3-year, no-bid extension for Alameda County’s ambulance contract, despite firefighter criticism

Source: Matthias Gafni, Bay Area News Group, May 10, 2017

Alameda County supervisors extended their ambulance contract with Paramedics Plus by three years despite fierce criticism by firefighters complaining the process wasn’t open for competitive bids and changes in service delivery were not included. … The agreement will lessen fines for failures to hit response times, saving the company about $3.5 million, along with other givebacks from the county, such as reimbursements for some 5150 (mentally unstable) transports and a continued break from paying support fees totaling about $5.5. million annually. The company has said it is bleeding money during its contract and needed the breaks, especially from the “draconian” fine system. Firefighters have complained that the extension should not have been awarded without a proper open bidding process. They believe ambulance service has suffered, and a change to the delivery system, similar to the Contra Costa County model pairing firefighters with private ambulance companies, is preferable. The vote came days after a judge dropped Alameda County from a federal lawsuit alleging it accepted illegal kickbacks from Paramedics Plus. The county was dropped from the suit because it agreed in April to pay $50,000 to the feds and $21,000 in attorney fees for accepting payments from the ambulance company. The company claims the agreement was legal. …

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Opinion: Contra Costa ambulance deal slightly helps response time, but has taxpayer risk
Source: Daniel Borenstein, Contra Costa Times, November 2015

The private-public partnership, apparently the first in California, is probably the best option available because it should slightly speed response time and reduce service duplication, and might enable the county to tap some federal dollars that would otherwise be lost. … But Contra Costans should realize that the plan carries downside financial risk and, contrary to some suggestions, probably won’t provide significant upside benefits for the beleaguered Contra Costa Fire Protection District for years, if at all. … An outside consultant, using current collection rates, estimates that the fire district will collect $39 million the first year and pay out, primarily to AMR, $37 million, netting a $2 million profit. But there are two major caveats. First, the consultant, former Livermore-Pleasanton Fire Chief Stewart Gary, warns in his analysis that declining numbers of patients with insurance to fully cover ambulance bills makes projections difficult and presents “one of the largest risks.” Second, the new venture will need about $9 million of seed money to cover early operations before bill payments start coming in. That advance will come from the fire district’s reserves and must be repaid.

Supes approve new cost-saving ConFire/AMR pact
Source: Martinez News-Gazette, July 26, 2015

In a search to further savings in a cash-strapped district, Contra Costa Fire has proposed a new partnership with its longtime ambulance provider, American Medical Response. ConFire will take over responsibility for billing and collecting insurance reimbursements as well as the liability if anticipated revenue doesn’t materialize. AMR will essentially function as a subcontractor providing ambulances and paramedics for a set fee. The new approach comes with added risks for taxpayers, but CityGate said that declining insurance reimbursements threaten all public agencies responsible for providing ambulance services. If private providers can’t turn a profit, they said, taxpayers could be asked to keep them afloat. Alameda County’s ambulance provider, Paramedics Plus, recently asked for an injection of $5 million of public funds to cover some of its losses. Contra Costa supervisors said they were still on board with ConFire’s plan and directed the county to proceed with negotiating a five-year contract that would take effect next year.