American Medical Response will remain Riverside County's primary ambulance service for the next three years, but after that, the company will have to compete with other providers for a contract, the Board of Supervisors decided today.
Following a two-hour discussion, the board voted 4-1 -- with Chairman John Tavaglione dissenting -- to extend AMR's current master ambulance contract by 36 months and to prepare a competitive bidding process whereby the Denver- based company will have to prove it's the best one to serve the county.
AMR, which employs 800 paramedics, nurses, emergency medical technicians and other personnel locally, has been the county's ambulance service provider since 1980.
"Our workers do a fantastic job and have served the county selflessly for decades," AMR-Riverside General Manager Tom McEntee told the board. "Contrary to what the critics say, I don't believe our emergency medical system is broken. It works flawlessly every day."
Calls for AMR's contract to go out to bid have been loudest in Murrieta, where officials point to delayed responses and unjustifiable fees charged by the company as reasons to look at alternative providers.
"Multiple cities, fire chiefs and medical professionals have all (expressed) the same concern: why has such a lucrative contract not gone out to bid for such a long time?" wondered Murrieta Mayor Doug McAllister. "This is not just about Murrieta. It's about transparency in government and good government."
Steve Sandefer, president of the Hemet Firefighters Association, said the public should be assured it's getting the optimal return on its money from AMR.
"Let's put this contract under the microscope and analyze everything front to back," he told the board. "This is not about AMR. I expect them to come out on top in a competitive bid. But to not look (at alternatives) is not doing the taxpayer justice."
Several AMR personnel addressed the board, saying that at the root of most complaints from unionized fire personnel was a desire for cities to expand their ranks of firefighter-paramedics and phase out the use of ambulances.
Tavaglione echoed that sentiment.
"The (unions) are hoping to gain something ... so they can increase their staffing, putting the care and safety of the patient second," the chairman said. "I've seen AMR in service. They get the job done and save lives."
County fire Chief John Hawkins praised AMR as a "competent ambulance transport agency" and recommended extending its contract to five years.
"This is about what's best for the patient," Hawkins said. "It's unfortunate that this has become a somewhat antagonized process."
Supervisor Bob Buster worried that companies offering "attractive bids" might not be able to deliver.
"Here's an area where you can tolerate that the least," the one-time heart patient said. "How do we get proposals we can count on?"
Supervisor Jeff Stone acknowledged that AMR had, by most accounts, done a satisfactory job.
"But if there's one thing I've learned, it's that competition makes us sharper," he said. "There is always room for improvement. Sometimes it's necessary to go through a transparent exercise so that citizens have confidence we've done what we need to do."
He proposed -- and a majority of board members supported -- hiring a consultant by August who will examine the county's emergency medical services system and recommend new standards or modifying current ones. The consultant will collaborate with "stakeholders," including representatives from the 28 cities within the county, to update the EMS system.
Under the board-approved timetable, bidding documents will be prepared by March 2014, with the goal of signing a new master ambulance agreement with AMR or a different entity by July 1, 2015.