San Bernardino County’s oldest ambulance contract may be up for grabs for the first time in over 30 years following the Civil Grand Jury’s sweeping recommendations to change how the county administers emergency transport.
In its annual report, the Grand Jury recommended that the county create a request for proposal (RFP) for a new “service provider contract,” along with creating one exclusive operating area, or EOA, for ground ambulance transport throughout the county.
Currently, the county contracts with American Medical Response, or AMR, to provide ambulance services to 11 of the county’s 27 EOAs; they contain some of the county’s most highly populated areas, such as San Bernardino, Rancho Cucamonga and Victorville.
According to the Grand Jury’s report, the areas currently serviced by AMR represent approximately 9 percent of the county’s total geographic area and over 80 percent of the total population. The contract has never gone out to bid since its establishment in 1981, the Grand Jury said.
While the contract can be extended on a five-year basis, the Grand Jury found that no one EOA can be put out to bid; the entire contract must be in the bidding process. This led the Grand Jury to recommend that the county create one EOA for the entire region.
“This would allow one provider to cover the county and require the provider to service populated and rural areas,” the Grand Jury report said.
The county has been discussing the issue for the last five years, according to the report. The bidding process could take 18 to 24 months, as ambulance services are considered a “critical service” to the county, in the same vein as police and fire departments.
The current contract extends AMR’s contract until March 31, giving AMR and a potential future provider time to smooth out the transition, a direct concern for county officials, according to the report.
“In the Grand Jury’s interviewing process, it became apparent that county leadership thought it would be difficult to provide the necessary level of critical service in a changeover process,” the Grand Jury said in its report.
The current contract has performance monitoring requirements and penalties to which AMR and all other ambulance providers must adhere, including maintaining a 90 percent response time of 9:59 minutes.
AMR, particularly the company’s Victorville branch, previously has been accused of not meeting these requirements. The San Bernardino County Professional Firefighters Union, or Local 935, claimed the ambulance company frequently ran out of units in the High Desert in early 2017, leading to resources being tied up at critical times.
AMR countered the claims by saying its ambulances continued to meet required compliance times. The company questioned the union’s motives, suggesting it was driven by the city of Victorville’s move to transition to a city-based Fire Department, which was still in discussion at the time.
As one of the additional ambulance providers in the county, the San Bernardino County Fire Department was mentioned in the Grand Jury report. While County Fire stated “it could provide better service, make a profit and cover the entire county,” the report apparently seemed to conclude the opposite.
“Currently, the department is not monitored for its response time like the primary provider,” the Grand Jury report said. “Based upon our interviews, it was stated that [County Fire] could not provide a more cost-efficient level of ambulance services.”
County Fire spokeswoman Tracey Martinez countered this conclusion, stating the department believed they could “provide a more robust ambulance service to the county” while re-investing revenues from ambulance services, in contrast to a private provider.
“Revenues from private ambulance companies go to stakeholders,” Martinez said. “We would re-invest the revenues into the county instead. This would go back to the county and to County Fire’s ambulance services.”
Martinez said the department plans to be “an active participant” in the bidding process when and if the contract goes up to bid.
The Grand Jury gives the county 90 days, or until Sept. 27, to issue a formal response to its recommendations. Both the county and ICEMA, the agency responsible for regulating medical care in the area, have said they plan on taking the time to thoroughly review the report’s findings.
“Because it is such a complex issue, we’re going to be having an internal discussion about this to come back and address the Grand Jury’s recommendations within the time allowed,” county spokesman David Wert said.
The county may take a proposed response to the Board of Supervisors as early as Sept. 11, Wert said.
July 14, 2018
Daily Press
By Paola Baker
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