Performance Audit and 2012 Financial Review of the Emergency Medical Services Levy

Key audit findings included:

• EMS’s overhead increased by 51 percent primarily due to changes in the County’s distribution methodology.
• Overhead charges to EMS and its programs generally represented benefits received, but equity could be improved in a few cases.
• EMS took steps to enhance the accountability, transparency, and cost-effectiveness of its Strategic Initiatives Program by developing and reporting on some performance measures.
• EMS did not quantify financial benefits for several of the strategic initiatives prior to expanding them into regional services.
• EMS managed the 2012 EMS levy in compliance with the council-adopted financial plan.

To improve the equity of overhead distribution, we recommend that Public Health merge the Consolidated Contract Oversight category into the Accounting, Budget, and Financial Services category and EMS include the King County Medic One Program in distributing Facilities Management overhead charges. In addition, we recommended that EMS continue to take steps to quantify and report the financial benefits of strategic initiatives intended to contain costs or gain efficiencies.

The primary purposes of the Performance Audit and 2012 Financial Review of the Emergency Medical Services levy were threefold: 1) review the major drivers of the increase in overhead charges to the EMS levy fund from 2012 to 2013 and how the EMS Division allocates those charges to its programs; 2) evaluate the analysis supporting the expansion of strategic initiatives into regional services and the selection of new strategic initiatives; and 3) assess the compliance of the 2012 EMS levy financial activities with the adopted financial plan.