Ventura Public Health County - EMSA

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VCPH . H. ··. . ·· · ··.·····.·· · R · ···· · ····· ·· ·VenturaCountyPublic HealthA Division of the Ventura County Health Care AgencyEMERGENCY MEDICAL SERVICES2220 E. Gonzales Rd., Suite 130, Oxnard, CA 93036-0619www.vchca.org/ph!emsPhone: 805-981-5301Fax:805-981 -5300BARRY R. FISHER, MPPADirectorSTEVEN l . CARROll, EMT-PEMS AdministratorANGELO SALVUCCI, M.D., F.A.C.E.PMedrcal DirectorDecember 8, 2011Sandy SalaberEMS Systems AnalystEmergency Medical Services Authority10901 Gold Center Drive, Suite 400Rancho Cordova, CA 95670-6073)Dear Sandy,The 2011 EMS Plan Update for Ventura County EMS Agency is submitted for your review.Standard changes are shown in the Excel document and Tables 2 through 9, Ambulance ZoneSummary Forms and the Trauma System Status Report are included as requested.Significant changes in the 2011 reporting period include the merger of our Public HealthEmergency Preparedness Office into the Ventura County EMS Agency structure. We are alsocurrently in the process of implementing a new electronic patient care reporting system throughImageTrend, Inc. When completed, this project will also include a STEM! and Trauma registryand will be connected to CEMSIS.Please feel free to contact me at (805) 981-5305 should you require any additional information orhave any questions.Sincerely,4L Steve CarrollEMS Administrator)

LEMSA:FY: 2010- 2011Venturaarearangeplan as we continue developingour pediatric specialty care 4.1Vehicles rrp-5.[[Air transport resources have beenidentified and a written MOU ison file with the Sheriff's Dept. forAir Rescue services.have identified various all terrainvehicles. Resources are availablethrough County Fire or CountyWe are continuing to review thisspecific area and have now placedthis into our short range plan,which includes futuredevelopment of a PICU atVentura County Medical Centerand transfer agreements withadjacent county PICU andPediatric Trauma Centers.

Ventura County has a wellestablished and maintainedSTEMI system and a recentlydeveloped Trauma system.Services not offered in our Countyare provided through agreementswith out-of-county specialty carehospitals. Ventura County EMS isalso working with all our hospito develop a Stroke Care System,with projected implementation onDecember 2012.p-[Prehospital and hospitalparticipate in review committeesfor both the STEMI and TraumaSystems. The proposed StrokeSystem will also have a similardesign when it is implemented bythe end of 2012.[Evaluation of the EMS System isconducted by the EMS AgencyCQI Program, PrehospitalServices Committee and theBoard of Supervisors appointedEMS Advisory Committee.5.r6.6.Evaluation[P"'ranannual reporting process is ashort

6AuditNeeds Assessmentprocess has been addressedthrough the development and· plementation of the PublicHealth Emergency Response Plan,in coordination with the Office ofEmergency Services and theRegional Disaster Medical HealthSpecialist. Short range plan is tofocus on the new EmergencyManual

Table 2- System Organization & Management (cont.))Continuing educationPersonnel trainingOperation of oversight of EMS dispatch centerNon-medical disaster planningAdministration of critical incident stress debriefing team (CISD)Administration of disaster medical assistance team (DMAT)Administration of EMS Fund [Senate Bill (SB) 12/612]Other:Other:Other:5.)XXXXXEMS agency budget for FY 10-11EXPENSESSalaries and benefits(All but contract personnel)Contract Services(e.g. medical director)Operations (e.g. copying, postage, facilities)TravelFixed assetsIndirect expenses (overhead)Ambulance subsidyEMS Fund payments to physicians/hospitalDispatch center operations (non-staff)Training program operationsOther:Other: - - - - - - - - - - - Other: - - - - - - - - - - - TOTAL EXPENSES 2000 3,637,062

Table 2- System Organization & Management (cont.))SOURCES OF REVENUESpecial project grant(s) [from EMSA}Preventive Health and Health Services (PHHS) Block Grant Office of Traffic Safety (OTS)State general fund633,421County general fundOther local tax funds (e.g., EMS district)County contracts (e.g. multi-county agencies)276,49968,061Certification feesTraining program approval feesTraining program tuition/Average daily attendance funds (ADA)Job Training Partnership ACT (JTPA) funds/other paymentsBase hospital application feesTrauma center application fees)Trauma center designation fees150,000Pediatric facility approval feesPediatric facility designation feesOther critical care center application feesType:Other critical care center designation feesType:Ambulance service/vehicle fees260.410ContributionsEMS Fund (SB 12/612)2,525,170Other grants:Other fees: - - - - - - - - - Other (specify):TOTAL REVENUE 3,637,062TOTAL REVENUE SHOULD EQUAL TOTAL EXPENSES.IF THEY DON'T, PLEASE EXPLAIN BELOW.

