COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

January 7, 2004

BOARD MEETING DATE:

January 27, 2004

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Health Services Director

Barbara Pletz, EMS Administrator

SUBJECT:

Amendment Extending the Agreement with American Medical Response West for Countywide Advanced Life Support First Response and Emergency Ambulance Service

Recommendation

Adopt a resolution authorizing the President of the Board to execute an Amendment Extending the Agreement with American Medical Response West for Countywide Advanced Life Support First Response and Emergency Ambulance Service.

Background

In 1998 your board approved an agreement with American Medical Response West (AMR) for Countywide Advanced Life Support First Response and Emergency Ambulance Service. These services are provided by AMR and its subcontractors which are the San Mateo Emergency Medical Services Group (JPA), the California Department of Forestry and Fire Protection, and the City and County of San Francisco through its Airport Commission.

A key feature of our EMS system, under the current contract, is the unified structure and integration between fire service first response and emergency ambulance service utilizing a single dispatch center. This collaborative arrangement has received a number of awards from the National Council for Public-Private Partnerships, International City-County Management Award for Outstanding Partnerships, the League of Cities Helen Putnam Award for Excellence in Public Safety, and the International Association of Fire Chiefs.

The term of the Agreement is January 1, 1999 through December 31, 2004, with an option for two, two-year extensions at the County's sole discretion.

The San Mateo County Civil Grand Jury recently published its 2003-2004 on the San Mateo County Emergency Medical Services Contract. It said that:

-Advanced life support, paramedic, and ambulance medical emergency transport services are being provided in compliance with the contract between the County and AMR.

-The interest of the citizens is well served by the present arrangement within the county for delivering quality emergency medical response services. Advanced life support, paramedic, and ambulance medical emergency transport services provided by AMR, the JPA, dispatch center personnel, firefighters and paramedics are being provided effectively in a professional manner.

-The emergency medical response and ambulance transport services are being provided in a manner that is in the best interest of the County and the health and safety of the ill and injured; and the County's EMS Agency is appropriately monitoring the standards and contract for such services.

Discussion

The Contractor is in compliance with the contract. The County EMS Program staff conducted a comprehensive contract compliance review in May 2002 and found excellent compliance in most areas. AMR, the fire service, and County staff are working together on those areas identified for improvement.

A report presented to the Emergency Medical Care Committee (EMCC) on September 17, 2003 provided detailed information regarding Contractor and Subcontractor performance, customer surveys, and the contract compliance review.

The San Mateo County Prehospital Emergency Medical Services Group (JPA) and the San Mateo County Fire Chiefs Association both submitted letters of support for the two-year extension of the agreement. Firefighters Union Local 250 provided testimony supporting the two year extension at the September 17, 2003 meeting of the EMCC. At its November 19, 2003 meeting the EMCC voted unanimously to recommend that the County extend the contract for an additional two years.

The contract is being amended at this time, a year prior to its original expiration date, to permit all participating parties to make necessary plans for the provision of the services contained in the contract. Additionally, we have learned through experience that emergency ambulance Request for Proposal Processes and the resulting negotiations between the parties, require longer than one year to accomplish.

Vision Alignment

The amendment to the agreement with American Medical Response keeps the commitment of ensuring basic health and safety for all and goal number 7: Maintain and enhance the public safety of all residents and visitors; and the commitment of responsive, effective and collaborative government and goal number 22: County and local governments effectively communicate, collaborate and develop strategic approaches to issues affecting the entire community. The agreement contributes to these commitments and goals by assuring quality and timely emergency response throughout San Mateo County.

Fiscal Impact

The new expiration date for the contract is December 31, 2006. All other provisions of the contract, including allowable fee schedules, remain unchanged.

The amendment will not result in any net county cost. The amendment has been reviewed and approved by County Counsel