COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

January 4, 2007

BOARD MEETING DATE:

January 23, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center

SUBJECT:

Agreement with American Medical Response West

RECOMMENDATION:

Adopt a Resolution:

A) Waiving the Request For Proposals (RFP) process

B) Authorizing the execution of an Agreement with American Medical Response West for medical transport services of patients for the period January 1, 2006 through December 31, 2011 in the amount of $425,000.

C) Authorizing the Chief Executive Officer of San Mateo Medical Center or her designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

VISION ALIGNMENT:

Commitment: To Ensure Basic Health and Safety for All.

Goal 5: Provide residents access to healthcare and preventive care.

The agreement contributes to this commitment and goal by providing patients with access to medical transportation by ambulance.

Performance Measure:

Measure

FY2005-06 Actual

FY2006-07

Projected

Percent of transports occurring within Required Response Time (RRT)

N/A

>90%

Transport turn around time within established guidelines for each trip

N/A

<5%

Percent of patient encounters listed on monthly injury incident reports

N/A

<5%

BACKGROUND/DISCUSSION:

San Mateo County is responsible for providing emergency and medically related non-emergency transportation as part of comprehensive care to its patients.

The ambulance transport contracts were handled by the San Mateo County Health Department, which implemented a new ambulatory transport system under the San Mateo County Mental Health Assessment and Referral Team (SMART) program in 2006. The San Mateo Medical Center had been in renegotiations with the ambulance transport company for interfacility transportation services not covered under the SMART program since January 2006. An arrangement to continue receiving professional services under the terms of the previously existing contract was in effect during the course of these discussions. Negotiations for the new contract were not concluded until the end of June 2006. Final contract documents were delayed due to an extended review process and staff turnover.

The new contract terms shall follow established SMART Program protocols for continuous, uninterrupted, countywide response, assessment, and interfacility transportation of SMMC inpatients. Both non-emergency transport (basic life support) and critical care transport (with RN or paramedic staffing) will be provided. Included will be transport to other hospitals and may include transport to SMMC in some cases, e.g. a SMMC patient who was previously taken to another facility for care not available at SMMC or for diagnostic tests. Payment to the vendor would be for patients who do not have any source of other payment for ambulance transport and will not exceed a cap of $85,000 per year.

This contract is tied to the San Mateo County Health Department’s contract with American Medical Response (AMR). The Health Department did an RFP for all services and AMR was the chosen vendor. AMR was also selected for mental health services to maintain consistency of high quality services. AMR has been a partner for many years and has continued to provide high levels of service.

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

FISCAL IMPACT:

The term of the Agreement is January 1, 2006 through December 31, 2011. The maximum amount the County shall be obligated to pay Contractor is $425,000. The maximum amount of the previous contract for this service was $340,000. Funds are included in the San Mateo Medical Center's FY2006-07 adopted budget and contract obligations for additional years will be appropriated in future budgets.

A six year contract with this vendor protects the hospital from rate increases during the six year period. Were the hospital to enter into a contract for a shorter period of time, it is highly likely that higher rates would be charged by the vendor, and the hospital would incur higher costs. For this reason, the County Manager has approved a waiver of the three year contract requirement. The volume of patients seen has increased and is not mathematically proportional to patients seen in the previous 12 month period.