Emergency Ground Ambulance Contract #12-254

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ICEMA initial response to the recommendation

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ICEMA response to the Civil Grand Jury inquiry

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2019-2020 Civil Grand Jury’s current status of the recommendation

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2019-2020 Civil Grand Jury’s conclusion RECOMMENDATION 18-12 Create one Exclusive Operating Area (EOA) that covers the entire County. This would allow one provider to cover the County and require the provider to service populated and rural areas. If one EOA were created to encompass the remaining sixteen EOAs, the current provider could retain grandfathering protection. INITIAL RESPONSE State Law prohibits grandfathering protection as described by the grand jury, therefore ICEMA cannot create one EOA that covers the entire county in the foreseeable future as certain contract providers have contractual rights to provide services in their respective areas for varying lengths of time. As these contracts head toward expiration, ICEMA will consider moving toward creating one EOA that covers the entire county. San Bernardino County Grand Jury Final Report The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-12 resulted in the subsequent response from the County of San Bernardino: Question Reference 18-12 There is no progress to report due to State law continuing to prohibit grandfathering protection as described in the previous response to the Grand Jury Report. Several of the current ambulance providers have either California Health or Safety Code, Sections 1797.224 or 1797.226 conferred, or contractual rights to provide services that remain intact until specific census metrics are reached, which will not occur in the foreseeable future. CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. RECOMMENDATION 18-13 Create a Request for Proposal (RFP) for a new service provider. INITIAL RESPONSE As the process moves forward, ICEMA will work to identify the approach that best serves the public. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-13 resulted in the subsequent response from the County of San Bernardino: 29 San Bernardino County Grand Jury Final Report CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges the response of ICEMA. There is no RFP process in place and there will not be one until progress is made on Recommendation 18-12. RECOMMENDATION 18-14 Present a new contract to the Board of Supervisors. INITIAL RESPONSE A contract would not be presented to the Board of Supervisors but rather the ICEMA Board of Directors. This would occur following a resolution to the issues outlined in the responses. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-14 resulted in the subsequent response from the County of San Bernardino: No, as there is no resolution to 18-12 and 18-13. On March 19, 2019, Contract 12-254 (Amendment No.8: Item 46) was amended to extend the agreement three (3) years, for the period of April 1, 2019 through March 31, 2022. CURRENT STATUS The 2019-20 San Bernardino County Civil Grand Jury acknowledges the response from ICEMA. On March 19, 2019 the ICEMA Board of Directors approved a three year extension for Contract 12-254 until March 31, 2022. CONCLUSION The 2019-20 Civil Grand Jury acknowledges the responses from ICEMA and there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. Consequently, there is no RFP process in place. Lastly, on March 19, 2019 the ICEMA Board of 30 San Bernardino County Grand Jury Final Report Directors approved a three year extension for Contract 12-254 (as amended) until March 31, 2022. San Bernardino County Grand Jury Final Report FISCAL YEAR 2013-2014 RECONCILIATION REPORT

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ICEMA response to the Civil Grand Jury inquiry

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2019-2020 Civil Grand Jury’s current status of the recommendation

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2019-2020 Civil Grand Jury’s conclusion RECOMMENDATION 18-12 Create one Exclusive Operating Area (EOA) that covers the entire County. This would allow one provider to cover the County and require the provider to service populated and rural areas. If one EOA were created to encompass the remaining sixteen EOAs, the current provider could retain grandfathering protection. INITIAL RESPONSE State Law prohibits grandfathering protection as described by the grand jury, therefore ICEMA cannot create one EOA that covers the entire county in the foreseeable future as certain contract providers have contractual rights to provide services in their respective areas for varying lengths of time. As these contracts head toward expiration, ICEMA will consider moving toward creating one EOA that covers the entire county. San Bernardino County Grand Jury Final Report The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-12 resulted in the subsequent response from the County of San Bernardino: Question Reference 18-12 There is no progress to report due to State law continuing to prohibit grandfathering protection as described in the previous response to the Grand Jury Report. Several of the current ambulance providers have either California Health or Safety Code, Sections 1797.224 or 1797.226 conferred, or contractual rights to provide services that remain intact until specific census metrics are reached, which will not occur in the foreseeable future. CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. RECOMMENDATION 18-13 Create a Request for Proposal (RFP) for a new service provider. INITIAL RESPONSE As the process moves forward, ICEMA will work to identify the approach that best serves the public. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-13 resulted in the subsequent response from the County of San Bernardino: 29 San Bernardino County Grand Jury Final Report CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges the response of ICEMA. There is no RFP process in place and there will not be one until progress is made on Recommendation 18-12. RECOMMENDATION 18-14 Present a new contract to the Board of Supervisors. INITIAL RESPONSE A contract would not be presented to the Board of Supervisors but rather the ICEMA Board of Directors. This would occur following a resolution to the issues outlined in the responses. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-14 resulted in the subsequent response from the County of San Bernardino: No, as there is no resolution to 18-12 and 18-13. On March 19, 2019, Contract 12-254 (Amendment No.8: Item 46) was amended to extend the agreement three (3) years, for the period of April 1, 2019 through March 31, 2022. CURRENT STATUS The 2019-20 San Bernardino County Civil Grand Jury acknowledges the response from ICEMA. On March 19, 2019 the ICEMA Board of Directors approved a three year extension for Contract 12-254 until March 31, 2022. CONCLUSION The 2019-20 Civil Grand Jury acknowledges the responses from ICEMA and there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. Consequently, there is no RFP process in place. Lastly, on March 19, 2019 the ICEMA Board of 30 San Bernardino County Grand Jury Final Report Directors approved a three year extension for Contract 12-254 (as amended) until March 31, 2022. San Bernardino County Grand Jury Final Report FISCAL YEAR 2013-2014 RECONCILIATION REPORT