Table 2- System Organization & Management (cont.)EMS System: -----------"V- e.:.:n tu r a ;:C:;.:o;.:;:u"""n:.;;.ty.Reporting yearEMSAdmin./Coord./DirectorEMS Administrator1.055.75/hr36%Asst. Admin./Admin.Asst.!Admin. Mgr.Admin. Assistant Ill1.032.26 I hr36%Program Coordinator/Field Liaison(Non-clinical)Program Administrator Ill1.038.49 I hr36%Trauma CoordinatorSenior Program Admin.1.043.37 I hr36%Medical DirectorEMS Medical Director0.594.41 /hr02010-2011ALS Coord ./Field Coord./Training CoordinatorIndependent ContractorOther MD/MedicalConsult!Training Medical DirectorDisaster Medical PlannerInclude an organizational chart of the local EMS agency and a county organization chart(s) indicating how theLEMSA fits within the county/multi-county structure.

Table 2- System Organization & Management (cont.)Dispatch SupervisorMedical PlannerData Evaluator/AnalystPD Registered Nurse II0.640.25 I hr0Other ClericalAdministrative Assistant II1.029.33 I hr36%Other ClericalOffice Assistant Ill1.019.32 I hr36%Courier I1.015.93 I hr0QA/QI CoordinatorPublic Info. & EducationCoordinatorExecutive SecretaryData Entry ClerkOtherInclude an organizational chart of the local EMS agency and a county organization chart(s) indicating how theLEMSA fits within the county/multi-county structure.

TABLE 3: SYSTEM RESOURCES AND OPERATIONS- Personnel/TrainingEMS System:Revision #4 (4/20/07)VenturaReporting Year:2010-2011NOTE: Table 3 is to be reported by agency.Number recertified this year15419692431432112Number of certification reviews resulting in:a) formal investigations12b) probation2c) suspensions0d) revocations3e) denials1f) denials of renewal0g) no action taken11.2.3.Number of EMS dispatch agencies utilizing EMD Guidelines:Early defibrillation:a) Number ofEMT I (defib) certifiedb) Number of public safety (defib) certified (non-EMT-I)Do you have a first responder training programI200D yes Xno

TABLE 4: SYSTEM RESOURCES AND OPERATIONS- CommunicationsEMS System:VenturaCounty:VenturaReporting Year:2010-2011Note: Table 4 is to be answered for each county.1.Number of primary Public Service Answering Points (PSAP)'""'62.Number of secondary PSAPs13.Number of dispatch centers directly dispatching ambulances14.Number of designated dispatch centers for EMS Aircraft. 15.Do you have an operational area disaster communication system?Yes x Noa. Radio primary frequency -----"1'-"5'--'4 , ,.0'""'5'-"'5 -----b. Other methods-------------c. Can all medical response units communicate on the same disaster communications system?Yes X Nod. Do you participate in OASIS? YesXNoe. Do you have a plan to utilize RACES as a back-up communication system?Yes XNo1) Within the operational area? YesXNo2) Between the operational area and the region and/or state? YesXNo6.Who is your primary dispatch agency for day-to-day emergencies?Ventura County Fire Protection District7.Who is your primary dispatch agency for a disaster?Ventura County Sheriffs Department and Ventura County Fire Protection District

TABLE 5: SYSTEM RESOURCES AND OPERATIONSResponse/TransportationEMS System:VenturaReporting Year:2010-2011Note: Table 5 is to be reported by agency.Early Defibrillation Providers1.Number of EMT-Defibrillation providers8SYSTEM STANDARD RESPONSE TIMES (90TH PERCENTILE)Enter the response times in the appropriate boxesI S and CPR capable first responderNot DefinedNot DefinedNot DefinedEarly defibrillation responderNot DefinedNot DefinedNot DefinedNot DefinedAdvanced life support responderNot DefinedNot DefinedNot DefinedNot DefinedTransport Ambulance8 min, 0 sec20 min, 0 sec30 min, 0 sec orASAPNot DefinedNot Defined'I

