and is necessary to continuously improve
• We should pursue professional growth and development through continuing education, participation in professional organizations, and support of pre-hospital research
• In a situation where there may be a conflict of interest, our ultimate obligation is to the public we serve.
EXCELLENCE IN LEADERSHIP
• We should promote a supportive professional environment, which is guided by responsibe stewardship
• We should actively encourage collaborative decision-making by those who are closest to the situation
• We should be sensitive to others and offer support, praise, and recognition to encourage both professional and personal development
• We should possess both an energy level and personal style that empowers and inspires enthusiasm in others
• Suggestion and criticisms should be perceived as a challenge for improvement and innovation.
• Equity and fairness should be reflected in all our policies and procedures.
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 existing private ambulance company terminated their contract with the County. The Board of Supervisors and a couple of Fire Chiefs proposed to change the existing system to a fire based system and 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.. 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 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 Advanced Life Support engines.
Key components of the JPA system include:
• Medical Control
• Centralized Dispatch Center with Emergency Medical Dispatch Trained Personnel
• 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 & Management
• Firefighter/Paramedic Personnel from Sub-contracting Fire Agencies Staffing the Ambulances
• Compliance with Standards
Members of the JPA include the following agencies:
• CAL FIRE – Emergency Command Center
• 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
• Mosquito Fire Protection District
• Pioneer Fire Protection District
• Rescue Fire Protection District
• Marshall Medical Center
Sub-contracting Fire agencies to the JPA operate the medic units and are paid an annual fixed rate for their costs with funds from CSA7. These costs include personnel, operating expenses, equipment and administrative overhead. Non-transporting sub-contracting fire agencies do not receive funds from CSA7 for medical supplies and training. Some of these 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 ambulance submits the budget request 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 firefighter/paramedics and other medical workers.