201 S. Anaheim Blvd.
Suite 300
Anaheim, CA 92805
Tel: (714) 765-4000
Fax: (714) 765-4008
www.anaheim.net
CITY COUNCIL AGENDA REPORT
City of Anaheim
FIRE AND RESCUE DEPARTMENT
DATE: JUNE 17, 2025
FROM: FIRE AND RESCUE DEPARTMENT
SUBJECT: APPROVAL OF SECOND AMENDMENT TO AGREEMENT
WITH CARE AMBULANCE FOR ON-CALL SURGE
AMBULANCE SERVICES
ATTACHMENT (Y/N): YES ITEM # 10
GOVERNMENT CODE § 84308 APPLIES: YES
RECOMMENDATION:
That the City Council, by Motion:
1) Approve the Second Amendment to Agreement with Falck Mobile Health Corp dba Care Ambulance (Care Ambulance), extending the original agreement for one (1) additional year through June 30, 2026 for On-Call Surge Ambulance Services and increasing the hourly rate for On-Call Surge Ambulance Services from $229.73 to $236.60 per hour; and
2) Authorize the Fire Chief, or designees, on behalf of the City of Anaheim (Anaheim), to execute the Second Amendment and any related documents.
DISCUSSION:
The City of Anaheim has an obligation to administer ambulance services under Health and Safety Code 1797.201. According to the Orange County Health Care Agency, Anaheim is an exclusive operating area which allows the City to continue pre-hospital emergency medical services (EMS) through the City’s 201 rights and must continue its provision of pre-hospital EMS in the same manner and scope as it has been providing since January 1, 1981. This allows the City to maintain control over the program in Anaheim, whether provided through a contracted ambulance transport company or an in-house ambulance program.
At the City Council meeting on May 7, 2019, RFP 310-122718 was awarded to Care Ambulance for the provision of contracted ambulance services. The agreement with Care Ambulance began on July 1, 2019, and included an initial three-year term (ending on June 30, 2022) with the option to extend for an additional three-year term. During periods of high EMS demand, when all contracted ambulances were utilized, Care Ambulance would provide additional on-call surge ambulance services at a rate of $180 per hour in year one of the agreement, increasing to $229.73 per hour in year six of the agreement.
Second Amendment with Care Ambulance for On-Call Surge Ambulance Services June 17, 2025
On-call surge ambulance services are activated during periods of high demand, where a significant increase in 911 calls results in the reduced availability of Anaheim Fire & Rescue ambulances, and potential response delays exceeding 15 minutes. Some factors that affect the availability of Anaheim Fire & Rescue ambulances include the number of simultaneous 911 calls, Hospital Emergency Department saturation, and major emergency incidents drawing multiple units. Surge ambulance services are billed in 15-minute increments to ensure the amount paid is consistent with the actual amount of time involved.
At the July 28, 2020, City Council meeting, the City Council approved the transition from contracting for ambulance services to providing in-house ambulance services staffed and supported by Anaheim Fire & Rescue. The in-house model would require the acquisition of ten (10) ambulances and the hiring of forty-two (42) Emergency Medical Technicians (EMTs) to staff the Anaheim Fire & Rescue ambulances 24 hours per day, 365 days per year.
At the City Council meeting on April 26, 2022, the First Amendment to the agreement with Care Ambulance was approved, resuming contracted ambulance services while Anaheim Fire & Rescue continued to purchase and upfit ambulance vehicles, along with recruit, hire, and train EMTs to staff the Anaheim Fire & Rescue Ambulance Program.
The First Amendment extended the term of the agreement with Care Ambulance for one additional three-year term, expiring on June 30, 2025. The First Amendment ensured the City maintained an adequate level of ambulance services while Anaheim Fire & Rescue worked to finalize the transition to providing in-house ambulance services.
The proposed Second Amendment to the agreement with Care Ambulance will extend the term for one additional year (July 1, 2025 – June 30, 2026) for on-call surge ambulance service and increase the cost of on-call surge ambulance services to $236.60 per hour. The additional one-year term will provide Anaheim Fire & Rescue with additional time to conduct a competitive Request for Proposals (RFP) process with the goal of entering a new multi-year agreement for on-call surge ambulance services prior to June 30, 2026.
The increase in the hourly rate is due to market conditions and increased labor costs.
Contracting for on-call surge ambulance services will ensure Anaheim Fire & Rescue maintains continuity of service within the City by providing redundant emergency transport safeguards, protecting the community's access to reliable emergency medical transport.
Care Ambulance has demonstrated a strong commitment to collaborating with the City of Anaheim to meet its emergency transportation needs. Their dedication to maintaining consistent and dependable surge ambulance services underscores their alignment with the City's priorities for public safety and operational readiness.
IMPACT ON BUDGET:
Sufficient funds are available in Anaheim Fire & Rescue’s Fiscal Year 2024/25 General Fund Budget, and future years will be subject to the City Council’s approval of budget appropriations.
Second Amendment with Care Ambulance for On-Call Surge Ambulance Services June 17, 2025
Respectfully submitted,
Pat Russell
Fire Chief
Attachments:
1. Second Amendment with Falck Mobile Health Corp dba Care Ambulance
2. Original Agreement, First Amendment, and Letter of Extension