TABLE 6: SYSTEM RESOURCES AND OPERATIONSFacilities/Critical CareEMS System:Reporting Year:Ventura2010-2011NOTE: Table 6 is to be reported by agency.TraumaTrauma patients:a) Number of patients meeting trauma triage criteria1813b) Number of major trauma victims transported directly to a traumacenter by ambulance1343c) Number of major trauma patients transferred to a trauma center92d) Number of patients meeting triage criteria who weren't treatedat a trauma center488Emergency Departments)Total number of emergency departments8a) Number of referral emergency services0b) Number of standby emergency services1c) Number ofbasic emergency services7d) Number of comprehensive emergency services0Receiving Hospitals1.Number of receiving hospitals with written agreements42.Number of base hospitals with written agreements4

TABLE 7: SYSTEM RESOURCES AND OPERATIONS-- Disaster MedicalEMS System:VenturaCountyVenturaReporting Year:2010-2011NOTE: Table 7 is to be answered for each county.SYSTEM RESOURCES1.Casualty Collections Points (CCP)a. Where are your CCPs located? H oc.:::.sp"'-'i ta l'-"P- a rki · n:.c:g. . L o::. :t -s2.3.b. How are they staffed? Hospital personnel and PH nursesc. Do you have a supply system for supporting them for 72 hours?yesCISDDo you have a CISD provider with 24 hour capability?yes K noresponse plan?4.noMedical Response Teamyes K no- -a. Do you have any team medical response capability?b. For each team, are they incorporated into your local)xyes X noc. Are they available for statewide response?yes no Kd. Are they part of a formal out-of-state response system?yes no XHazardous Materialsa. Do you have any HazMat trained medical response teams?yes no ]Lb. At what HazMat level are they t r a i n e d ? - - - - - - - - - - c. Do you have the ability to do decontamination in anemergency room?d. Do you have the ability to do decontamination in the field?OPERATIONS1.Are you using a Standardized Emergency Management System (SEMS)that incorporates a form of Incident Command System (ICS) structure?2.What is the maximum number of local jurisdiction EOCs you will need tointeract with in a disaster?yes x noyes K noyesx12no

3.\4.Have you tested your MCI Plan this year in a:a. real event?yes X nob. exercise?yesxnoList all counties with which you have a written medical mutual aid agreement.Medical Mutual Aid with all Region 1 and Region 6 counties5.Do you have formal agreements with hospitals in your operational area toparticipate in disaster planning and response?)yes X no6.Do you have a formal agreement with community clinics in your operationalareas to participate in disaster planning and response?yes L no7.Are you part of a multi-county EMS system for disaster response?yes8.Are you a separate department or agency?yes no L9.If not, to whom do you report? ;:H -e - a lt h'-'C a r- -e- -A: :g - e n- -cy.,,- P- u b li c.:.H e a lt h- D::.::e p a"-"rt m e nt.:;8.If your agency is not in the Health Department, do you have a planto coordinate public health and environmental health issues withthe Health Department?yesno xno

TABLE 8: RESOURCES DIRECTORY -- Approved Training ProgramsEMS V.::::e;:.:n.:.::tu:.:.r.::::.aReporting Year: 2010-2011NOTE: Table 8 is to be completed by county. Make copies to add pages as needed.Training Institution NameConejo Valley Adult SchoolAddress1025 Old Farm RoadThousand Oaks CA 91360'Cost of ProgramStudent Eligibility:*BasicOpenRefresherTraining Institution NameEMS Training Institute, Inc.AddressP.O. Box 940514Simi Valley CA 93094'Cost of ProgramStudent Eligibility:Open*BasicRefresher**Contact Person telephone no.John Everlove805-497-2781**Program Level: EMTNumber of students completing training per year:Initial training:27Refresher:2Cont. Education0Expiration Date:02-28-15Number of courses:2Initial training:2Refresher:0Cont. Education:0Contact Person telephone no.MarkKomins877-368-8724**Program Level: EMTNumber of students completing training per year:Initial training:0761Refresher:Cont. Education0Expiration Date:02-28-14Number of courses:12Initial training:0Refresher:12Cont. Education: Open to general public or restricted to certain petsonnel only.Indicate whether EMT-1, EMT-11, EMT-P, or MICN; tfthere is a training program that offers more than one level complete all information for each level.

