The county EMS seeks a new ambulance contract after last year’s failed attempt to secure one.

Not unlike a GPS that sends the driver in circles before successfully arriving at the destination, the Monterey County Emergency Medical Services Agency has followed a circuitous route to get to a new 10-year exclusive ambulance contract for the county. The last attempt launched in 2017 was fraught with political rancor and ended in failure last year when only one ambulance company – current provider American Medical Response-West – bid on the contract.

After that bid was declared too expensive and rejected by county officials in May 2019, the EMS Agency was forced to start over. The Monterey County Board of Supervisors extended AMR’s contract set to expire on Jan. 30, 2020, by two years. A new draft request for proposals (RFP in government lingo), is now out for public comment, and while it appears changes were made that will quell some of the objections to the last RFP, there remain sticking points that will likely lead to more political wrangling.

Money and increased response times are at issue in a new proposal to put a cap on the number of times that fire districts may call on neighboring districts and city fire departments for mutual aid when those ambulances are closer to an emergency call. The ambulance company would be fined $500 per call for such calls if they exceed 3 percent of total call volume, according to Monterey County EMS Bureau Chief Teresa Rios.

“We’ve never seen this before, but it was put in the contract and we don’t know why,” Monterey County Regional Fire District Chief Michael Urquides says. “It makes no sense, because what you should be doing is encouraging sending the closest ambulance.”

Rios contends the closest ambulance “will always be available for priority calls. The 3-percent cap is to ensure that the ambulance contractor provides adequate resources in all areas they are contractually required to service,” she writes by email.

To Urquides, that’s exactly the problem. Discouraging mutual aid calls will cost ambulance users in the end, Urquides contends, because a for-profit ambulance company will be forced to place ambulances in areas with low call volume, thereby increasing costs for all users. Response times could also be impacted in rural areas because the company would be incentivised to send its own ambulance rather than call a closer agency.

Representatives of fire districts also argue that determining how mutual aid agreements between agencies work is not the responsibility of the EMS Agency.

In another replay of last year’s fight between fire agencies and the EMS Agency over whether there was enough public input in the last RFP process, Urquides says the agency is shutting out the county’s Emergency Medical Care Committee, made up of fire officials, doctors, nurses, EMS officials and citizen representatives. A May meeting was canceled due to Covid-19 and the next meeting is scheduled for July 8 – six days after the public comment period ends at noon on July 2.

The RFP can be viewed and comments submitted at bit.ly/AmbulanceRFP