COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 11, 2006

BOARD MEETING DATE:

September 26, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Barbara Pletz, EMS Administrator

SUBJECT:

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

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board of Supervisors to execute an Amendment to the Agreement with American Medical Response West (AMR) for countywide advanced life support first response and emergency ambulance service extending the term of the agreement through June 30, 2009 at no Net County Cost.

VISION ALIGNMENT:

Commitment: Ensure Basic Health and Safety for All.

Goal(s) 5: Residents have access to healthcare and preventive care.

This contract contributes to the goal by improving emergency services provided to people having behavioral emergencies in the field setting.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Percent of “on-time” responses to 911 medical emergency calls

91%

93%

BACKGROUND:

The current County contract with AMR for countywide advanced life support first response and emergency ambulance service began January 1, 1999. It is a six-year contract with two, two-year extensions at the County’s sole option. The first of these extensions was granted in January 2004 and expires December 31, 2006.

A key feature of the emergency medical services (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.

DISCUSSION:

County staff completed an extensive compliance review of the AMR contract in May 2005 and found excellent compliance in most areas. The response time standard compliance requirement for ambulances and first response in the contract is a minimum of 90% in all five response time zones. The contractor is fined for all late responses, by the minute, even if it maintains a compliance of over 90%. The Contractor has maintained a response time compliance of over 90% during the term of the contract except for December 2005 (89.89%), February 2006 (88.88%), and March 2006 (89.76%). Response times have improved in April (91.7%), May (91.2%), and June (91.4%).

The Health Department met with the San Mateo County Prehospital Emergency Medical Services Group (JPA) prior to beginning negotiations with AMR for this second contract extension. The Health Department and the JPA agreed upon a number of proposed amendments to the contract and these were included in the negotiation process.

The items that are included in the amendment include but are not limited to:

●

The term is extended by two and a half years resulting in an expiration date of June 30, 2009, putting the contract onto the County’s fiscal year.

●

Contractor is required to submit its ambulance deployment plan for review and obtain approval for any decrease in ambulance hours. Contractor will be fined for staffing less than the required number of ambulances.

●

The amounts of the financial penalties for late responses are increased substantially such as:

○

Basic life support ambulance transport per occurrence from $350 to $2,500

○

An additional incentive has been added – if Contractor maintains a monthly compliance of 95% or better within a zone, all fines for that zone will be waived for that month.

Beginning September 2006, the Health Department will embark on a one-year “EMS System Redesign” planning effort prior to developing a Request for Proposals (RFP) for EMS services set to commence in July 2009. The target date for Board of Supervisors approval for the RFP is January 2008.

The amendment has been reviewed and approved by County Counsel and Risk Management. Contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance, as well as all other contract provisions required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

FISCAL IMPACT:

Revenues from this amendment are included in the tentatively Adopted FY 2006-07 Budget for the Emergency Medical Services division. The amendment will not result in any Net County Cost.