-----·'"'"-'·"TABLE 8: RESOURCES DIRECTORY --Approved Training ProgramsEMS System:.:.V-' e;.:.:n.:.:tu::.:.r.::::.aCouncy:.:.V-' e;.:.:n.:.:tu::.:.r.::::.aReporting Year: 2010-2011NOTE: Table 8 is to be completed by county. Make copies to add pages as needed.Training InstitutionNameAddressStudent Eligibilicy:Moorpark College7075 Campus RoadMoorpark, CA 93021*Cost of ProgramBasicOpenRefresherTraining Institution NameOxnard CollegeAddress4000 S. Rose AvenueOxnard, CA 93033Cost of ProgramStudent Eligibilicy:Open*BasicRefresher**Contact Person telephoneno.Carol Higashida805-378-1433**Program Level: EMTNumber of students completing training per year:Initial training:69Refresher:0Cont. Education001-31-15Expiration Date:2Number of courses:Initial training:2Refresher:0Cont. Education:0Contact Person telephone no.Dana Sullivan805-488-0911**Program Level: EMTNumber of students completing training per year:Initial training:16943Refresher:Cont. Education0Expiration Date:01-31-12Number of courses:9Initial training:6Refresher:3Cont. Education:0 Open to general public or restricted to certain personnel only.Indicate whether EMT-1, EMT-II, EMT-P, or MICN; if there is a training program that offers more than one level complete all information for each level.I

TABLE 8: RESOURCES DIRECTORY-- Approved Training ProgramsEMS System:-'-V- e.:.:n tu r aCouncy:.:.V- e.:.:n tu r aReporting Year: 2010-2011NOTE: Table 8 is to be completed by county. Make copies to add pages as needed.Training InstitutionNameAddressStudent Eligibilicy:*Simi Valley Adult School3150 School RoadSimi Valley, CA 93062Cost of ProgramBasicOpenRefresherTraining InstitutionNameAddressStudent Eligibilicy:Restricted*Ventura City Fire Department1425 Dowell DriveVentura, CA 93003Cost of ProgramBasicRefresher**Contact Person telephoneno.Sterling Johnson805-579-6200**Program Level: EMTNumber of students completing training per year:Initial training:107Refresher:4Cont. EducationExpiration Date:11-30-15Number of courses:7Initial training:6Refresher:1Cont. Education:0Contact Person telephoneno.Nancy Merman805-339-4461**Program Level: EMTNumber of students completing training per year:Initial training:0Refresher:0Cont. Education0- Expiration Date:06-30-140Number of courses:Initial training:0Refresher:0Cont. Education:0 Open to general public or restricted to certain petsonnel only.Indicate whether EMT-I, EMT-II, EMT-P, or MICN; if there is a training program that offers more than one level complete all information for each level.

TABLE 8: RESOURCES DIRECTORY-- Approved Training ProgramsEMS System: V.:.:.e:.:.nt u:.:.:ra"'----------------County:- .V.::::e n tu:.:.r::::.aReporting Year: 2010-2011NOTE: Table 8 is to be completed by county. Make copies to add pages as needed.Training Institution NameVentura CollegeAddress4667 Telegraph RoadVentura, CA 93003Cost of ProgramStudent Eligibility: *BasicOpenRefresherTraining InstitutionNameAddressStudent Eligibility:Restricted*Ventura County Fire Department165 Durley A venueCamarillo, CA 93010Cost of ProgramBasicRefresher**Contact Person telephone no.Meredith Mundell805-654-6342**Program Level: EMTNumber of students completing training per year:Initial training:77Refresher:0Cont. Education0Expiration Date:11-30-15Number of courses:3Initial training:3Refresher:0Cont. Education:Contact Person telephoneno.Mark Komins805-389-9776**Program Level: EMTNumber of students completing training per year:Initial training:0Refresher:351Cont. Education0Expiration Date:02-28-15Number of courses:0Initial training:0Refresher:1Cont. Education:0 Open to general public or restncted to certain personnel only.Indicate whether EMT-1, EMT-11, EMT-P, or MICN; if there is a training program that offers more than one level complete all information for each level.

