Riverside County supervisors have started a process that would put the county’s ambulance services contract out to bid for the first time in recent memory.
By a 4-1 vote Tuesday, June 12, the board approved a three-year extension to the county’s contract with American Medical Response. The contract, which was set to expire July 1, now runs until June 30, 2015.
John Tavaglione voted against the extension.
At the same time, supervisors approved a timeline proposed by Supervisor Jeff Stone that calls for a new emergency medical services plan to be finished by March 3, 2014, with a consultant to guide that plan to be chosen by September of this year.
By June 1, 2014, the board is to hold a public hearing to award a contract to AMR, a competitor or a series of private ambulance companies.
The new contract is supposed to start July 1, 2015. AMR is to be given a year’s notice if they aren’t chosen as the future contractor.
The board’s action promises an in-depth look and possible shakeup of the way ambulances are provided in what has been one of the nation’s fastest-growing counties. State legislation in the 1980s gave exclusive territorial rights in the county to several private companies. AMR inherited those rights after buying those companies.
The current contract dates back to 2004 and was renewed in 2009. It has never been bid out and county officials have estimated its annual worth at $95 million, although AMR makes less than that because it can’t get full reimbursement from every patient it transports.
Support for bids
In recent months, the county Fire Chiefs Association, the union representing Cal Fire/Riverside County firefighters and the city of Murrieta have called for the contract to go out to bid. They say competition will provide the best patient care at the lowest cost and make much-needed improvements to the county’s emergency services network.
AMR contends a bid process isn’t needed, since it consistently meets response time standards outlined in its contract. AMR has said it employs nearly 800 people countywide and has spent close to $30 million since 2004 to improve ambulance service.
Thomas McEntee, AMR’s general manager for Riverside County, asked supervisors Tuesday for a five-year extension to give the company the certainty it needs to spend on improvements, such as special monitors that can determine what kind of heart attack a patient is having and relay that information to hospitals.
A three-year extension doesn’t provide enough time for AMR to make those enhancements, said company spokesman Jason Sorrick. He said AMR is reviewing the board’s vote to determine if the changes are in line with the current contract or whether they represent a fundamental change requiring further negotiations between the county and AMR.
“What they voted on really wasn’t the best thing for patient care,” Sorrick said.
Uniformed AMR workers attended the meeting, including emergency medical technician Cynthia Gonzalez. “Please put patient care first and leave politics out of this decision,” she told the board.
Murrieta officials, including Councilman Doug McAllister, asked supervisors to open the contract to bidding.
AMR has said Murrieta wants a bid process so it can raise money from ambulance companies to help pay for the city Fire Department, a charge McAllister denied. “This is about good government,” he said. “This is about transparency.”
Hemet Councilman Larry Smith told the board to give AMR a five-year extension, so his city could work with the company to create a new dispatch system to avoid sending fire engines out to minor calls.
‘They save lives’
Tavaglione favored a five-year extension with annual performance reviews that gave AMR a one-year termination notice if they didn’t meet standards. By opening the contract to bids, he said he was concerned the county could lose local control over emergency services to the state, since grandfather rights would be lost and state regulators would be involved in the bidding process.
“I’ve seen AMR in service,” he said. “They get the job done and they save lives.”
But Stone said competition would improve service.
“AMR, again, is a great company,” he said. “They may be the victor in this in the end. But I think they’ll be better as a company and I think we’ll be better in delivering health services for our constituents” through a bid process.”
Supervisor Marion Ashley was concerned that Stone’s timetable was unrealistic. “We don’t want to play Russian roulette with our lives by rushing to the net on this process,” he said, adding he wanted to make sure AMR is fairly compensated for its lost investment to improve emergency services in case it loses the contract.
Ashley and Stone ended up voting for the contract extension.
Stone said the board can extend AMR’s contract if the timetable isn’t being met. County officials could examine the value of AMR’s investments and a buyout provision could be negotiated, he added.