Title
a. Approve Amendment No. 10 to the Agreement between the County of Monterey and American Medical Response West for the provision of Advanced Life Support Ambulance Services for the County of Monterey (Agreement No. A-11610) to extend the Agreement term to January 31, 2022, implement an ambulance service rate adjustment of 9.4%, replace Exhibit B (Monterey County Ambulance Rate Table) to said Agreement, and to make other substantive amendments to various sections of the Agreement; and
b. Authorize the Director of Health, the Assistant Director of Health, or the Emergency Medical Services (EMS) Director to execute Amendment No. 10 to the Agreement between the County of Monterey and American Medical Response West for the provision of Advanced Life Support Ambulance Services for the County of Monterey.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve Amendment No. 10 to the Agreement between the County of Monterey and American Medical Response West for the provision of Advanced Life Support Ambulance Services for the County of Monterey (Agreement No. A-11610) to extend the Agreement term to January 31, 2022, implement an ambulance service rate adjustment of 9.4%, replace Exhibit B (Monterey County Ambulance Rate Table) to said Agreement, and to make other substantive amendments to various sections of the Agreement; and
b. Authorize the Director of Health, the Assistant Director of Health, or the Emergency Medical Services (EMS) Director to execute Amendment No. 10 to the Agreement between the County of Monterey and American Medical Response West for the provision of Advanced Life Support Ambulance Services for the County of Monterey.
SUMMARY/DISCUSSION:
On December 15, 2009, the Board of Supervisors awarded the Agreement for the provision of Advanced Life Support Ambulance Services for the County of Monterey to American Medical Response West (AMR). This Agreement is set to expire on January 30, 2020. In January 2019, the EMS Agency released an RFP for Exclusive Ambulance Service Provider for the Monterey County Exclusive Operating Area. In May 2019, the EMS Agency determined that the proposal received failed to meet the goals and objectives outlined in the RFP and rejected the bid. To provide sufficient time to conduct a new procurement, EMS staff negotiated with the incumbent contractor, AMR, Amendment No. 10 to the existing Agreement. The amendment includes an extension to the contract term to January 31, 2022, a 9.4% rate increase, and replacement of Exhibit B (Monterey County Ambulance Rate Table).
Pursuant to Section 17.2 of the County of Monterey and AMR Agreement (Agreement), AMR is entitled to an annual rate increase, based on the greater of:
1. Two percent (2%) divided by Monterey’s average collection rate from the previous 12-month period for which figures are then available; or,
2. Percentage calculated from the following CPI Factors divided by the Monterey’s average collection rate from the current year. Department of Labor, Bureau of Labor Statistics CPI as of the previous 12-month period for the published figure are then available for the San Francisco-Oakland-San Jose:
A. 85% of the Medical Care CPI
B. 2% of the Transportation CPI
C. 13% of All Items CPI
The language in Section 17.2 of the Agreement automatically entitles AMR to the greater of the two options for a rate increase. The calculation described in Option 1 result in a rate increase of 9.4%. The calculation described in Option 2 results in a rate increase of 35%. Because AMR is requesting a rate increase less than the amount of Option 2, contractually the Board of Supervisors should authorize the rate increase.
Amendment No. 10 also amends sections of the Agreement to:
1. Allow the use of Basic Life Support (BLS) ambulances for (a) inter-facility transfers, when medically appropriate; (b) long-distance transfers originating within Monterey County, when medically appropriate; and (c) special contracted services when that level of service is appropriate for the patient’s needs.
2. Change the submittal frequency of financial reports from monthly to quarterly.
3. Allow the Contractor to sub-contract for additional ambulance services when a special event requires a greater number of ambulances than Contractor is able to provide.
4. Allow the use of EMT-Expanded scope to staff BLS ambulances.
5. Allow Contractor to utilize ambulance, with greater than 250,000 on them, for special events.
6. Change the submittal date of Contractor’s Peripheral Provider invoices.
7. Delete superfluous language in the Agreement that no longer applies.
8. Add language to allow County and Contractor to meet and confer in instances where State and/or Federal law and/or regulations substantially affect the operation or provision of the Agreement.
9. Not impose response time penalties for the first six (6) months after significant changes in call priority assignment.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan initiatives 2. Enhance public health and safety through prevention and 4. Engage MCHD workforce and improve operational functions to meet current and developing population health needs. It also supports one of the ten essential public health services, specifically, 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
The Office of the County Counsel and Risk Management has reviewed proposed Amendment No. 10 to Agreement A-11610 as to form and legality.
FINANCING:
There are no General Fund Impacts resulting from this Board action as the contract is funded by revenues received in the CSA 74 Ambulance Services Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Teresa Rios, Management Analyst III, 7082
Approved by: Elsa Jimenez, Director of Health, 4526
Attachments:
Amendment No. 10 to the Agreement is on file with the Clerk of the Board
Amendment No. 9 to the Agreement is on file with the Clerk of the Board
Amendment No. 8 to the Agreement is on file with the Clerk of the Board
Amendment No. 7 to the Agreement is on file with the Clerk of the Board
Amendment No. 6 to the Agreement is on file with the Clerk of the Board
Amendment No. 5 to the Agreement is on file with the Clerk of the Board
Amendment No. 4 to the Agreement is on file with the Clerk of the Board
Amendment No. 3 to the Agreement is on file with the Clerk of the Board
Amendment No. 2 to the Agreement is on file with the Clerk of the Board
Amendment No. 1 to the Agreement is on file with the Clerk of the Board
Advanced Life Support Ambulance Service Agreement is on file with the Clerk of the Board