TABLE 8: RESOURCES DIRECTORY-- Approved Training ProgramsEMS .System:.:.V e.:.:n.!::tu:.!.r:::.aCounty: - -V- e:.:.nt u:.:.ra -------Reporting Year: 2010-2011NOTE: Table 8 is to be completed by county. Make copies to add pages as needed.Training InstitutionNameAddressStudent Eligibility:Restricted*Oxnard Fire Department360 West Second St.Oxnard, CA 93030Cost of ProgramBasicRefresher**Contact Person telephoneno.Stephanie Huhn805-385-8361**Program Level: EMTNumber of students completing training per year:Initial training:0Refresher:33Cont. Education01-31-12Expiration Date:Number.of courses:0Initial training:0Refresher:1Cont. Education:0 Open to general pubhc or restricted to certam personnel only.Indicate whether EMT-1, EMT-11, EMT-P, or MICN; if there is a training program that offers more than one level complete all information for each level.

TABLE 9: RESOURCES DIRECTORY-- Dispatch AgencyEMS System: , V-"'e:!.!;ntu r:::::.aCounty: -'-V-- e ntu ra --------Reporting Year: 2010-2011NOTE: Make copies to add pages as needed. Complete information for each provider by county.Written Contract:DyesX noMedical Director:DyesX noOwnership:X PublicD PrivateWritten Contract:DyesX noOwnership:X PublicD PrivateMedical Director:DyesX noX Day-to-dayD DisasterNumber of Personnel providing services:];] EMD TrainingEMT-DBLSLALS---If public:X FireDLawD Otherexplain:- - - - -If public: D city;X Day-to-dayD DisasterNumber of Personnel providing services:22EMD TrainingEMT-DBLSLALS---If public:X FireDLawD Otherexplain:If public: X city;D county;D county;D state;D state;ALS- - - OtherX fire district;D FederalALS- - - OtherD fire district;D Federal

EMS PLANAMBULANCEZONESUMMARYFORMIn order to evaluate the nature of each area or subarea, the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone .Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA1Name of CurrentProvider( ):Lifeline Medical TransportServing the Ojai Valley since 1935Include company name(s} and length of operation (uninterrupted) in specified area or subarea.Area or subarea (Zone) Geographic Description:Combination of Metropolitan/Urban, Suburban/Rural and Wilderness areasincluding the City of Ojai.Statement of Exclusivity, Exclusive or non-Exclusive (HS 1797.6):Exclusive)Include intent of local EMS agency and Board action .Type of Exclusivity, "Emergency Ambulance", " ALS", or "LALS " (HS 1797.85):Emergency Ambulance for 911 calls onlyInclude type of exclusivity (Emergency Ambulance, ALS, LALS, or combination) and operational definition of exclusivity (i.e., 911calls only, all emergencies, all calls requiring emergency ambulance service, etc.).Method to achieve Exclusivity, if applicable (HS 1797.224):GrandfatheredLifeline Medical Transport is a subsidiary of Ojai Ambulance Inc. and has servedASA 1 since 1935. Paramedic service was added to the service area in 1986.Current owner, Steve Frank, purchased the company in 1994 from previousowner, Jerry Clauson. Ojai Ambulance changed it's name to Lifeline MedicalTransport in 2001, however no change in scope or manner of service hasoccurred.If grandfathered, pertinent facts concerning changes in scope and manner of service. Description of current providerincluding brief statement of uninterrupted service with no changes to scope and manner of service to zone. Includechronology of all services entering or leaving zone, name or ownership changes, service level changes, zone areamodifications , or other changes to arrangements for service.If competitively-determined, method of competition, intervals, and selection process. Attach copy/draft of lastcompetitive process used to select provider or providers.

