The cost of ambulance services will go up by 25 percent in a new contract with the county’s existing contractor, American Medical Response, unanimously approved by the five-member Monterey County Board of Supervisors on Tuesday, July 8.
In return, the contract includes a commitment by AMR officials to additional weekly ambulance hours, a phasing in of improved ambulances, an expansion of specific types of care and other enhancements.
AMR has been the county’s ambulance provider for the last 17 years, with its latest contract with the county ending on Jan. 31, 2026. The new contract goes into effect on Feb. 1 and lasts through 2032, with the possibility of an extension to 2037.
The new contract comes after previous failed attempts at achieving a contract since 2019 by the Emergency Management Services Bureau through the request for proposals process. Each time AMR remained as the contractor as the county worked to create new contract proposals.
The latest RFP was hammered out after reaching out to the public and stakeholders, including fire services and others. It was released to the public on Jan. 30, with four companies attending a "pre-proposers' conference," according to the county’s EMS Bureau staff who presented to the board.
Two companies responded to the RFP with contract proposals by the deadline on April 22: AMR and an unnamed company. A selection committee used a scoring system to determine which company to recommend.
Continuing with AMR came with positives, said Debra Hopgood, an EMS Bureau management analyst, including continued services to the county by a management team with local experience.
AMR will continue to provide dispatch services to the county, she said, as well as a dedicated ambulance in Big Sur and training for first responders, among other services.
In addition, she said the county will implement a new clinical scorecard that will go beyond looking at response times to include the quality of care provided. AMR also committed to phasing in new Type III ambulances with larger compartments that will benefit both patients and staff.
More basic life support ambulances will be added to respond to less urgent care needs, Hopgood said, freeing up the advanced life support ambulances to respond to higher acuity patients. AMR officials also agreed to implement a 911 nurse navigation line, where patients with lower acuity needs will be patched through for assessment of treatment needs and coordination of care.
“The EMS system frequently sees the use of 911 for situations that could be better managed by resources other than by an ambulance and transport to an emergency department,” Hopgood said. There is no charge to patients for use of the nurse navigation program.
“We believe that the various new programs and resources that we are discussing today will work together in concert to ensure the EMS system provides the right resources to meet patient needs and that those resources are capable of providing the highest levels of care reserved for the highest acuity patients,” she said.