Agenda Item No: L.2
AGENDA REPORT
DATE: September 16, 2025
TO: Mayor and Council
FROM: David Gassaway, City Manager
SUBJECT: Resolution 2025 -191 CM Revised Joint Exercise of Powers Agreement for Emergency Ambulance Services
Authorizing the City Manager to Sign a Revised Joint Exercise of Powers Agreement for the Provision and Management of Emergency Ambulance Services
Funding Source: N/A
Contact: David Gassaway, (707) 428-7400
RECOMMENDED ACTION
Adopt resolution.
STATEMENT OF ISSUE
In March 2022, the Cities of Vallejo, Rio Vista, Benicia, Dixon, Suisun City and Fairfield hired AP - Triton to conduct a comprehensive ambulance transportation study in Solano County. Upon the findings of the report, the cities pursued a Joint Exercise of Powe rs Agreement (JEPA) for the provision of Emergency Ambulance Services. The JEPA was not executed by all of the parties and further negotiations have taken place. A revised JEPA has been negotiated for consideration by the parties.
DISCUSSION
Background
In March 2022, the Cities of Vallejo, Rio Vista, Benicia, Dixon, Suisun City, and Fairfield hired AP Triton to conduct a comprehensive Emergency Ambulance Services Transportation & Optimization Study in Solano County. AP Triton is the leading industry exper t in this field. AP Triton released its findings and recommendations to the cities in November of 2022.
AP Triton recommended exploring an ambulance subcontracting model, which could maintain the existing high level of service and improve sustainability f or ambulance services in the areas being served. The recommended model is referred to as an alliance model, or a public/private provider model, where a managing lead public agency subcontracts with an ambulance service provider to provide ambulance transportation services. The primary benefit to this model is that it allows access to the Public Provider Ground Emergency Medical Transport (PP-GEMT) Program.
PP-GEMT provides an add -on-increase to the fee -for-service for Medi -Cal plans. This is a significant revenue stream available through the State of California that private ambulance providers are not eligible to participate in. The additional revenue, estimated at more than $5 million annually, may fund additional 911 system services to enhance emergency medical service delivery across Solano County.
The intent of negotiations for the alliance model was to include all cities, except for Vacaville (Vacaville manages their own ambulance service area along with the Vacaville Fire Protection District), as well as the Dixon Fire Protection District, East Vallejo Fire District, Montezuma Fire Protection District, and Suisun Fire Protection District on request from the County of Solano. The structure is formalized through a Joint Exercise of Powers Agreement for Emergency Ambulance Services (JEPA) and referred to as “Solano County Fire and EMS” or “SCFE.”
The effort was established to respond to a Request for Proposals (RFP) for Countywide Emergency Ambulance Services for the Exclusive Operation Area within Solano County. The RFP, and oversight of countywide ambulance services, is administered by the Solano Emergency Medical Services Cooperative (SEMSC), a Joint Powers Authority established in 1996, as the recognized emergency medical services agency under Health and Safety Code 1797.50.
In December 2023, City Council authorized a JEPA under Resolution 2023-292. The JEPA specifies various terms of the agreement, including:
Establishes Fairfield as the lead agency responsible for administering SCFE Creation of an E xecutive Committee consisting of the city managers of the participating jurisdictions to provide financial, operational, and service coordination amongst the participants
Creation of a Technical Advisory Committee comprised of Fire Chiefs of the participat ing jurisdictions to advise on operational requirements
Management responsibilities for the City of Fairfield as SCFE administrator and responsible party under contract with SEMSC
Provisions for withdrawal, termination, and dissolution of SCFE, as well as limitations of liability and legal authority provided under the JEPA
Fairfield, as lead agency, is also responsible for maintaining a subcontract with an ambulance transportation service provider. On December 16, 2024, the council adopted Resolution 2024 - 296 approving a Tentative Agreement with Medic Ambulance Services, Inc. to provide medical transport subcontract services.
Current Status
In July 2025, SEMSC released a competitive RFP process to select the next countywide emergency ambulance services provider. Responses to the RFP are due October 10, 2025. Fairfield is currently preparing a response to the SEMSC RFP, and if selected, is responsible for maintaining service in compliance with requirements of the SEMSC Exclusive Operation Area.
Since adoption of the initial JEPA, both the City of Vallejo and the East Vallejo Fire Protection District, represented by the County of Solano (referred to hereon as East Vallejo), are the only agencies to have not ratified the JEPA. They have sought amendments to provisions with which they do not agree.
