To: Board of Directors
From: Lewis Broschard, Chief, Contra Costa County Fire Protection District
Report Title: Emergency Ambulance Services Pre-Award Agreement
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Fire Chief, or designee, to execute an Ambulance Services Pre-Award Agreement between Contra Costa County Fire Protection District (District) and American Medical Response West, Inc. (AMR) establishing the form of emergency ambulance services subcontract that the District and AMR will execute, if the County emergency ambulance services contract is awarded to the District, for the period of May 15, 2024 through December 31, 2025.
FISCAL IMPACT:
The Ambulance Services Pre-Award Agreement does not provide for any payments to be made by either party.
BACKGROUND:
The District has been providing ambulance services in the Alliance model since January 1, 2016. This model has been successful in the County; and other agencies throughout the State are also starting to implement similar models.
The District conducted a competitive Request for Proposal (RFP) process in mid-2023. Requests for RFP responses (RFP No. 2307-669) were solicited through the County Public Works procurement process on July 24, 2023. A mandatory pre-proposal bidders conference was held on August 2, 2023. Responses to the RFP were due on September 15, 2023 with RFP presentations and interview conducted on October 6, 2023.
Three ambulance companies submitted proposals including American Medical Response West, Inc. (AMR), Priority Ambulance, and Royal Ambulance. An assessment panel, consisting of both internal and external assessors with emergency ambulance transport management experience from the District, San Ramon Valley FPD, and the Cosumnes Community Services District. Additionally, a labor representative was included from the fire service with experience serving on the statewide Emergency Medical Services Commission. The assessment panel reviewed and scored the written RFP responses, as well as participating in and scoring the RFP response oral presentations by each proposer.
The assessment panel selected AMR as the most qualified respondent to provide emergency ambulance services under a subcontract with the District. AMR is the current provider of emergency ambulance response services under its contract with the District. AMR has executed a confidential non-disclosure and non-competition agreement with the District as a condition of being selected as the prospective emergency response services subcontractor.
The purpose of the Ambulance Services Pre-Award Agreement is to establish the form of the emergency ambulance services subcontract that AMR and the District will enter into if the County LEMSA awards the County emergency ambulance services contract to the District. Under the terms of the ambulance services subcontract, AMR will be obligated to provide emergency ambulance services in the service area, at the District’s direction, using AMR personnel and a combination of District and AMR equipment. The District will have the sole responsibility for owning, maintaining, and upgrading the ambulance fleet for the duration of the contract. The District will be responsible for billing and collection of patient fees and other charges. AMR will be compensated for its services at an hourly ambulance unit rate. The parties have agreed to execute the subcontract in the present form and to make it consistent with the County LEMSA Contract between the County and the District and the District’s response to the LEMSA RFP.
If the District is not awarded the LEMSA Contract, the parties will have no further obligations to each other under the Ambulance Services Pre-Award Agreement. Additionally, the subsequent subcontract between AMR and the District will not be effective unless the Board considers and approves it at a later date, pursuant to award of a contract for emergency ambulance services between the District and the County.
If the District is awarded the LEMSA Contract, and the ambulance services subcontract is executed, it is anticipated that the payment limit of the subcontract will be approximately $300,000,000 over the five years of the subcontract. The revenue received by the District, through patient billing and reimbursements from healthcare providers and other emergency ambulance transport revenue streams, would be used to fully offset the cost of the subcontract.
The District and AMR are working together to develop a competitive response to the County LEMSA RFP for emergency ambulance service.
CONSEQUENCE OF NEGATIVE ACTION:
If the Pre-Award Ambulance Services Agreement is not approved, the District will not be able to submit a response to the County LEMSA Request for Proposals for countywide ambulance service using the Alliance model.