Measure B Special Tax Revenue Fund for Trauma Centers, Emergency Medical Services, and Bioterrorism Response

COUNTY OF LOS ANGELES DEPARTMENT OF AUDITOR-CONTROLLER KENNETH HAHN HALL OF ADMINISTRATION 500 WEST TEMPLE STREET, ROOM 525 LOS ANGELES, CALIFORNIA 90012-3873 PHONE: (213) 974-8301 FAX: (213) 626-5427 OSCAR VALDEZ ASSISTANT AUDITOR-CONTROLLERS AUDITOR-CONTROLLER MAJIDA ADNAN CONNIE YEE RACHELLE ANEMA CHIEF DEPUTY AUDITOR-CONTROLLER ROBERT G. CAMPBELL December 24, 2024 TO: Supervisor Kathryn Barger, Chair Supervisor Hilda L. Solis, Chair Pro Tem Supervisor Holly J. Mitchell Supervisor Lindsey P. Horvath Supervisor Janice Hahn FROM: Oscar Valdez Auditor-Controller SUBJECT: MEASURE B SPECIAL TAX REVENUE FUND FOR TRAUMA CENTERS, EMERGENCY MEDICAL SERVICES, AND BIOTERRORISM RESPONSE Section 8 of the Los Angeles County Board of Supervisors (Board) Measure B Resolution requires the County Auditor-Controller to file an annual statement of financial activity with your Board no later than January 1st of each year. Accordingly, Attachment I reflects the Statement of Financial Activity for the Health Services Measure B Special Tax Fund for the Fiscal Year (FY) ended June 30, 2024. The Statement includes a summary of the amount of funds collected and expended pursuant to Measure B. Section 8 also requires a status of projects required or authorized to be funded pursuant to Sections 3, 6, and 7 of the Resolution. Accordingly, Attachment II presents the Status of Measure B Projects for FY 2023-24 as provided by the Department of Health Services (DHS). If you have any questions related to the Statement of Financial Activity please call me, or your staff may contact Jung Son at (213) 974-8327 or via e-mail at jeson@auditor.lacounty.gov. Questions related to the status of Measure B Projects may be directed to Ferris Ling of DHS at (626) 525-5800 or via e-mail at fling@dhs.lacounty.gov. OV:CY:RA:EW:JS H:\Special Funds\Special Funds Unit\MEASURE B-BW9\FY2023-24 Attachments c: Fesia A. Davenport, Chief Executive Officer Edward Yen, Executive Officer, Board of Supervisors Christina R. Ghaly, M.D., Director, Department of Health Services Jeffrey Prang, Assessor Elizabeth Buenrostro Ginsberg, Treasurer and Tax Collector Help Conserve Paper – Print Double-Sided “To Enrich Lives Through Effective and Caring Service” Attachment I Page 1 of 3 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Statement of Financial Activity For the Fiscal Year Ended June 30, 2024 Revenues: Voter Approved Special Taxes - Current Year $ 3 31,899,709 Voter Approved Special Taxes - Prior Year 2 ,051,091 Penalties, Interest & Costs - Delinquent Taxes 9 59,050 Interest Earnings 6 ,333,684 Prior Years’ Refunds - Physician and Hospital Claims 1 01,269 Total Revenues $ 3 41,344,803 Current Year Expenditures: Services and Supplies: Non-County Trauma Hospitals (Direct Payment) Trauma Center Provisions for Reimbursement (TCPR) Antelope Valley Hospital (AVH) $ 6 ,574,295 Ronald Reagan UCLA Medical Center (UCLA) 6 ,237,602 2023 Measure B Advisory Board (MBAB) Projects: Antelope Valley Hospital $ 1,822,031 California Hospital Medical Center 732,486 Cedars-Sinai Medical Center 732,486 Children's Hospital Los Angeles 732,486 Henry Mayo Newhall Memorial 732,486 Huntington Memorial Hospital 732,486 Long Beach Memorial Medical Center 732,486 Northridge Hospital Medical Center 732,486 Pomona Valley Hospital Medical Center 732,486 Providence Holy Cross Medical Center 732,486 Ronald Reagan UCLA Medical Center 1,669,461 St. Francis Medical Center 732,486 St. Mary Medical Center 732,486 Total MBAB Projects funded by Services and Supplies 1 1,548,838 Total Non-County Trauma Hospitals (Direct Payments) $ 24,360,735 Enhanced Trauma Access City of Los Angeles Fire Dept.