EMS PLANAMBULANCEZONESUMMARYFORMIn order to evaluate the nature of each area or subarea, the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone.Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA2Name of Current Provider(s ):American Medical ResponseServing since 1962Include company name(s} and length of operation (uninterrupted} in specified area or subarea .Area or subarea (Zone) Geographic Description :Combination of Metropolitan/Urban, Suburban/Rural and Wilderness areasincluding the Cities of Fillmore and Santa Paula .Statement of Exclusivity, Exclusive or non-Exclusive (HS 1797.6):ExclusiveInclude intent of local EMS agency and Board action.)Type of Exclusivity, "Emergency Ambulance", "ALS", or "LALS" (HS 1797.85):Emergency Ambulance for 911 calls onlyInclude type of exclusivity (Emergency Ambulance, ALS, LALS, or combination) and operational definition of exclusivity (i.e. , 911calls only, all emergencies, all calls requiring emergency ambulance service, etc.).Method to achieve Exclusivity, if applicable (HS 1797.224):GrandfatheredAmerican Medical Response currently provides service to ASA 2. Paramedicservice was added to the service area in 1992. There have been numerousownership changes in the past 15 years due to ambulance industry consolidations;however no change in scope or manner of service has occurred .Previous Owners:Courtesy Ambulance 1962-1991Pruner Health Services 1991-1993Careline 1993-1996Medtrans 1996-1999American Medical Response 1999-presentIf grandfathered, pertinent facts concerning changes in scope and manner of service. Description of current providerincluding brief statement of uninterrupted service with no changes to scope and manner of service to zone. Includechronology of all services entering or leaving zone, name or ownership changes, service level changes, zone areamodifications, or other changes to arrangements for service.If competitively-determined, method of competition , intervals, and selection process. Attach copy/draft of lastcompetitive process used to select provider or providers.

EMS PLANAMBULANCEZONESUMMARYFORMIn order to evaluate the nature of each area or subarea, the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone.Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA3Name of Current Provider(s):American Medical ResponseServing since 1962Include company name(s) and length of operation (uninterrupted) in specified area or subarea.Area or subarea (Zone) Geographic Description:Combination of Metropolitan/Urban, Suburban/Rural and Wilderness areasincluding the City of Simi Valley.Statement of Exclusivity, Exclusive or non-Exclusive (HS 1797.6):Exclusive)Include intent of local EMS agency and Board action .Type of Exclusivity, "Emergency Ambulance", "ALS", or "LALS" (HS 1797.85):Emergency Ambulance for 911 calls onlyInclude type of exclusivity (Emergency Ambulance, ALS, LALS, or combination) and operational definition of exclusivity (i.e., 911calls only, all emergencies, all calls requiring emergency ambulance service, etc.).Method to achieve Exclusivity, if applicable (HS 1797.224):GrandfatheredAmerican Medical Response currently provides service to ASA 3. Paramedicservice was added to the service area in 1983. There have been numerousownership changes in the past 15 years due to ambulance industry consolidations;however no change in scope or manner of service has occurred.Previous Owners:Brady Ambulance 1962-1975Pruner Health Services 1975-1993Careline 1993-1996Medtrans 1996-1999American Medical Response 1999-presentIf grandfathered, pertinent facts concerning changes in scope and manner of service. Description of current providerincluding brief statement of uninterrupted service with no changes to scope and manner of service to zone. Includechronology of all services entering or leaving zone, name or ownership changes, service level changes, zone areamodifications, or other changes to arrangements for service.If competitively-determined, method of competition, intervals, and selection process. Attach copy/draft of lastcompetitive process used to select provider or providers.

EMS PLANAMBULANCEZONESUMMARYFORMIn order to evaluate the nature of each area or subarea, the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone.Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA4Name of Current Provider(s):American Medical ResponseServing since 1962Include company name(s) and length of operation (uninterrupted) in specified area or subarea.Area or subarea (Zone) Geographic Description:Combination of Metropolitan/Urban, Suburban/Rural and Wilderness areasincluding the Cities of Moorpark and Thousand Oaks.Statement of Exclusivity, Exclusive or non-Exclusive (HS 1797.6):Exclusive)Include intent of local EMS agency and Board action.Type of Exclusivity, " Emergency Ambulance", "ALS", or "LALS" (HS 1797.85):Emergency Ambulance for 911 calls onlyInclude type of exclusivity (Emergency Ambulance, ALS, LALS, or combination) and operational definition of exclusivity (i.e., 911calls only, all emergencies, all calls requiring emergency ambulance service, etc.).Method to ach ieve Exclusivity, if applicable (HS 1797.224):GrandfatheredAmerican Medical Response currently provides service to ASA 4. Paramedicservice was added to the service area in 1983. There have been numerousownership changes in the past 15 years due to ambulance industry consolidations;however no change in scope or manner of service has occurred.Previous Owners:Conejo Ambulance 1962-1975Pruner Health Services 1975-1993Careline 1993-1996Medtrans 1996-1999American Medical Response 1999-presentIf grandfathered , pertinent facts concerning changes in scope and manner of service. Description of current providerincluding brief statement of uninterrupted service with no changes to scope and manner of service to zone. Includechronology of all services entering or leaving zone, name or ownership changes, service level changes, zone areamodifications, or other changes to arrangements for service.If competitively-determined , method of competition, intervals, and selection process. Attach copy/draft of lastcompetitive process used to select provider or providers.