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2019-2020 Civil Grand Jury’s conclusion RECOMMENDATION 18-12 Create one Exclusive Operating Area (EOA) that covers the entire County. This would allow one provider to cover the County and require the provider to service populated and rural areas. If one EOA were created to encompass the remaining sixteen EOAs, the current provider could retain grandfathering protection. INITIAL RESPONSE State Law prohibits grandfathering protection as described by the grand jury, therefore ICEMA cannot create one EOA that covers the entire county in the foreseeable future as certain contract providers have contractual rights to provide services in their respective areas for varying lengths of time. As these contracts head toward expiration, ICEMA will consider moving toward creating one EOA that covers the entire county. San Bernardino County Grand Jury Final Report The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-12 resulted in the subsequent response from the County of San Bernardino: Question Reference 18-12 There is no progress to report due to State law continuing to prohibit grandfathering protection as described in the previous response to the Grand Jury Report. Several of the current ambulance providers have either California Health or Safety Code, Sections 1797.224 or 1797.226 conferred, or contractual rights to provide services that remain intact until specific census metrics are reached, which will not occur in the foreseeable future. CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. RECOMMENDATION 18-13 Create a Request for Proposal (RFP) for a new service provider. INITIAL RESPONSE As the process moves forward, ICEMA will work to identify the approach that best serves the public. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-13 resulted in the subsequent response from the County of San Bernardino: 29 San Bernardino County Grand Jury Final Report CURRENT STATUS The 2019-20 Civil Grand Jury acknowledges the response of ICEMA. There is no RFP process in place and there will not be one until progress is made on Recommendation 18-12. RECOMMENDATION 18-14 Present a new contract to the Board of Supervisors. INITIAL RESPONSE A contract would not be presented to the Board of Supervisors but rather the ICEMA Board of Directors. This would occur following a resolution to the issues outlined in the responses. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-14 resulted in the subsequent response from the County of San Bernardino: No, as there is no resolution to 18-12 and 18-13. On March 19, 2019, Contract 12-254 (Amendment No.8: Item 46) was amended to extend the agreement three (3) years, for the period of April 1, 2019 through March 31, 2022. CURRENT STATUS The 2019-20 San Bernardino County Civil Grand Jury acknowledges the response from ICEMA. On March 19, 2019 the ICEMA Board of Directors approved a three year extension for Contract 12-254 until March 31, 2022. CONCLUSION The 2019-20 Civil Grand Jury acknowledges the responses from ICEMA and there has been no progress by ICEMA on the recommendations developed by the FY2017-2018 Civil Grand Jury due to state law provisions prohibiting grandfathering and due to the contractual rights of the ambulance providers to provide services in their respective areas for varying lengths of time. Consequently, there is no RFP process in place. Lastly, on March 19, 2019 the ICEMA Board of 30 San Bernardino County Grand Jury Final Report Directors approved a three year extension for Contract 12-254 (as amended) until March 31, 2022. San Bernardino County Grand Jury Final Report FISCAL YEAR 2013-2014 RECONCILIATION REPORT

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Original FY2017-2018 Grand Jury -Report recommendations

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Original HUSD initial response to the recommendations

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Current status ORIGINAL RECOMMENDATION 18-4 Provide all District personnel with training on sexual harassment, sexual assault and sexual battery, defining the elements of each in accordance with Penal Code 243.4.* Training should include a third party expert such as personnel from the Crimes Against Children Unit, San Bernardino County Sheriff’s Department. INITIAL RESPONSE: We are currently exploring the available training to include the elements of Penal Code 243.4* and mandated reporting requirements under Penal Code 11166**. We hope to have a training schedule in place within the 60 days. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-4 resulted in the subsequent response from the County of San Bernardino: 35 San Bernardino County Grand Jury Final Report

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Original HUSD initial response to the recommendations

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Current status ORIGINAL RECOMMENDATION 18-4 Provide all District personnel with training on sexual harassment, sexual assault and sexual battery, defining the elements of each in accordance with Penal Code 243.4.* Training should include a third party expert such as personnel from the Crimes Against Children Unit, San Bernardino County Sheriff’s Department. INITIAL RESPONSE: We are currently exploring the available training to include the elements of Penal Code 243.4* and mandated reporting requirements under Penal Code 11166**. We hope to have a training schedule in place within the 60 days. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-4 resulted in the subsequent response from the County of San Bernardino: 35 San Bernardino County Grand Jury Final Report

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Current status ORIGINAL RECOMMENDATION 18-4 Provide all District personnel with training on sexual harassment, sexual assault and sexual battery, defining the elements of each in accordance with Penal Code 243.4.* Training should include a third party expert such as personnel from the Crimes Against Children Unit, San Bernardino County Sheriff’s Department. INITIAL RESPONSE: We are currently exploring the available training to include the elements of Penal Code 243.4* and mandated reporting requirements under Penal Code 11166**. We hope to have a training schedule in place within the 60 days. The 2019-2020 SAN BERNARDINO CIVIL GRAND JURY request for additional information from the County of San Bernardino regarding Recommendation 18-4 resulted in the subsequent response from the County of San Bernardino: 35 San Bernardino County Grand Jury Final Report

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