- Trauma Air Transport $ 4 40,000 Total Enhanced Trauma Access 440,000 Physician Services for Indigents Program (PSIP) PSIP - Trauma $ 8 46,486 (a) PSIP - Emergency Room 4 ,462,319 (a) PSIP - Refunds / Canceled Warrants (8,280) Total PSIP 5,300,525 Auditor-Controller Services 775,788 Total Services and Supplies $ 3 0,877,048 Other Charges - Intergovernmental Transfer (IGT): IGT for non-County Trauma Hospitals - FY 2023-24 (TCPR) $ - (b) IGT Refund for FY 2022-23 TCPR (8,480,468)(c) Total Other Charges (8,480,468) Other Financing Uses - Operating Transfers Out: Enhanced Trauma Access County Fire Department - Air Ambulance Services $ 2 ,640,000 Sheriff’s Department - Air Search and Rescue 1 ,320,000 Total Enhanced Trauma Access $ 3,960,000 County Hospitals and Martin Luther King, Jr. Community Hospital (MLKCH): LA General Medical Center $ 100,187,000 Harbor-UCLA Medical Center 67,458,000 Olive View-UCLA Medical Center 39,453,000 Subtotal $ 2 07,098,000 MLKCH IGT 3 5,303,000 Total County Hospitals and MLKCH $ 242,401,000 County Public Health: Bioterrorism ($9.86m/year) Salaries & Employee Expenses $ 7,513,239 Other Operating Expenses 2,348,761 Total Bioterrorism $ 9 ,862,000 Trauma Prevention Initiative (TPI) - Base ($685k/year) Salaries & Employee Expenses $ 232,717 Attachment I Page 2 of 3 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Statement of Financial Activity For the Fiscal Year Ended June 30, 2024 Other Operating Expenses 452,283 Total TPI - Base 6 85,000 TPI - Expansion ($1.30m/year) Salaries & Employee Expenses $ 430,272 Other Operating Expenses 869,728 Total TPI - Expansion 1 ,300,000 Risk Communication ($365k/year) Salaries & Employee Expenses $ 296,543 Other Operating Expenses 68,871 Total Risk Communication 3 65,414 Emergency Preparedness Overtime for Environmental Health Strike Team ($500k/year) Salaries & Employee Expenses $ 405,763 Other Operating Expenses 94,237 Total Environmental Health Strike Team 5 00,000 Office of Violence Prevention (OVP) Operations & Contracts Services ($3m/year) Salaries & Employee Expenses $ 778,734 Other Operating Expenses 2,221,266 Total OVP Operations 3 ,000,000 OVP Trauma Prevention Initiative (TPI) - Reducing Violence Countywide ($2m/year) Salaries & Employee Expenses $ 620,085 Other Operating Expenses 1,379,915 Total OVP TPI 2 ,000,000 Total Public Health 17,712,414 Department of Health Services Emergency Medical Services (EMS) Administration Salaries & Employee Expenses $ 1,487,465 Other Operating Expenses 268,535 Total Administration $ 1 ,756,000 Trauma & Emergency Medicine Information System (TEMIS) 1 ,639,746 (e)* Total EMS 3,395,746 City of Long Beach - EMS, Bio., & Trauma & Violence Prevention Program Salaries & Employee Expenses $ 977,684 Other Operating Expenses 22,316 Total City of Long Beach 1,000,000 City of Pasadena - EMS, Bio., & Trauma & Violence Prevention Program Salaries & Employee Expenses $ 24,354 Other Operating Expenses 30,412 Total City of Pasadena 5 4,766 County Human Relations Commission (HRC) - Anti-Hate Initiative Other Operating Expenses $ 123,088 Total HRC 1 23,088 Total Other Ongoing Funding 1,177,854 MBAB Projects: 2018 MBAB - LA County Fire Dept - Advanced Provider Response Units $ 1 29,747 (e) 2021 MBAB - LA County EMS - Hospital Emergency Response Team (HERT) Preparedness 5 ,033 2021 MBAB - LA County Fire Dept - Assessment Engines Expansion - (e) Total MBAB Projects funded under Operating Transfers Out 134,780 Total Other Financing Uses - Operating Transfers Out $ 2 68,781,794 Total FY 2023-2024 Expenditures $ 2 91,178,374 Prior Year Expenditures: IGT for Non-County Hospitals - FY 2022-23 $ 41,431,988 LA City Fire Dept - Expanded Access Air Transport 169,376 2019 MBAB - Children's Hospital Special Needs Car Seat Resource Program 48,158 2021 MBAB - LA City Fire Dept - Flight Data Monitoring 101,808 2021 MBAB - Hawthorne Police Dept - Stop the Bleed Training 21,000 Attachment I Page 3 of 3 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Statement of Financial Activity For the Fiscal Year Ended June 30, 2024 2021 MBAB - Compton Fire Dept - Automated Emerg. Defibrillators (AEDs) 21,972 2021 MBAB - UCLA - Instr. Designer & EMS Educators to Curate Lessons - (e) Reversal of Prior Year Over-Accrued PSIP Expenditures (526) Total Prior Year Expenditures 4 1,793,776 Grand Total Expenditures $ 3 32,972,150 Revenues Over Expenditures $ 8 ,372,653 Less: Contractual Obligations Prior Year Commitments as of July 1, 2023 $ 42,067,636 Outstanding Commitments as of June 30, 2024 (48,596,438)(d) Net Change in Contractual Obligations (6,528,802) Net Change in Fund Balance $ 1 ,843,851 Fund Balance, July 1, 2023 5 1,763,690 Fund Balance Closing, June 30, 2024 $ 5 3,607,541 Less: Carryovers for Projects to be Spent in FY 2024-25 (888,163)(e) Obligations for Future Years (34,010,000)(f) (34,898,163) Adjusted Available Fund Balance, June 30, 2024 $ 1 8,709,378 (g) FOOTNOTES: (a) Includes