Title
a. Approve and authorize the Director of Health Services or designee to execute a retroactive Amendment No. 1 to AGREEMENT No. A-17430 the Ambulance Services Provider Agreement between the County of Monterey and American Medical Response West (AMR), to clarify maximum allowable standby rates for Basic Life Support (BLS) and Advanced Life Support (ALS) Special Events Coverage and replace Exhibit B with updated Exhibit B‑1; and
b. Approve and authorize the Director of Health Services or designee to execute up to three future amendments that do not significantly change the scope of services.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute a retroactive Amendment No. 1 to AGREEMENT No. A-17430 the Ambulance Services Provider Agreement between the County of Monterey and American Medical Response West (AMR), to clarify maximum allowable standby rates for Basic Life Support (BLS) and Advanced Life Support (ALS) Special Events Coverage and replace Exhibit B with updated Exhibit B‑1; and
b. Approve and authorize the Director of Health Services or designee to execute up to three future amendments that do not significantly change the scope of services.
SUMMARY:
The Director of Health Services seeks approval to execute Amendment No. 1 to the Ambulance Service Provider Agreement with American Medical Response West (AMR). This amendment clarifies that County‑approved ALS and BLS standby rates for Special Events Coverage represent maximum allowable charges and provides AMR authority to charge any amount up to, but not more than, those rates. The amendment also replaces Exhibit B with updated Exhibit B‑1 to reflect these maximum rates.
DISCUSSION:
AMR is contracted to provide Advanced Life Support (ALS), Basic Life Support (BLS), Interfacility Transport (IFT), Critical Care Transport (CCT), Standby, and Communications/Dispatch services under the County’s Exclusive Operating Area. The existing agreement includes parameters for Special Events Coverage (Section 5.5) and Board-approved hourly rates (Exhibit B).
Amendment No. 1 includes the following changes:
Adds language to Section 5.5 specifying that listed BLS and ALS standby rates are maximum rates authorized by the County.
Clarifies that AMR may not charge more than the County‑approved maximum rate under any circumstances.
Replaces the existing Exhibit B in its entirety with updated Exhibit B‑1, as attached.
All other terms and conditions of the Agreement dated July 17, 2025, remain unchanged and in full effect.
This amendment supports the EMS Agency’s responsibility under California law to oversee, regulate, and ensure compliance within the local EMS system.
This work supports the County of Monterey Health Department 2025-2028 Strategic Plan Goal(s): Provide Exceptional Person-Centered Care through Accessible, Community-Focused Health Services. It also supports the following of the ten essential public health services, specifically: 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 has reviewed and approved this agreement as to legal form.
This item was reviewed and supported by the EMS Agency leadership team.
FINANCING:
There is no impact on the General Fund associated with this action.
This amendment concerns rate clarification only and does not change any financial obligations between the County and AMR.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This agreement supports the Board of Supervisors Strategic Plan Goals of Well‑Being and Quality of Life and Safe and Resilient Communities by ensuring that residents and visitors have continued access to ambulance services within the County of Monterey.
Mark a check next to the related Board of Supervisors Strategic Plan Goals:
X Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
X Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
Prepared by: Kimberley Hernandez, Emergency Medical Services Analyst I, 755-4738
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Amendment No. 1 to the Ambulance Service Provider Agreement
Original Ambulance Service Provider Agreement