WOODLAND — County supervisors on Tuesday approved a five-year contract with American Medical Response to provide exclusive ambulance service, advanced life support and critical care transport in Yolo County.
The vote followed a monthlong delay requested by Sutter Davis and Woodland Memorial hospitals, both of which wanted time to negotiate lower rates for inter-facility transfers with AMR. No such reduction was worked out, but supervisors voted 4-0 to move ahead with the contract with the understanding that county staff would continue to work with AMR and the hospitals in an attempt to reduce the cost to hospitals.
Supervisors Don Saylor and Jim Provenza of Davis, Matt Rexroad of Woodland and Oscar Villegas of West Sacramento all voted in favor of the contract while Supervisor Duane Chamberlain recused himself due to an existing relationship with a party to the contract.
Tuesday’s vote was the culmination of more than a year of effort that began in December 2012 when supervisors voted to withdraw from the 10-county emergency medical services agency that Yolo County had been a part of for 37 years and create a Yolo County EMS agency instead.
The move was supported by virtually all of the fire chiefs in Yolo County as well as city managers who testified at the time that a local EMS agency would provide more efficient, effective and expedient services to county residents.
AMR has continued to operate as the county’s ambulance service provider during the past year and a half while the county formed a local emergency medical services agency and sought bids for an exclusive ambulance service provider. During that time, AMR earned praise from fire chiefs throughout the county for working with them to lower response times.
The county, meanwhile, issued a request for proposals in July 2013 and, following a bidding process, a panel of stakeholders unanimously recommended that AMR be awarded the contract, Health Director Jill Cook said Tuesday.
The contract will give AMR exclusive rights to provide ambulance service, advanced life support and critical care transport in Yolo County for the next five years with the possibility of a five-year extension beyond that.
When the contract came before supervisors for approval in January, fire chiefs and other representatives from the Davis, UC Davis, Esparto, West Sacramento, Winters, Woodland and Yocha Dehe fire departments turned out to speak in support of the contract, but representatives from Sutter Davis and Woodland Healthcare asked supervisors to postpone a vote.
William Alger, CEO of Woodland Healthcare, said the contract would require both hospitals to pay significantly higher rates for inter-facility transfers then they currently do. The estimate he provided for Woodland was approximately $228,000 more annually.
Cook countered that those rates — for ambulance transport between hospitals — were included in the bidding process and that Woodland Healthcare had a representative on the panel that unanimously approved the AMR bid. The rates, she said, had been public since October, but neither hospital expressed concern until just a few days prior to the January Board of Supervisors meeting.
Though they expressed doubt that holding off on approving the contract would make a difference, supervisors in January agreed to give both sides 30 days to come to an agreement. On Tuesday, it was clear that hadn’t happened.
Karl Pedroni, AMR’s general manager, said he had been working with the hospitals to resolve the issue but later learned from legal counsel that the rates included in the contract could not be changed.
Cook concurred, saying under the bidding process, the rates for inter-facility transport cannot be altered, but that AMR and the hospitals could try to make up the difference elsewhere.
“AMR can continue to try to make them whole on another level and I know AMR is committed to continuing,” Cook said.
Cook added that the inter-facility transport rate in the contract was generally on par with rates elsewhere in the state.
“There are rates that are lower and rates that are higher,” she said.
Meanwhile, Janet Wagner, chief administrative officer at Sutter Davis Hospital, said she was not privy to the increased rates at any time.
“No one has come to talk to me about the cost of this contract,” Wagner told supervisors Tuesday. “I am the decision-maker at Sutter Davis. I am responsible for paying the bills. … The cost of this contract is way more than I would like to pay.”
However, pressed by Rexroad, Provenza and Villegas as to whether the hospitals knew about, or should have known about the rates as far back as October, Cook repeatedly said, “Yes.”
“I am surprised,” Cook said. “The bids were public in October. I was surprised to learn that they just learned about the rates.”
And given that the bidding process that led to the rates took a full year and cost more than $100,000, supervisors were not inclined to go through it again.
“I don’t see anything that indicates to me that the process was flawed,” Provenza said. “We got rates that were reasonable overall and improve the safety in the community.”
Provenza said he would like staff to continue working with the hospitals to see if the cost of the inter-facility rates could be made up elsewhere, but added that the harm that would be done by having to repeat the entire process “would be a much greater harm.”
“I totally agree,” Rexroad said.
The new contract with AMR will take effect on March 1.
— Reach Anne Ternus-Bellamy at firstname.lastname@example.org or 530-747-8051. Follow her on Twitter at @ATernusBellamy