estimated accrued expenditures in the amounts of $0.62 million and $4.46 million for trauma and ER claims, respectively. (b) An encumbrance was established in the amount of $48.60 million for FY 2023-24 intergovernmental transfer (IGT) payments for the Non-County trauma hospitals. A payment was issued to the State of California in July 2024 and will be reflected in the FY 2024-25 Measure B report. Also refer to footnote (d). (c) State of California refunded for FY 2022-23 IGT payments due to an increase of federal share in enhanced trauma payments as allowed by the Affordable Care Act. (d) The fund had an outstanding commitment of $48,596,438 for FY 2023-24 IGT payments for Non-County trauma hospitals. (e) As of June 30, 2024, the following projects were carried forward to FY 2024-25 to be funded using the fund balance: 2018 MBAB - LA County Fire Dept. - Two Advanced Provider Response Units $ 28,361 2021 MBAB - LA County Fire Dept. - Assessment Engines Expansion 82,483 2021 MBAB - UCLA - Instructional Designer & EMS Educators to Curate Lessons 1 85,065 FY 2023-24 DHS EMS Agency - TEMIS 5 92,254 Total Carryovers $ 888,163 (f) The following projects that were not in FY 2023-24 Adopted Final Budget are to be funded using Measure B fund balance: Various MBAB Projects for 2023 $ 9 ,917,000 FY 2024-25 DHS EMS Agency - TEMIS 1 ,918,000 FY 2025-26 DHS EMS Agency - TEMIS 1 ,737,000 FY 2026-27 DHS EMS Agency - TEMIS 4 38,000 FY 2023-24 MLKCH - Board Motion approved 1/23/2024 8 ,000,000 FY 2024-25 MLKCH - Board Motion approved 1/23/2024 4 ,000,000 FY 2025-26 MLKCH - Board Motion approved 1/23/2024 4 ,000,000 FY 2026-27 MLKCH - Board Motion approved 1/23/2024 4 ,000,000 Total Obligations $ 34,010,000 (g) The remaining $18.71 million represents unspent and unallocated Measure B funds. Prepared By: Los Angeles County Department of Health Services, Finance Reviewed By: Department of Auditor-Controller, Accounting Division Attachment II Page 1 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 COUNTYWIDE SYSTEM OF TRAUMA CENTERS – $242.40 million allocated to Los Angeles County (County) Hospitals; $72.96 million allocated to non-County hospitals County Hospitals and Martin Luther King, Jr. Community Hospital (MLKCH) A total of $242.40 million was included in the Fiscal Year (FY) 2023-24 Final Adopted Budget and allocated for trauma and emergency care services provided by LA General Medical Center, Harbor-UCLA Medical Center, Olive View-UCLA Medical Center, and MLKCH. LA General Medical Center $100.19 million Harbor-UCLA Medical Center 67.46 million Olive View-UCLA Medical Center 39.45 million Subtotal $207.10 million MLKCH - IGT 35.30 million Total $242.40 million Status: At the close of FY 2023-24, the $242.40 million was distributed to the three County Hospitals, totaling $207.10 million, based on estimated unreimbursed costs at each County hospital, as well as to Health Services Administration for the Intergovernmental Transfer (IGT) payment, with a net total of $35.30 million, in support of MLKCH under the MLK-LA lease agreement. Non-County Hospitals Department of Health Services entered into an agreement for Trauma Center Provisions of Reimbursement (TCPR) with 13 non-County hospitals for FY 2023-24. On June 4, 2024, the Board of Supervisors (Board) approved the FY 2023-24 funding methodology for the total allocation of $72.96 million in Measure B funds for the TCPR. Under the TCPR, $48.60 million of Measure B funds was used as an IGT payment to draw down $50.58 million* of federal Medi-Cal matching funds, of which $43.91 million was for 11 private hospitals and $6.67 million was for physician staffing for projects at 13 non-County trauma hospitals, except for Antelope Valley Hospital (AVH) and Ronald Reagan UCLA Medical Center (UCLA). As public hospitals, AVH and UCLA participate in a program that precludes them from receiving the Medi-Cal matching funds. In addition, $24.36 million was used as direct payments to the 13 non-County trauma hospitals. Attachment II Page 2 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 Measure B Federal Match* Total Trauma Services: AVH and UCLA $ 12.81 million $ 0.00 million $ 12.81 million 11 Private Hospitals 42.19 million 43.91 million 86.10 million Subtotal $ 55.00 million $ 43.91 million $ 98.91 million 2023 Measure B Advisory Board Projects for 13 