Title
Chief Administrative Office and Health and Human Services Agency recommending the Board consider the following:
1) Approve, in concept, the transfer of the ambulance billing function from the Health and Human Services Agency to the Chief Administrative Office; and
2) Authorize the Chief Administrative Officer, or designee, to negotiate a new contract for ambulance billing services with Wittman Enterprises.
FUNDING: Ambulance Service Fees.
Body
DISCUSSION / BACKGROUND
The Emergency Medical Services and Emergency Preparedness & Response (EMS-EP) programs were transferred from HHSA to the CAO effective July 1, 2019. The Ambulance Billing function, which was separate from the program functions, remained with HHSA in the Administration and Finance Division.
With the transition of EMS-EP to the CAO’s office, the Manager of EMS-EP evaluated the appropriate organizational placement of the Ambulance Billing Function. The Manager has analyzed the work that her staff does in support of the billing function and the support that HHSA's Administration and Finance Division provides to the billing function. In addition, she has met with the current billing vendor, Intermedix, and has interviewed other billing vendors. The recommendation is to transfer the Ambulance Billing Function to the Chief Administrative Office and to transition from the current billing vendor to Wittman Enterprises. Both HHSA and CAO staff agree that it would be more efficient if the fiscal and programmatic support for ambulance billing is centralized. This allows for close coordination between the biller, staff, and the medics in the field who are completing the documentation required for billing.
Wittman Enterprises was the County's billing vendor until 2016, when a Request for Proposals was awarded to Intermedix. The resulting three-year contract expired June 30, 2019. The Board approved a one-year extension to provide time to review the services and make a recommendation for a successor agreement. The recommendation to contract with Wittman is the result of interviews with several billing vendors and a site visit to Wittman's offices in Rancho Cordova. Based on EMS staff's previous experience with Wittman and Wittman's proposal, the recommendation is to negotiate a five-year agreement. This would include all services currently provided by Intermedix along with some services that Intermedix is not currently providing, at the same rate of 4.25% of net collections. Wittman is also willing to provide additional services that are not offered by Intermedix at an additional cost. One example is refund processing, which is time-consuming for County staff.
A formal competitive process is not required for this service; however, staff interviewed the other viable vendors and received feedback from the ambulance Joint Powers Authorities (JPAs) regarding Wittman's qualifications. Both JPAs are supportive of a transition to Wittman.
If the Board supports the recommendations, staff will return to the Board in September with an amendment to the personnel allocation. Staff will also return with a proposed contract for review and approval.
ALTERNATIVES
The Board could direct issuance of a formal Request for Proposals, or direct continuation of the current contract with Intermedix.
PRIOR BOARD ACTION
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT
HHSA
FINANCIAL IMPACT
The financial impact is yet to be determined, and will depend upon the classifications that are added to the CAO and deleted from HHSA. All costs are funded by ambulance service fees.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Good Governance. Better aligning the fiscal and programmatic aspects of ambulance billing should create efficiencies.
CONTACT
Sue Hennike