To: Board of Supervisors
From: Lewis Broschard, Chief, Contra Costa County Fire Protection District
Report Title: AMR Contract Amendment and Extension
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
Acting as the governing board of the Contra Costa County Fire Protection District, APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract amendment with American Medical Response West, increasing the payment limit by $135,000,000 to a new payment limit of $570,000,000, and extending the term through December 31, 2027, to update the current service plan for compliance with Contra Costa EMS Agency regulations that become effective on January 1, 2026.
FISCAL IMPACT:
The ongoing costs of this contract extension will be funded through the collection of transport fees as approved by the Board of Supervisors for the duration of the contract. The revenues collected and the subsequent expenses are paid from the Fire District EMS Transport Fund.
BACKGROUND:
The District has been providing ambulance services in the Alliance model with American Medical Response West, Inc. (AMR) 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 contract is currently set to expire on December 31, 2025.
On November 4, 2025, the Board of Supervisors approved a contract extension with the District for the provision of emergency ambulance services in Emergency Response Areas I, II, and V. As a result of this contract extension with the County, and the District’s continuing need for AMR's services to match the terms set forth in that contract extension, the District and AMR now seek to extend their contract by two years with a new termination of December 31, 2027. This contract amendment includes an increase to the existing payment limit by $135,000,000 to a new payment limit of $570,000,000. In addition, because of new/changed Contra Costa Emergency Medical Services Agency (CCEMSA) regulations that become effective on January 1, 2026, the parties need to revise the existing Service Plan to reflect the new/changed CCEMSA regulations, including a onetime purchase of video laryngoscope equipment.
The expenses in this contract extension include the usual and customary costs associated with daily staffing of all system ambulances, field supervision, repair and maintenance of ambulances and support vehicles, overhead and management staffing, administrative expenses, crew overtime, occupancy costs, nurse navigation program costs, ambulance system status management personnel and systems costs, and other expenses directly related to the provision of emergency ambulance services. The extension of the contract between AMR and the District will ensure continued emergency ambulance services are provided in Emergency Response Areas (ERA) I, II, and V.
CONSEQUENCE OF NEGATIVE ACTION:
If the amendment and extension is not approved, the current contract will expire on December 31, 2025 and there will be a lapse in emergency ambulance services within ERAs I, II and V, negatively impacting the community's access to timely and critical emergency services.