Non-County Trauma Hospitals: Physician Staffing $ 8.44 million $ 6.67 million $ 15.11 million Data Collection 8.32 million 0.00 million 8.32 million Trauma Center Staff Education 0.60 million 0.00 million 0.60 million Stop the Bleed 0.60 million 0.00 million 0.60 million Subtotal $ 17.96 million $ 6.67 million $ 24.63 million Total $ 72.96 million $ 50.58 million $123.54 million *The private trauma hospitals received an additional $1.98 million in supplemental Medi-Cal funding. The $50.58 million Federal Medi-Cal match includes funding from additional enhanced Federal Medical Assistance Percentage (2.5% in the first quarter and 1.5% in the second quarter) allowed by the Families First Coronavirus Response Act for the period from July 1, 2023, to December 31, 2023. Status: Direct payments of approximately $24.36 million were issued to the 13 non- County trauma hospitals from DHS at the end of FY 2023-24. Balance: At the close of FY 2023-24, $48.60 million remained in the encumbrance awaiting the State’s instructions to send the IGT payment to the California Department of Health Care Services for the following hospitals: California Hospital Medical Center $ 6.99 million Cedars-Sinai Medical Center 4.92 million Children’s Hospital Los Angeles 3.39 million Henry Mayo Newhall Memorial 2.30 million Huntington Memorial Hospital 3.28 million Long Beach Memorial Medical Center 4.09 million Northridge Hospital Medical Center 4.86 million Pomona Valley Hospital Medical Center 4.63 million Providence Holy Cross Medical Center 4.50 million St. Francis Medical Center 6.05 million St. Mary Medical Center 3.59 million Total $48.60 million Attachment II Page 3 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 TRAUMA ACCESS EXPANSION TO UNDERSERVED AREAS – $4.40 million allocated The FY 2023-24 Final Adopted Budget included $4.40 million for expanded access to trauma services in order to maintain the infrastructure and facilitate the emergency air transport of trauma patients in the Antelope Valley, East San Gabriel Valley, San Fernando Valley, and Malibu. Air transport of trauma patients is sometimes necessary for these areas due to distance, traffic, weather conditions, etc. The budgeted funds were allocated as follows: Los Angeles County Fire Department $2.64 million Los Angeles County Sheriff’s Department 1.32 million City of Los Angeles Fire Department 0.44 million Total $4.40 million Status: A total of $4.40 million was transferred from the Measure B fund to the following departments: the County Fire Department for expanding the delivery of paramedic air squad services to County, $2.64 million; the County Sheriff’s Department for staffing and operational costs related to air search and rescue services in the Antelope Valley, $1.32 million; the City of Los Angeles Fire Department for providing trauma air transport services in the San Fernando Valley and surrounding communities, $0.44 million. An additional payment of $0.17 million was issued to the City of Los Angeles Fire Department in FY 2023-24 using the rollover funding from FY 2022-23 for prior year expenses. Balance: None. PHYSICIAN SERVICES FOR INDIGENTS PROGRAM – $5.30 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $5.30 million from Measure B revenues to fund non-County physician trauma services provided to eligible indigent patients within the County and non-County physician emergency services provided to eligible indigent patients with non-traumatic emergency conditions. The status of this project is as follows: Status: At the close of FY 2023-24, net payments totaling $0.22 million were issued to non-County physicians for trauma services, and $5.08 million was established as accrued liabilities for payment of trauma and emergency room claims. Attachment II Page 4 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 Balance: At the close of FY 2023-24, an estimated expenditure accrual of $5.08 million was established for payment of pending claims in the next fiscal year. AUDITOR-CONTROLLER – ADMINISTRATIVE COSTS – $0.80 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $0.80 million to cover the administrative costs incurred on the assessment, collection, and accounting services for the Measure B Special Tax revenues. Status: A total of $0.78 million was transferred to the Auditor-Controller to cover the service costs for