SR-700-001-05 (2)
FIRE:ADMIN:WK:BWD:F:STFRPRTS\AmbulanceContractAuthorization.doc6
Council Meeting: May 25, 2004 Santa Monica, California
TO: Mayor and City Council
FROM: City Staff
SUBJECT: Authorization for the City Manager to Negotiate and Execute a Contract
for Emergency Ambulance Services with Gerber Ambulance Service.
Introduction
This report recommends that the City Council authorize the City Manager to negotiate
and execute a contract for emergency ambulance services with Gerber Ambulance
Service.
Background
American Medical Response has provided emergency ambulance services to the City
since 1993. Their current contract with the City will expire on June 30, 2004.
In response to the City?s desire to pursue additional revenue opportunities, the Fire
Department has explored and developed a plan for increased revenue production. The
plan will recover costs for services currently being provided by Santa Monica Fire
Department paramedics for response, assessment, treatment and/or transportation by
establishing and invoicing an Advanced Life Support Assessment Fee (ALSAF) and a
Code-3 Response Fee when applicable. The Code-3 Response Fee covers costs
when City paramedics use lights and siren in the response to and/or the transport of a
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patient.
Changes in regulations governing Emergency Medical Service (EMS) now allow for
costs associated with EMS service delivery to be recovered. Similar cost recovery
efforts for Fire Department EMS service delivery are being initiated in cities throughout
California.
The ALSAF is based on the current Los Angeles County General Public Ambulance
Rates and treatment activities. Advanced Life Support (ALS) treatment activities may
include oxygen saturation, cardiac support, and the administration of medications.
Basic Life Support (BLS) treatment activities may include functions such as bandaging,
splinting and cardio pulmonary resuscitation (CPR). The ALSAF amount will be the
difference between the County approved ALS rate and the BLS rate. The ALSAF will
be adjusted when modifications occur in the Los Angeles County General Public
Ambulance Rates schedule.
Staff prepared a Request For Proposal (RFP) for emergency ambulance services that
detailed both the desired ambulance service requirements and fee invoicing
procedures, should Council move to adopt the proposed fee at budget adoption in
June. The RFP was distributed to 22 ambulance providers listed in the Department of
Health, Prehospital Care Manual.
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Discussion
Eight replies were received and evaluated against the RFP requirements. Only two
responses met all of the RFP requirements. Staff further evaluated the two most
responsive replies by contacting references and discussing management experience,
responsiveness to needs, required reports and promptness of payments. Additionally,
staff visited both ambulance provider facilities to observe the condition of vehicles and
equipment and their work environments. After completing the RFP evaluation and
comparing reference information, vehicles, equipment, and facilities, staff has
determined that Gerber Ambulance Service meets or exceeds City requirements for the
following reasons:
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Waiver of any charges to the City for processing the invoices associated with the
ALSAF and Code-3 response fees for the first year of the contract. Charges in
subsequent years will not exceed 6% of the collected ALSAF and Code-3 Response
Fee amounts.
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The quality of service will be improved by monitoring the Fire Department radio
system and deploying ambulances from pre-staged designated areas in anticipation
of a response to reduce the response times and continually moving more
ambulances into the Santa Monica area during increased ambulance use.
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Immediately able to provide the materials and services as per the RFP
requirements.
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Financial data was reviewed by Finance Department and found to be sufficient to
meet the RFP requirements.
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Reference contacts provided highly laudable comments with regards to the
character, integrity, reputation, experience and efficiency.
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Rapid repair and service of ambulances and equipment is provided through their
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own maintenance program.
Budget/Financial Impact
As part of the contract with the City, Gerber Ambulance Service will process fee
invoices for transportation at the County of Los Angeles BLS rate, less 5 percent.
Additionally, Gerber Ambulance Service will separately invoice the ALSAF for the
Santa Monica Fire Department. The Code-3 Response Fee will be added when
applicable. As of July 1, 2003, the difference between the County approved ALS rate
of $593.00 and BLS rate of $386.75 is $206.25 and the County Code-3 response rate
is $90.50. Gerber Ambulance Service will invoice the ALSAF for all transported
patients receiving an assessment by Santa Monica Fire Department paramedics. If the
patient is not transported via ambulance, there will be no charge.
The ALSAF is within the rate limits established by Los Angeles County and will provide
recovery of legitimate costs for services performed by Santa Monica Fire Department
paramedics. The contract will require Gerber Ambulance Service to remit to the City an
amount equal to 100% of the collected ALSAF and Code-3 Response Fees. In
addition, Gerber Ambulance Service will reimburse the City the amount of $23.00 per
patient transported, paid from fees invoiced by Gerber Ambulance Service for goods
and supplies used or consumed. Based on an average of 6,876 patients transported
per year, the projected increase to the General Fund will total $875,517. Formal action
by the City Council on June 15 (budget adoption) will establish the ALSAF and Code-3
Response Fees. The contract will not be executed until after that date and will be
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effective on July 1, 2004.
Recommendation
It is recommended that the City Council authorize the City Manager to negotiate and
execute a contract for emergency ambulance services with Gerber Ambulance Service.
Prepared by: Jim Hone, Fire Chief
William Kolberg, Deputy Chief - Fire Administration
Bruce Davis, Paramedic Coordinator - Fire Administration
Marsha Jones Moutrie, City Attorney
Linda A. Moxon, Deputy City Attorney
Randy Chow, Finance
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