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D. 7

To:	Contra Costa County Fire Protection District Board of Directors
From:	Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:	March 12, 2019

Contra

Costa

County

Subject:

Contract Amendment with American Medical Response West (AMR)

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 03/12/2019

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, Director
Candace Andersen, Director
Karen Mitchoff, Director
Federal D. Glover, Director

ABSENT:

Diane Burgis, Director

Contact:

Terence Carey, Assistant Chief - EMS (925) 941-3300

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: March 12, 2019
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Fire Chief, or designee, to execute a contract amendment with American Medical Response West (AMR), effective April 1, 2019, to revise the payment provisions and update Exhibit D (Ambulance Unit Hour Rates) in the Service Plan with no change to original term or payment limit, for emergency ambulance services.

FISCAL IMPACT:

The contractual unit hour rate increase is theoretically cost neutral. The District's ambulance service rates will increase by 3.0%, but only a fraction of amounts billed are actually collected by the District. That fraction (the collection realization rate) is multiplied by the 3.0% CPI increase to determine AMR's ambulance unit hour rate increase. AMR then collects 100% of ambulance unit hours invoiced to the District.

FISCAL IMPACT: (CONT'D)

Factors that impact future transport collections include transport volume, services provide (e.g., mileage and oxygen), payer mix, payment caps, and potential changes to the Affordable Care Act and other relevant legislation.

The increase is 100% funded out of the CCCFPD EMS Transport Fund.

BACKGROUND:

Effective January 1, 2016, the Contra Costa County Fire Protection District (District) became the exclusive operator of emergency ambulance service within Exclusive Operating Areas 1, 2, and 5 in Contra Costa County. The District contracts with American Medical Response West (AMR) for actual ambulance unit hours. The ambulance unit hour rates are specified in Exhibit D to the Service Plan of the Contract between the District and AMR.

The modifications to the AMR contract are as follows:

Exhibit D (Ambulance Unit Hour Rates) is replaced with a new Exhibit D reflecting new Ambulance Unit Hour Rates effective April 1, 2019. This is a contractual unit hour rate increase pursuant to Service Plan Section P.2. (Ambulance Unit Hourly Rate Adjustments).

The Contract between the District and the Contra Costa County Emergency Medical Services Agency (CCCEMSA) allows the District to request an ambulance service rate increase after the first twelve (12) month of service. The District's increase is based on changes in the Consumer Price Index, All Urban Consumers for Medical Care (U.S. city average) (1982-4=100) ("CPI"). The District's annual rate increase is the greater of three percent (3%) or the increase in the CPI for the subject calendar year.

The CPI for calendar year 2018 was 2.0%; therefore, the District has requested a 3.0% increase in its Ambulance Services Rate Schedule to be effective April 12, 2019.

To determine AMR's contractual unit hour rate increase, 0.030 (or 3.0%) is multiplied by the collection realization percentage for calendar year 2017. The District's 2017 collection realization percentage is 0.2326 (or 23.26%). This results in a unit hour rate increase for AMR of 0.006978 (or .6978%).

CONSEQUENCE OF NEGATIVE ACTION:

AMR is contractually entitled to a CPI-related unit hour rate increase on April 1, 2019.