placement of direct assessments on the secured tax roll and distribution of collections. Balance: At the close of FY 2023-24, the unspent amount of $0.02 million was returned to the Measure B Fund. DEPARTMENT OF PUBLIC HEALTH (DPH) BIOTERRORISM RESPONSE – $9.86 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $9.86 million to support the County’s Public Health program for bioterrorism preparedness activities and addressing the medical needs of people exposed to bioterrorism or chemical attacks. Status: A total of $9.86 million was transferred to the DPH to cover the following actual costs incurred for the bioterrorism preparedness activities: salaries and benefits, $7.51 million; equipment, supplies, and expenses, $2.35 million. Balance: None. DPH TRAUMA PREVENTION PROGRAM – $0.68 million allocated This allocation is to support the County’s Public Health program for trauma prevention activities in regions of the County that experience a disproportionately high burden of trauma. The FY 2023-24 Final Adopted Budget included an allocation of approximately $0.68 million. Status: A total of approximately $0.68 million was transferred to DPH to cover the actual costs incurred for the trauma prevention activities: salaries and benefits, $0.23 million; supplies and expenses, $0.45 million. Attachment II Page 5 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 Balance: None. DPH TRAUMA PREVENTION INITIATIVE EXPANSION – $1.30 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $1.30 million to support the County’s Public Health program for Trauma Prevention Initiative Expansion (TPI Expansion) activities. Status: A total of $1.30 million was transferred to DPH to cover the actual costs incurred for the TPI Expansion activities: salaries and benefits, $0.43 million; supplies and expenses, $0.87 million. Balance: None. DPH RISK COMMUNICATION – $0.37 million allocated The FY 2023-24 Adopted Final Budget included an allocation of $0.37 million to support the County’s Public Health program for risk communication. Funds would enhance risk communication capacity and support development of a catalogue of terrorism-specific public messages, videos, and mass media campaign content. Status: A total of $0.37 million was transferred to DPH to cover the following actual costs incurred for risk communication activities: salaries and benefits, $0.30 million; supplies and expenses, $0.07 million. Balance: None. DPH EMERGENCY PREPAREDNESS – OVERTIME (OT) ENVIRONMENTAL HEALTH STRIKE TEAM – $0.50 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $0.50 million to support the County’s Public Health program for emergency preparedness. Funds would support OT for Environmental Health Strike Team members who are deployed Countywide on a regular basis in response to possible terrorism events for situational awareness, threat assessment, disaster prevention, field study, and community engagement. Status: A total of $0.50 million was transferred to DPH to cover the following actual costs incurred for OT Environmental Health Strike Team: salaries and benefits, $0.41 million; Attachment II Page 6 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 other operating expenses, $0.09 million. Balance: None. DPH OFFICE OF VIOLENCE PREVENTION (OVP) – $3.00 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $3.00 million to support the operations of the OVP to coordinate, provide technical assistance, and expand practices for preventing and addressing violence in the County. Status: A total of $3.00 million was transferred to DPH to cover actual costs incurred for the OVP program: salaries and benefits, $0.78 million; other operating expenses, $2.22 million. Balance: None. DPH REDUCING VIOLENCE COUNTYWIDE – TRAUMA PREVENTION INITIATIVE (TPI) – $2.00 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $2.00 million to implement the expansion and enhancement of the TPI for DPH’s OVP program. This includes the expansion of services in Supervisorial Districts, in addition to the Second District, with a focus on TPI communities, including East Los Angeles, Commerce, Hawaiian Gardens, La Puente, Puente Valley, and the Antelope Valley. This also includes support from community-based organizations conducting gang intervention work. Status: A total of $2.00 million was transferred to DPH to cover actual costs incurred for the