RIVERSIDE COUNTY: End ambulance monopoly


BY MATT SHOBERT The Press EnterprisePublished: 04 March 2012 01:00 AM

As the first responders to virtually every serious illness and traumatic injury throughout Riverside County, firefighters and fire paramedics are acutely aware of how every second counts in the race to save lives. Ensuring that those needing emergency care are receiving the quickest and best ambulance care possible is critical to giving the sick and injured the greatest opportunity to make a full recovery.

With the county of Riverside’s contract for ambulance service set to expire soon, I firmly believe that Riverside County has a tremendous opportunity to enhance the pre-hospital emergency medical care it provides to its residents. The best way to accomplish this and to strengthen our emergency response system is by putting the county’s 10-year, nearly $1 billion ambulance contract out for a competitive bid.

Riverside County’s emergency medical system is in need of improvement. For example, our current system allows for a breakdown in the “continuity of care” for the patient. The fire department paramedic who typically responds first does not maintain control over the patient being treated. Under the current contract, that patient must be transferred from the fire paramedic to the ambulance paramedic while on-scene, which ultimately delays the patient’s transfer to the hospital — a critical factor when every second can help save someone’s life.

Another example is that the current ambulance contract includes far too many response time exemptions, allowances and situational excuses that allow an ambulance provider to arrive late with minimal penalty. Under the current ambulance contract, a provider can arrive later than 10 minutes as long as it pays fines. A $5 fine is assessed, if the ambulance is a minute late. This current system is detrimental to residents’ safety, as it provides a disincentive to improve ambulance response times.

Closed-door negotiations are not going to achieve all the improvements that Riverside County residents deserve. Our emergency medical system is 20 years behind those in similarly-situated counties. While all the stakeholders and participants in our current system are to be commended for system upgrades that have occurred over time, there still remains significant room for improvement. Putting the ambulance contract out for a competitive bid through the Request for Proposal (RFP) process allows Riverside County to design exactly what improvements it needs and wants to ensure that our residents are receiving the best possible care.

A competitive bid process for a public contract is always in the best interest of taxpayers, especially when that public contract is valued at as much as $1 billion over a 10-year period. Many of our neighboring counties in Southern California put their ambulance contracts out for competitive bid from qualified providers. Even though the Townsend Paramedic Act of 1980 encourages competitive bidding processes for ambulance service, Riverside County has not put its ambulance contract out for bid for more than 31 years.

Riverside County officials must also ensure that the competitive bid process is structured in a way that does not impact current levels of service. A way to accomplish this is by extending the current ambulance contract by a maximum of one year, which would allow a suitable amount of time to complete the competitive bid process for a new ambulance contract. Jurisdictions such as Los Angeles and Orange counties regularly put out bids for ambulance services and change providers without any disruption to public safety services. There is no reason why Riverside County cannot do the same.

Riverside County puts everything out to bid — from fleet vehicles to road construction to pens and paper. Emergency medical service should be no different. In doing so, I believe that the residents of Riverside County would receive the highest quality of ambulance service possible — certainly higher than our current level of care.

Economics 101 teaches us that by placing this contract out to bid, services would improve and the associated costs would decrease.

Matt Shobert is the fire chief of Murrieta.