Supervisors Yet to Look at Ambulance Bid

A push for county officials to put its emergency services provider contract out to bid remains in limbo.

Thursday, April 12, 2012

Murrieta Patch

By Maggie Avants

Putting the county’s ambulance provider contract out to bid—an issue Murrieta city officials had hoped would be a topic of discussion at this week’s Riverside County Board of Supervisors meeting—was not included in the agenda.

The Board in an October workshop had agreed to consider opening the bid process for the contract that has been long-held by American Medical Response. They asked the responsible department, Riverside County Emergency Services Agency, to bring the matter back to them within 60 days.

That has not happened.

“I am very disappointed,” Murrieta City Councilman Alan Long told Patch, when reached by phone Wednesday.

AMR’s contract is set to expire in June.

“I know there are a lot of priorities in the county but with something as important as emergency medical services, this should take priority. This was supposed to be heard in January,” Long said.

“Above all else—emergency medical services aside—we are talking about a contract worth $100 million a year that has never been put out to bid. Our voters deserve to know—prior to the June primary—what actions our Board of Supervisors will take.”

Planning for the fiscal year and dealing with Liberty Quarry hearings were cited among the reasons the item has yet to make it back onto the agenda.

“The plan had been to bring it back to the Board early this year but a number of issues have delayed the review,” said Ray Smith, spokesperson for the Riverside County Executive Office, in an email last week to Patch.

“We’ve spent inordinate time on the review of the proposed Liberty Quarry project and union negotiations. The biggest, however, is the budget…especially for the Executive Office, because those decisions determine the direction for reducing the deficit and affect every service the county provides to residents,” Smith wrote.

“The ambulance contract will return to the Board as soon as we’ve dealt with the budget-planning priorities that need to be addressed before the start of the fiscal year in July.”

Smith could not give an exact date of when that might be.

A Matter of Timing

Long, a battalion chief for the Anaheim Fire Department, said he is intimately familiar with emergency response systems because of his line of work, and cites an “aging” county system as a main reason he believes the contract should be put out to bid. Long has said the county system is 20 years behind other counties.

In the meantime, Murrieta fire Chief Matt Shobert is proposing a $350 fee per emergency medical response to Murrieta residences and businesses. Citizens could avoid the $350 per call by opting into a $48 annual fee for unlimited calls.

Shobert has said inadequate response times by AMR are putting a drain on the Murrieta Fire Department budget. It is something the department can not sustain for much longer, he said.

According to Shobert, Murrieta firefighter/paramedics typically arrive to the scene prior to AMR medics. The fees collected through the paramedic response program would be used to recoup supplies used by Murrieta fire to treat patients upon arrival, Shobert said.

“Our beef is really not with AMR, per se,” Shobert said. “It is more with the county contract. The debate has been that AMR is achieving the benchmarks set forth by the county contract—and yes they are but I have argued and debated the whole time that perhaps the bar is set a little bit too low.”

The department has begun keeping a log of every call, he said. Fire captains are tasked with documenting whether AMR was on scene prior to fire crews arriving; if they were not, they jot down the time elapsed until arrival.

The county contract specifies AMR must arrive within 9 minutes 59 seconds, 90 percent of the time.

How Calls Are Dispatched

Jason Sorrick, director of government affairs for AMR, blames the city’s method of dispatch as the reason for alleged poor response times by AMR in Murrieta.

“The reason why AMR is not arriving on scene before MFD more often is because it takes Murrieta fire, on average, one minute and 38 seconds to have someone pick up the phone from their dispatch center and provide us with the location to respond to,” Sorrick said, in an email to Patch.

“They are the only ones that still use a phone to call us with the address. We have documented calls where it has taken them over 10 minutes to call us. Since the address is not transferring electronically to our dispatch center, our dispatchers must confirm all the address information before dispatching our crew, which adds to the delay,” Sorrick continued.

“Therefore, the fire department is getting a jump of almost two minutes on our crews. Our response time clock does not start until we receive the address from Murrieta fire. This issue can be fixed if the department worked with AMR to link their dispatching system to ours, which would allow simultaneous dispatching and elimination of this delay,” Sorrick wrote.

Bruce Barton, director of the county’s emergency response agency, or REMSA, contends the system continues to improve—most recently because a new computer-aided dispatch, or CAD link, was installed for all cities that contract with Cal Fire/Riverside County Fire Department.

When 911 calls are routed in, the updated technology is utilized to send simultaneous information to public safety officials and ambulance crews, he said.

“What the Board (of Supervisors) has done, on Aug. 16, 2011, is to require that we work with the county fire department and the contracted ambulance provider to get the CAD link up and running and it went live on March 19,” Barton told Patch last week in a phone interview.

Barton said the city of Riverside has had the technology in place since 2007, and Corona Fire Department has had something similar since 2002.

“Any city can be involved; all they have to do is have to do is request it,” Barton said. Murrieta would just need to send a letter, he said.

Corona fire Chief John Medina acknowledged his department for 10 years has used a CAD dispatch system for paramedic calls. They bank off of the city of West Covina’s CAD, he said, and call information is routed through phone lines.

“We have a special tone and they (AMR) immediately get our dispatch information from a computer printout,” Medina told Patch. “The technology is there, distance is really not a factor any more. Compared to where we were before, it has been an improvement. We should always strive for improvement.”

Currently, AMR is dispatched calls through the Murrieta police and fire dispatch center, located at the Murrieta Police Station.

Dispatcher Dawn Morrison handles fire and medical aid calls when she is on duty, in addition to police calls. Morrison explained that when a 911 call comes in for Murrieta and it requires medics, she sends an audible alert to Murrieta fire with the tap of a foot pedal, and begins entering information into the city’s computer system that gets transferred to a monitor aboard fire engines. At the same, she uses a devoted phone line to call AMR, alerting them to the location of the incident.

“The calls are simultaneously dispatched—there may be a lag of six seconds at the most,” Shobert said. “Perhaps the delay is when we are calling it in, the AMR dispatcher still has to enter it into their CAD.”

Shobert said he would be open to discussing an upgrade to the Murrieta dispatch system. Because Murrieta has a combination police and fire dispatch, some bugs would need to be worked out, he said.

“It is certainly something we would consider after checking how it would mesh with our police and fire systems and how it would be implemented,” Shobert said. “We would certainly consider it but I won’t admit we are sitting here holding onto their calls for a minute and 38 seconds because that is not true.”

The Murrieta Fire Department has stated it strives for a five minute, 30 second response time, 90 percent of the time.

“From the time we get dispatched to the time we make make contact with patient…that is the essence of what we are talking about,” said Murrieta fire Engineer and Spokesperson Matt Corelli.

Long said it is a crucial time to ensure the county’s system is up to par.

“The aging baby boomer population is going to require it,” he said. “That is where most of our (paramedic) calls are going to start coming from.”