expansion of the OVP program: salaries and benefits, $0.62 million; other operating expenses, $1.38 million. Balance: None. DHS EMERGENCY MEDICAL SERVICES AGENCY (EMS) – ADMINISTRATIVE COST – $1.76 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $1.76 million to support the County’s EMS Agency for the administration and coordination of trauma and emergency services related to prehospital and hospital emergency care, including the Attachment II Page 7 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 care provided in, en route to, from or between acute care hospitals and other health care facilities. Status: A total of $1.76 million was transferred to the County’s EMS Agency to cover the actual costs incurred for the administration and coordination of trauma services: salaries and benefits, $1.49 million; operating expenses, $0.27 million. Balance: None. DHS EMS AGENCY – TRAUMA & EMERGENCY MEDICINE INFORMATION SYSTEM (TEMIS) – $2.23 million allocated On June 22, 2023, an amendment was made to extend the term of the contract for another three-month period through September 30, 2023. The FY 2023-24 Final Adopted Budget included an allocation of approximately $0.28 million. The Board authorized DHS to execute Amendment No. 12 to Sole Source Agreement No. H-212780 with ESO Solutions, Inc. for the TEMIS. The amendment was executed, extending the contract through June 30, 2026. A budget adjustment was requested for $1.95 million and approved in 2024. Status: A total of $1.64 million was transferred to the County’s EMS Agency to cover the actual costs of TEMIS. Balance: At the close of FY 2023-24, the remaining funds of $0.59 million was carried forward to be spent in FY 2024-25. CITY OF LONG BEACH – $1.00 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $1.00 million for the City of Long Beach as an ongoing Measure B funding to support its EMS, Bioterrorism, and Trauma and Violence Prevention programs. Status: In FY 2023-24, a total of $1.00 million was transferred to the City of Long Beach to cover actual costs of EMS, Bioterrorism, and Trauma and Violence Prevention programs: salaries and benefits, $0.98 million; other operating expenses, $0.02 million. Balance: None. Attachment II Page 8 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 CITY OF PASADENA – $0.30 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $0.30 million for the City of Pasadena as an ongoing Measure B funding to support its EMS, Bioterrorism, and Trauma and Violence Prevention programs. Status: In FY 2023-24, a total of $0.05 million was transferred to the City of Pasadena to cover actual costs of EMS, Bioterrorism, and Trauma and Violence Prevention programs: salaries and benefits, $0.02 million; other operating expenses, $0.03 million. Balance: At the close of FY 2023-24, a total of $0.25 million in unspent funds was returned to the Measure B Fund. LOS ANGELES COUNTY COMMISSION ON HUMAN RELATIONS – $2.09 million allocated The FY 2023-24 Final Adopted Budget included an allocation of $2.09 million for the County Commission on Human Relations as an ongoing Measure B funding to support its continuous trauma and injury prevention activities under the Anti-Hate Initiative (LA vs. Hate Campaign). Half of this amount is an annual allocation for FY 2023-24 and the other half is a carryover from FY 2022-23. Status: In FY 2023-24, a total of $0.12 million was transferred to the County Commission on Human Relations to cover actual costs of other operating expenses incurred. Balance: At the close of FY 2023-24, the unspent balance of $1.97 million was returned to the Measure B Fund. VARIOUS BOARD APPROVED PROJECTS RECOMMENDED BY MEASURE B ADVISORY BOARD (MBAB) – $0.45 million allocated 2018 MBAB Project On March 12, 2019, the Board approved the allocation of unobligated and unspent Measure B funds to support various projects recommended by MBAB. One of the projects received funding for $1.90 million to support the County Fire Department to pilot two Advanced Provider Response Units, which perform more advanced assessments and simple interventions in the field. A total of $1.74 million was transferred to the County Attachment II Page 9 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 Fire Department in the previous fiscal years as follows: FY 2019-20, $0.36 million; FY 2020-21, $0.39 million; FY 2021-22, $0.49 