Published: January 24, 2014; 02:52 PM

Riverside County could do a better job with its emergency ambulance service by changing response time standards and expanding a new way to help 911 callers, according to a consultant who outlined two options for putting the county’s lucrative ambulance contract out to bid for the first time in recent memory.

The Abaris Group’s study will help guide the county Board of Supervisors as they consider overhauling the county’s complex emergency response system. That could involve seeking bidders to provide emergency transport to hospitals.

A number of private companies held those rights in western Riverside County until American Medical Response bought them out in the 1990s. AMR has said bidding out the contract, which generates almost $100 million in average annual revenue, isn’t in patients’ best interests.

But critics say competitive bidding could improve patient care and lower costs.

In June 2012, county supervisors voted to extend AMR’s contract three years – AMR wanted five years – until June 30, 2015 and conduct a complete study of the county’s emergency medical service network. Northern California-based Abaris received a $470,000 contract in November 2012 to put the study together.

In an October report, Abaris found that overall, the county’s system meets residents’ needs and that AMR meets expectations.

However, the consultant said the response time requirements and definitions in AMR’s contract are not consistent with state and national guidelines and contain “a permissive list of exemptions.” Penalties for being late to a call are not as stringent as other counties, the report read.

In a statement, AMR spokesman Jason Sorrick said the report “validates what AMR has been communicating all along, which is that we have continuously met or exceeded our contractual requirements for decades and that the majority of stakeholders believe we do a great job.”

AMR is willing to develop a new contract that includes the changes recommended in the report, Sorrick said.

Abaris suggests a number of ways to improve the system, from re-evaluating response times to more widespread use of emergency medical dispatch, which allows dispatchers to provide medical information to 911 callers.

Abaris presented three scenarios for how the county could contract out emergency ambulance service. The first option is to keep the current system, which is the cheapest and least-complicated choice but “creates an ‘ad-infinitum’ monopoly,” the consultant’s report read.

The second option involves dividing the county into a series of ambulance zones, each with its own contract for service; a similar zone network exists now with all but a handful of zones controlled by AMR. The third alternative is to create a single zone with one contract to be put out to bid.

Sorrick said contracting with AMR “is a win-win situation for the county, patients and stakeholders, and the most fiscally responsible direction to go.” He said a bid process could cost millions to get off the ground and delay changes to the emergency response system.

County supervisors are expected to talk about ambulance service on Feb. 11.

Contact Jeff Horseman at 951-368-9547 or

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