Through additional negotiations, Vallejo and East Vallejo have requested changes to the management structure of the agreement, the process for identifying expenditure of funds collected by SCFE, administration fees for the City of Fairfield, and other terms generally related to management of the contract with SEMSC. Fairfield has engaged with both agencies to seek terms acceptable to all parties. Vallejo has requested to be included in the current draft form of the JEPA. Unfortunately, East Vallejo has not requested inclusion as of the drafting of this report.
To proceed with the JEPA in a timely manner, and to be responsive to the SEMSC RFP, staff find some amendments to the JEPA acceptable.
The proposed amended JEPA is agreed upon by the cities of Benicia, Dixon, Fairfield, Rio Vista, Suisun City, and Vallejo. The currently proposed version of the JEPA removes all of the Fire Protection Districts (exclusive of Cordelia District whic h contracts with the City of Fairfield for services), which are now all represented by the County of Solano (the County of Solano has sought to consolidate all Fire Protection Districts for purposes of gaining efficiencies of operation and financing of fir e protection in unincorporated areas of the county – a process which is underway with Solano LAFCO). However, discussions with the Fire Districts regarding participation in the JEPA are ongoing.
Staff recommend adopting the version of the JEPA attached t o this report. It provides Fairfield with sufficient funding to manage the SCFE on an annual basis, provides for the ability for Fairfield to recoup all costs of responding to the SEMSC RFP, and ensures a structure that benefits all participating agencies. One new provision is a severability clause for parties that do not ratify the JEPA. If any party to the JEPA fails to ratify the JEPA within 60 days of an award of the SEMSC contract for countywide services, then the remaining parties to the JEPA may proceed under the terms of the JEPA.
FINANCIAL IMPACT
The public/private provider model allows access to the Public Provider Ground Emergency Medical Transport (PP -GEMT) Program. The PP -GEMT provides an add -on-increase to the fee - for-service for Medi -Cal plans. This is a significant revenue stream, estimated in excess of $5 million annually, that private ambulance providers do not have access to. This additional revenue will be used to ensure 911 system sustainability and generate more revenue to enhance EMS delivery to the citizens of Fairfield and the rest of Solano County. This will also ensure that the City of Fairfield will continue to receive the $1.4 million to provide paramedic services that the city is receiving through the current Public Provider Par tnership (PPP) agreement with Medic Ambulance.
Provisions of the JEPA require Fairfield to hold in a six-month operating reserve. The operating reserve is intended as a stop-gap reserve should there be any reduction in revenue to the system.
It will also serve to cover costs during any future transitions away from SCFE should the contract be lost in the future. The operating reserve will be funded from revenues beyond expenditure.
To receive PPGEMT funds, SCFE must front-load costs and seek reimbursement from the State of California. This creates a deficit of operating revenue at startup. The City of Fairfield, as the JEPA administrator, may be required to lend SCFE monies. The JEPA provides a provision that allows Fairfield to recoup any startup costs. If Fairfield is successful in obtaining the SEMSC contract, any need to loan money to SCFE will be presented to Council at the time of contract approval. Staff, with assistance from AP -Triton and Medic Ambulance, has developed a conservative financial model to anticipate future revenue. The model anticipates the City of Fairfield recouping any startup costs within 12 to 14 months of operations.
Finally, all costs to pay Medic Ambulance for their fee as the subcontracted emergency ambulance transportation service provider will be paid from proceeds of SCFE operations. A final contract, including costs of service for Medic Ambulance, will require City Council approval prior to commencement of service. The costs associated with Medic Ambulance are withheld from this and other staff reports since the current SEMSC RFP process is open and competitive. Disclosing any specific financial information at this time could imperil Fairfield and SCFE from submitting a competitive bid against any prospective private party competitors.
PUBLIC CONTACT/ADVISORY BODY RECOMMENDATION
The prior JEPA, Medic Ambulance contract, and AP -Triton contract have previously been approved by City Council. Stakeholders were also involved in the Emergency Ambulance Services Transportation & Optimization Study conducted by AP-Triton.
ALTERNATIVE ACTION
The council may choose not to authorize the city manager to sign the JEPA. However, doing so at this time would invalidate prior efforts and costs of pursuing the JEPA. Additionally, it may risk the City’s opportunity to maintain funds currently provided through the Public Provider Partnership currently received from Medica Ambulance, the current private Countywide service provider.
COORDINATED WITH
Fire Department, City Attorney’s Office, and Finance Department
STAFF CONTACT
David Gassaway, City Manager
(707) 428-7400
[email protected]
ATTACHMENTS
Attachment 2: Proposed Resolution
Attachment 3: Proposed JEPA Clean Version
Attachment 4: Proposed JEPA Redline Version