million; and FY 2022-23, $0.50 million. The status of this project for FY 2023-24 is summarized below (in millions): FY 2023-24 FY 2023-24 Balance Forward 2018 MBAB Project Budget Expenditure to FY 2024-25 LA County Fire Dept. – Advanced Provider $ 0.16 $ 0.13 $ 0.03 Response Units 2019 MBAB Project On February 11, 2020, the Board approved the allocation of unobligated and unspent Measure B funds to support various projects recommended by MBAB. One of the projects received funding for $0.15 million to support Children’s Hospital Los Angeles to establish a Special Needs Car Seat Program, which would allow car seats to be loaned to families who have children with special needs that require special car seats for transportation. A total of $0.02 million was transferred to Children’s Hospital Los Angeles in the previous fiscal years as follows: FY 2020-21, $0.00 million; FY 2021-22, $0.02 million; and FY 2022-23, $0.00 million. The status of this project for FY 2023-24 is summarized below (in millions): FY 2023-24 FY 2023-24 Balance Forward 2019 MBAB Project Budget Expenditure to FY 2024-25 Children’s Hospital Los Angeles – Special * $ 0.00 $ 0.05 * $ 0.00 Needs Car Seat Program *Encumbrance was set up using FY 2021-22 budget for $0.15 million, and $0.13 million was carried forward to FY 2022-23 and 2023-24, but only $0.05 million was expended and paid to Children’s Hospital Los Angeles. The remaining balance of $0.08 million was returned to the Measure B Fund. 2021 MBAB Projects On February 7, 2022, the Board approved the allocation of unobligated and unspent Measure B funds to support various projects recommended by MBAB. The FY 2023-24 amount of $0.44 million was designated for the following projects: (1) City of Compton Fire Department to purchase eight Automated Emergency Defibrillators (AEDs) that are compatible with their monitor/defibrillators which would improve the transition of care from basic life support to advanced life support; (2) City of Hawthorne Police Department to conduct Stop the Bleed training for 250 community members; (3) Regents of UC-UCLA Payment Solutions and Compliance for On-Line Lessons for the Instructional Design Program; (4) City of Los Angeles Fire Department to implement Flight Data Monitoring Attachment II Page 10 of 10 Measure B Special Tax Revenue Fund For Emergency Medical Services, Trauma Centers, and Bioterrorism Response Status of Measure B Projects For the Fiscal Year Ended June 30, 2024 technology, integrating flight following tracking with aircraft’s onboard systems; (5) the County DHS EMS Agency to support the Hospital Emergency Response Team (HERT) training module development; and (6) the County Fire Department to add forty-four assessment units within the department. The status of each project is summarized below (in millions): FY 2023-24 FY 2023-24 Balance Forward 2021 MBAB Projects Budget Expenditures to FY 2024-25 1. City of Compton Fire Dept. – 8 AEDs (a) $ 0.00 $ 0.02 (a) $ 0.00 2. City of Hawthorne Police Dept. – Stop the (b) 0.00 0.02 (b) 0.00 Bleed Training 3. UCLA – Instructional Designer & EMS 0.19 0.00 0.19 Educators to Curate Lessons 4. City of Los Angeles Fire Dept. – Flight (c) 0.00 0.10 (c) 0.00 Data Monitoring 5. LA County DHS EMS Agency – HERT 0.02 0.01 (d) 0.00 Preparedness 6. LA County Fire Dept. – Assessment 0.08 0.00 0.08 Engines Expansion Total $ 0.29 $ 0.15 $ 0.27 (a) Encumbrance was set up using FY 2022-23 budget for $0.03 million, and $0.03 million was carried forward to FY 2023-24, but only $0.02 million was expended and paid to the City of Compton Fire Department. The remaining balance of $0.01 million was returned to the Measure B Fund. (b) Encumbrance was set up using FY 2022-23 budget for $0.02 million, and $0.02 million was carried forward to FY 2023-24. The entire balance was expended and paid to the City of Hawthorne Police Department. (c) Encumbrance was set up using FY 2022-23 budget for $0.11 million, and $0.11 million was carried forward to FY 2023-24, but only $0.10 million was expended and paid to the City of Los Angeles Fire Department. The remaining balance of $0.01 million was returned to the Measure B Fund. (d) The remaining balance of $0.01 million was returned to the Measure B Fund. Prepared by: Los Angeles County Department of Health Services Finance - Special Funds Unit November 21, 2024