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COUNTY OF SAN MATEOInter-Departmental Correspondence | ||
Health Department | ||
DATE: |
January 28, 2008 | |
BOARD MEETING DATE: |
February 12, 2008 | |
SPECIAL NOTICE/HEARING: |
None | |
VOTE REQUIRED: |
Majority | |
TO: |
Honorable Board of Supervisors | |
FROM: |
Charlene A. Silva, Director, Health Department Barbara Pletz, EMS Administrator | |
SUBJECT: |
Emergency Ambulance Request for Proposals | |
RECOMMENDATION: | ||
Adopt a Resolution authorizing the Director of the Health Department to issue a Request for Proposals (RFP) for Emergency Ambulance Services. | ||
VISION ALIGNMENT: | ||
Commitment: Ensure basic health and safety for all. | ||
Goal 5: Residents have access to healthcare and preventive care. | ||
The emergency ambulance RFP contributes to this commitment and goal by attracting qualified ambulance providers to submit proposals to provide excellent quality emergency ambulance service at a reasonable price to patients and third-party payers. | ||
BACKGROUND: | ||
Health and Safety Code Section 1797.224 permits local Emergency Medical Services (EMS) agencies to create one or more exclusive operating areas (EOA) for ambulance service as long as a competitive process is utilized to select the provider. San Mateo County’s EOA has existed since 1976 and is county-wide with the exception of the City of South San Francisco. The last ambulance RFP was conducted in 1997 and the resulting contract with American Medical Response West (AMR) ends on June 30, 2009. | ||
The current contract with AMR includes both emergency ambulance service and fire service paramedic first response within the EOA. The San Mateo County Pre-hospital Emergency Services Group (JPA) is a subcontractor to AMR. The County’s Public Safety Communications dispatch center (PSC) dispatches the emergency ambulances and fire service paramedic first responders using Computer Aided Dispatch (CAD). | ||
In the fall of 2006 the County began the EMS System Redesign Process, with the Board- appointed Emergency Medical Care Committee, and the process concluded in December 2007. This process involved ten working committees and more than 100 participants. Most of the system redesign meetings were open to any participant in the EMS system including standing EMS committee members and hospitals. All stakeholders in the EMS system were represented including Public Safety Communications, fire first responders, fire labor, fire chiefs and transport paramedics. The finance and steering committees included system stakeholders such as County management, city management, and fire chiefs. County staff met with representatives from the American Federation of State, County and Municipal Employees (AFSCME) to discuss options and take questions from staff and union members as part of RFP development process. Recommendations resulting from the Redesign Process were considered in the development of the RFP and can be viewed at www.smhealth.org/ems. | ||
DISCUSSION: | ||
The RFP requires that proposers submit proposals that address two emergency medical response/transport models. Model A is for emergency ambulance only with an on-scene response time standard of 8:59 minutes. Model B is for ambulance service provided by a private ambulance which would subcontract with fire service for paramedic first response with an ambulance response time standard of 12:59 minutes. Model B is the present system. | ||
For dispatch services, the RFP specifies that PSC may continue to dispatch emergency ambulances and fire service first responders, as it does now, but offers the proposer the option of making a proposal to dispatch its own ambulances. In this option, PSC would receive the 911 medical requests from the local dispatch centers, interview the caller, determine the level of response needed, provide pre-arrival and post-dispatch instructions, and dispatch the fire service first responder. However, rather than having PSC dispatch the ambulance, there would be an electronic transfer of information from the PSC CAD to the ambulance contractor’s CAD and the contractor would dispatch its own ambulances. This option is included as it may result in more efficient ambulance deployment which in turn positively affects patient care as well as system costs. Additionally, it permits the County to hold the contractor 100% accountable for ambulance response time compliance. | ||
The RFP encourages proposers to maintain or decrease the current patient fees. In addition they are encouraged to maintain the initial patient fees for at least two years. | ||
The deadline for submission of proposals is June 18, 2008. Following negotiations with the selected contractor, a contract is scheduled to be brought to your Board for approval in January 2009 for a contract start date of July 1, 2009. | ||
FISCAL IMPACT: | ||
There is no fiscal impact associated with the issuance of the RFP. | ||
