Supervisors approve five-year contract with ambulance provider

RIVERSIDE – Despite concerns over the terms and the no-bid origin of the agreement, the Board of Supervisors today approved a five-year contract with American Medical Response to continue providing ambulance services throughout Riverside County.

”Based on my experience, we get very fine service from AMR,” Supervisor John Benoit said ahead of the board’s 3-1 vote to stay with the Denver-based firm. ”There’s a huge value associated with having a company with the kind of resources they bring to bear and the uniformity they offer.”

AMR has provided emergency transport services in the county since 1980. When its last contract renewal came due in 2012, a number of parties urged the board to consider other ambulance providers and compel AMR to compete for the county’s business.

Officials from Hemet and Murrieta questioned whether AMR was delivering top-notch service and said a competitive bidding process would be a good means of gauging its performance.

The board declined to put the ambulance contract out to bid and instead committed to AMR for three years, but directed county staff to conduct a study of the provider’s strengths and weaknesses and determine whether it was time to re-bid the ambulance contract.

Martinez, Calif.-based Abaris Group was retained to complete a comprehensive assessment of the county’s overall emergency medical services system and what was needed to improve it and the advanced life support service handled by AMR.

Based on Abaris’ findings, Department of Public Health officials determined that AMR remained the best choice for the county. The agency’s emergency medical services director, Bruce Barton, told the board today that ”multiple meetings” with the company had resulted in promises to make ongoing improvements.

Some of the enhancements AMR will make include:

— upgrading its durable medical equipment, such as cardiac monitors and radios, every five years;

— converting its entire fleet to Type III modular ambulances, which offer greater treatment capacity;

— improving emergency response times;

— extending service to remote mountain locations; and

— implementing a ”comprehensive patient and customer satisfaction program,” to be coordinated with county EMS personnel.

Supervisor Kevin Jeffries, a former firefighter and emergency medical technician, said he had been generally satisfied with AMR’s service over the years but did not like the idea of granting a five-year contract without competitive bidding.

For that reason, he voted against the compact with AMR.

”This is about protecting the public’s interest,” Jeffries said. ”Even our contract with (Cal Fire), as massive as that is, comes up for negotiation every three years. It’s very difficult to accept this as the path we must follow and not open this up to more competition or reviews of other providers. The ratepayers out there — are they getting the best deal financially?”

The AMR contract will be funded entirely from fees collected from public and private health insurance providers.

Jeffries also disliked the prospect of AMR receiving automatic contract renewals — approved by the Department of Purchasing and Fleet Management, not the board — through 2030.

Benoit broached the idea of holding an annual public performance review to determine whether AMR was abiding by its contract terms, but Supervisor John Tavaglione was strongly opposed.

”To bring this back every single year, I think, is wrong,” Tavaglione said. ”You’re going to politicize this. You’ll have basic life support ambulance companies start filtering in and … wanting to take over the AMR contract. They will make our jobs more difficult by pressuring us. You will not like it. Trust me.”

Board Chairman Marion Ashley agreed, prompting Benoit to alternately recommend that the board at least receive annual reports from county staff advising of the status of AMR’s contract and whether there were trouble spots that might require the board’s attention.

With the exception of Jeffries, the board agreed to the amendment.

The contract will expire on June 30, 2020.

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