Title
Chief Administrative Office, Emergency Medical Services and Emergency Preparedness and Response Division, recommending the Board consider the following:
1) Award Request for Proposals 21-990-036 for advanced life support ambulance operations services within County Service Area 3 (CSA 3) to the sole qualified proposer, California Tahoe Emergency Services Operations Authority (CTESOA); and
2) Authorize the Chief Administrative Officer, or designee, to negotiate an agreement for services with CTESOA for Board consideration.
FUNDING: CSA 3 - Ambulance service fees and benefit assessment revenue.
Body
DISCUSSION / BACKGROUND
The County is responsible for ensuring the provision of prehospital Advanced Life Support (ALS) services to the residents of the County, and does so by contracting for these services through County Service Areas. The County is divided into two County Service Areas (CSAs) for the provision of ambulance services. CSA 3 includes the Lake Tahoe Basin, the City of South Lake Tahoe, Meeks Bay, and Tahoma.
The County’s Emergency Medical Services (EMS) System is authorized by County Ordinance Code Chapter 8.74 - County Emergency Medical Service and Medical Transportation Ordinance (“EMS Ordinance”), under the provisions of Title 22 of the California EMS Act and the California Health and Safety Code.
CTESOA has been the contracted ambulance operator in the CSA 3 South Shore operating area for 20 years; however, the EMS Act provides for periodic competition for ambulance operations contractors. In addition, pursuant to a settlement agreement with the California State Emergency Medical Services Authority (Cal EMSA), a competitive process in CSA 3 was to be completed by the County no later than August 31, 2021.
The County issued RFP 21-990-036 on April 16, 2021 and responses were due on May 28, 2021. CTESOA was the only respondent. CTESOA is qualified to perform the services and has been meeting the requirements of its current contract with the county, consistently providing response times that exceed the 90% standard set forth in the contract. The current contract expires August 31, 2021.
CTESOA proposes to continue its current operations model, which includes both civilian EMTs and paramedics as well as firefighter-paramedics. This model helps constrain personnel costs while still providing all-risk response capability. The proposed cost for the first year of the 10-year agreement is $3,779,425, with escalators applied to certain line items in the following years. In addition, CTESOA is requesting a lump sum, to be negotiated, to be used for facility costs. The
ALTERNATIVES
The Board could choose not to award the RFP; however, failure to complete this process and enter into a contract before August 31, 2021 would violate the terms of our settlement agreement with Cal EMSA. In addition, it is unlikely that a new solicitation would elicit more proposals. In the solicitation of 2019, CTESOA was the only respondent.
PRIOR BOARD ACTION
19-0303: March 12, 2019, the Board awarded RFP 19-918-037 to CalTahoe
19-1102: August 27, 2019, the Board approved the current contract with CalTahoe for the period of September 1, 2019 through August 31, 2021
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Cal EMSA reviewed the RFP and draft contract.
CAO RECOMMENDATION
Approve as recommended.
FINANCIAL IMPACT
The proposed contract amount for year one exceeds the current revenue estimate for CSA 3; however, there is sufficient fund balance in the CSA to cover the agreement for the first year costs ($3,779,425) while maintaining adequate reserves for economic uncertainty. Staff will return to the Board with recommendations for increasing ambulance rates in CSA 3 to cover future year costs. Ambulance rates in the County are currently approximately 25% below the median of other jurisdictions' rates. Concurrent with the negotiation process, staff will work on a fiscal analysis and will ensure that any proposed agreement is supported by a sustainable funding plan.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Public Safety
CONTACT
Sue Hennike, Deputy CAO