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D.2

To:	Contra Costa County Fire Protection District Board of Directors
From:	Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:	May 12, 2015

Contra

Costa

County

Subject:

Emergency Ambulance Services Pre-Award Agreement

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 05/12/2015

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, Director
Candace Andersen, Director
Mary N. Piepho, Director
Karen Mitchoff, Director

ABSENT:

Federal D. Glover, Director

Contact:

Jeff Carman, (925) 941-3500

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: May 12, 2015
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

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 5, 2015, through March 31, 2016.

FISCAL IMPACT:

The Ambulance Services Pre-Award Agreement does not provide for any payments to be made by either party.

BACKGROUND:

At its September 9, 2014 meeting, the Contra Costa County Fire Protection District Board of Directors (the Board) received a report from District consultant The Ludwig Group that analyzed whether it would be financially feasible for the District to provide 911 emergency ambulance services under the County emergency ambulance services contract. The study concluded that the concept was feasible.

BACKGROUND: (CONT'D)

At the same meeting, the Board authorized the District Chief, or designee, to prepare and submit a proposal to provide emergency ambulance services in County Emergency Response Areas I, II, and V. In February 2015, the Contra Costa County Local Emergency Medical Services Agency (LEMSA) issued a request for proposals (RFP) to select its emergency ambulance services provider.

In February 2015, the Board authorized the District to enter into a consulting contract with AP Triton LLC (Triton) to assist the District in preparing a response to the RFP. Triton advised District staff that the most suitable and cost effective method for the District to provide services under the County emergency ambulance services contract (LEMSA Contract) would be for the District to subcontract with a private ambulance services provider to provide ambulance services. The District does not have the infrastructure or personnel necessary to directly perform ambulance services under the LEMSA Contract.

In March 2015 District staff, through a competitive selection process, selected American Medical Response West, Inc., a subsidiary of American Medical Response (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 County.

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 equipment. AMR will have the sole responsibility for owning, maintaining and upgrading the ambulance fleet. 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 form of subcontract is attached to the Ambulance Services Pre-Award Agreement as an exhibit. The parties have agreed to execute the subcontract in the form that is attached to the Ambulance Services Pre-Award Agreement, 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. The subcontract between AMR and the District is not effective unless the Board considers and approves it. 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 $188,000,000 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.

CHILDREN'S IMPACT STATEMENT:

No impact.

CLERK'S ADDENDUM

Chief Carman made a technical correction to the agreement, Page 1 under Recitals, paragraph A, to remove the end phrase "except for those portions of Emergency Response Area 1 that are in the jurisdiction of the Moraga-Orinda Fire Protection District".