EMS PLANAMBULANCEZONESUMMARYFORMIn order to evaluate the nature of each area or subarea, the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone.Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA5Name of Current Provider(s):American Medical ResponseServing since 1962Include company name(s) and length of operation (uninterrupted) in specified area or subarea.Area or subarea (Zone) Geographic Description:Combination of Metropolitan/Urban, Suburban/Rural and Wilderness areasincluding the City of Camarillo.Statement of Exclusivity, Exclusive or non-Exclusive (HS 1797.6):Exclusive)Include intent of local EMS agency and Board action.Type of Exclusivity, "Emergency Ambulance", "ALS", or "LALS" (HS 1797.85):Emergency Ambulance for 911 calls onlyInclude type of exclusivity (Emergency Ambulance, ALS, LALS, or combination) and operational definition of exclusivity (i.e., 911calls only, all emergencies, all calls requiring emergency ambulance service, etc.).Method to achieve Exclusivity, if applicable (HS 1797 .224):GrandfatheredAmerican Medical Response currently provides service to ASA 5. Paramedicservice was added to the service area in 1985. There have been numerousownership changes in the past 15 years due to ambulance industryconsolidations; however no change in scope or manner of service has occurred.Previous Owners :Camarillo Ambulance 1962-1978Pruner Health Services 1978-1993Careline 1993-1996Medtrans 1996-1999American Medical Response 1999-presentIf grandfathered, pertinent facts concerning changes in scope and manner of service. Description of current providerincluding brief statement of uninterrupted service with no changes to scope and manner of service to zone. Includechronology of all services entering or leaving zone, name or ownership changes, service level changes, zone areamodifications, or other changes to arrangements for service.If competitively-determined, method of competition, intervals, and selection process. Attach copy/draft of lastcompetitive process used to select provider or providers.

EMS PLANAMBULANCEZONESUMMARYFORM)In order to evaluate the nature of each area or subarea, 'the following information should be compiled for eachzone individually. Please include a separate form for each exclusive and/or nonexclusive ambulance zone.Local EMS Agency or County Name:Ventura County EMSArea or subarea (Zone) Name or Title:ASA6Name of Current Provider(s):Gold Coast AmbulanceServing since 1949Include company name(s) and length of operation (uninterrupted) in specified area or subarea .Area or subarea (Zone) Geographic Description:Combination of Metropolitan/Urban, Suburban/Ru

· ······ · Ventura Public Health County A Division of the Ventura County Health Care Agency EMERGENCY MEDICAL SERVICES 2220 E. Gonzales Rd., Suite 130, Oxnard, CA 93036-0619 . The 2011 EMS Plan Update for Ventura County EMS Agency is submitted for your review.

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533 Santa Clara Ave 9:00-11:00 A.M. Tue 1 Aug Santa Paula Centro Cristiano Emanuel 505 W Harvard Blvd 12:00-3:00 P.M. Thu 3 Aug West Ventura Ventura Catholic Charities 303 N Ventura Ave 9:00-11:00 A.M. Fri 4 Aug West Ventura Red Barn Market 995 N Ventura Ave 11:00-1:00 P.M. Mon 7 Aug Saticoy Saticoy Food Pantry* 11168 Violeta St 4:30-6:00 P.M .

Deputy Director, Population Health Management and Clinical Integration Telephone (805) 677-5110 Email Address johnson.gill@ventura.org Mailing Address 5851 Thille Street, 2 nd Floor Ventura, California 93003 1.2 Participating Entities. The Ventura ounty Health are Agency's (VHA) Whole Person are (WP) pilot, titled the . Ventura County

koperasi, dana pensiun, persekutuan, perkumpulan, yayasan, organisasi massa, organisasi sosial politik, atau organisasi lainnya, . 12 13 Penjelasan Pasal 1 Cukup jelas. BAB II NOMOR POKOK WAJIB PAJAK, PENGUKUHAN PENGUSAHA KENA PAJAK, SURAT PEMBERITAHUAN, DAN TATA CARA PEMBAYARAN PAJAK Pasal 2 (1) Setiap Wajib Pajak yang telah memenuhi persyaratan subjektif dan objektif sesuai dengan .