After the Santa Barbara County Board of Supervisors approved permits for the county Fire Department to start providing ambulance services next year, the current provider issued a statement alleging a violation of state law with the new permit process.
American Medical Response, whose longtime contract is set to expire in March, claims that the Board of Supervisors “does not have the authority to select which ambulance providers receive permits.”
California’s EMS Act says that each county may develop an emergency medical services program, and must designate a local emergency medical services agency, or LEMSA, that oversees delivery of emergency services and sets policies, rules, and procedures governing ambulance providers.
Santa Barbara County’s LEMSA is the Public Health Department.
“The board has effectively given the Fire District an exclusive right to provide ambulance service when it did not have the authority to do so,” said Sean Russell of Global Medical Response, AMR’s parent company, in last week’s statement.
“At the center of this is a board that was following the process until it realized AMR was going to win the contract, so they found a workaround to try to knock the incumbents out of the running.”
In response to questions from Noozhawk, Michael Rice of AMR said the company is currently “reviewing all of our options, including legal remedies.”
Santa Barbara County spokesperson Kelsey Gerckens Buttitta said that the county cannot comment on threatened, pending, or actual litigation, and that it has not been served with any complaint from AMR.
“AMR continues to be the county’s ambulance provider until its contract expires in March 2024,” Gerckens Buttitta said. “The county’s goal continues to be the provision of timely and responsive ambulance transport with the highest quality emergency medical care to meet the needs and expectations of our community.”
After about a year of AMR and County Fire vying for the county’s exclusive ambulance services contract, the Board of Supervisors voted last week to approve permits for the county Fire Department to take over ambulance services (including 9-1-1 call response and interfacility transports), and to deny AMR’s application.
The county started with a bidding process for an exclusive ambulance services contract.
Last fall, an independent review panel evaluated and scored both AMR’s and the county Fire Department’s proposals, and recommended AMR be awarded the contract. AMR’s application scored more than 300 points higher than County Fire’s.
When the county issued a notice of intent to award the contract to AMR, the Fire Department filed multiple protests and appeals to the decision, all of which were denied.
The supervisors decided to create a non-exclusive permit system in April, and later gave themselves authority to approve or deny the permits.
“An independent panel made the decision, and it wasn’t even close,” said Russell, the Pacific Region President for GMR. “AMR Santa Barbara’s capabilities far exceeded those of County Fire. Given AMR’s significant win margin, we were surprised by their protests, but we followed the process.”
The supervisors voiced their support for the Fire Department’s proposal, and concerns with AMR’s proposal, at last week’s hearing.
They also detailed them in the findings attached to their approvals and denials, to explain why they awarded the permits to one qualified provider over the other.
Findings for denying AMR’s application, prepared by county staff at the board’s request, state that AMR’s proposal does not demonstrate a community benefit and lacks visibility and transparency.
“Specifically, AMR’s proposal lacks sufficient detail regarding how AMR proposes to serve remote areas of the county, most notably the Cuyama Valley, while meeting LEMSA response time requirements,” the findings state.
“Additionally, AMR’s proposal demonstrates relatively few community benefits, such as a paramedicine program or an alternative destination program.”
The findings also say that AMR’s application fails to demonstrate improvements for promoting system integration, or how it would integrate with the interfacility transport and critical-care transport permit providers for a cohesive system.
These findings, along with AMR’s and the Fire Department’s applications and other documents and presentations, are available on the county’s website here.
County Fire Chief Mark Hartwig said that these permits will allow the Fire Department to “more fully integrate our paramedic first response with ambulance transport, and provide seamless continuity of care from ‘9-1-1- call’ to arrival at hospital emergency rooms.”
Hartwig added that some of the department’s improvements to service delivery include a fleet of new ambulances and equipment, community paramedicine programs, faster response times to priority calls, and more advanced life-support units.
The county Fire Department is set to start providing ambulance services on March 1, 2024.
The department website homepage says information on EMT, paramedic, and registered nurse transport professional recruitment is coming soon.
Hartwig told the supervisors last Tuesday that he will “reach out to the standing workforce today” and acknowledged that it is a “bit of an awkward situation.”
He said his department is working with the Human Resources Department on a recruitment plan.
“Their workforce is our workforce, and we want them to continue to serve,” he said.
Rice, of AMR, told Noozhawk that the company does have “open positions in other locations that are available to our Santa Barbara staff.”