The County of Monterey’s EMS makes improvements after failed ambulance contract attempts.

Lessons learned, says Teresa Rios, chief of the County of Monterey’s Emergency Medical Services Bureau, of two failed attempts at crafting new ambulance contracts since 2019. The first attempt resulted in only one bid from current provider American Medical Response that was rejected by the county as too costly. The second in 2021 resulted in zero bids. AMR sent a letter instead, calling the county’s request for proposals “seriously flawed.” The county and AMR made an agreement that kept the company in place.

Some aspects of the county’s last two RFPs were good, Rios says, “but others needed to be fine-tuned.” And figuring out how to cover a rural county encompassing 3,700 square miles continues to be a challenge. “The complexity of our county makes it difficult to serve – the geography that makes it beautiful is the same thing that makes it difficult to serve,” Rios says.

Since the last failed RFP, Rios says her agency has been making improvements that will lead to a more workable future ambulance contract. One of the biggest changes was restructuring how the county handles 911 calls, with a process for prioritizing “to assess the call better and send the right resource to the right person at the right time,” she says. “At one point, almost everything was an emergency.”

AMR was also previously required to pair a paramedic and emergency medical technician for all calls regardless of the call’s status, says AMR Regional Director Michael Esslinger. Lower-level calls can now use two EMTs, freeing up paramedics for higher-level calls. Esslinger says recent changes are the best he’s seen in 20 years. AMR is still reviewing details of a draft scope of work, “but there’s been great progress.”

The EMS Bureau is taking public input for a new RFP from 8:30am-12:30pm Wednesday, Nov. 8, at 1441 Schilling Place in Salinas. It is also available over Zoom. The draft scope of work and online public comment form is available at tinyurl.com/55axykby. The public comment period ends on Friday, Nov. 17.

Other opportunities for input include Zoom sessions from 10am-12pm, Monday, Nov. 6 and 5-7pm, Tuesday, Nov. 14. All Zoom meetings can be accessed at MoCoEMSAmbulance.