Fremont City Council Meeting: 02/21/23 07:00 PM
3300 Capitol Avenue Div/Dept: Fire Department
Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
COUNCIL STAFF REPORT (ID # 4814) DOC ID: 4814
Updated: 2/16/2023 11:27 PM by Susan Gauthier Page 1
ADOPT A RESOLUTION TO EXECUTE A LETTER OF INTENT WITH ALAMEDA COUNTY FIRE DEPARTMENT – Adopt a Resolution Authorizing the City Manager to Execute a Letter of Intent with the Alameda County Fire Department to Negotiate the Terms of a Proposal for Ambulance Services and/or Emergency Medical Service in Alameda County
Contact Persons:
Name: Curtis Jacobson Zoraida Diaz
Title: Fire Chief Deputy Fire Chief
Div/Dept: Fire Department Fire Department
Phone: 510-494-4200 510-494-4200
E-Mail: [email protected] [email protected]
Executive Summary: This staff report recommends that the City Council adopt a Resolution Authorizing the City Manager to Execute a Letter of Intent with the Alameda County Fire Department to Negotiate the Terms of a Proposal for Ambulance Services and/or Emergency Medical Service in Alameda County
BACKGROUND: In Alameda County, 911 ambulance transports are currently provided in two ways: 1) by City fire departments that maintain “201” rights to provide ambulance transport (Berkeley, Albany, Piedmont, and Alameda); or 2) through a contract between the Alameda County Emergency Medical Services (EMS) Agency and a private ambulance provider for the Cities of Oakland, Fremont, Hayward, Livermore, Pleasanton, and the contract cities of ACFD (Union City, San Leandro, Dublin). In April 2019, after concerns about the financial and operational viability of the private ambulance provider model arose, the Alameda County Board of Supervisors convened an Emergency Medical Services (EMS) Re-Design Task Force (“Task Force”). The Task Force evaluated these issues for over 18 months and had representatives from cities impacted by the Exclusive Operating Area (EOA) ambulance contract as well as hospitals, special districts, and long-term care facilities and received overarching support for development of a Fire-Based EMS delivery system, as explained further below.
Falck has been the contracted ambulance provider with Alameda County EMS Agency since July 1, 2019, and for a variety of reasons have continually struggled to meet contractual obligations, primarily related to ambulance response and transport times. Falck has been out of compliance in October, November, and December of 2021 and were placed on a monitored performance improvement plan that included many requirements to bring them into compliance. The Board of Supervisors received information about these contract compliance issues during regular meetings and these issues have also been reported in the media.
In October of 2021, Falck, with the support of EMS Agency staff, asked the Fire Chiefs for help in the form of staffing ambulances with Fire Agency Paramedics. As a result, Fire Chiefs within the County, in partnership with ACFD and local firefighter unions, have been working together for approximately one year to execute the recommendations of the EMS Re-Design Task Force. While Falck has supported partnerships that would make the system solvent Council Staff Report (ID # 4814) Meeting of February 21, 2023 Updated: 2/16/2023 11:27 PM by Susan Gauthier Page 2
within Alameda County, it is unknown whether they will bid on the new County contract or partner with ACFD on the new model. This new model would be similar to the model in Contra Costa County, in which the County Fire Department contracts with a private ambulance provider to provide primary response service to cities within the County. Surge capacity units would be provided by City Fire Departments on an as-needed basis dependent on predicted call volumes. This model would be more financially viable than the current “private provider only” model because cost recovery rates for public entities are higher (statutorily) than for private providers.
DISCUSSION/ANALYSIS: To submit a competitive bid to Alameda County’s ambulance RFP in Spring/Summer 2023, in partnership with ACFD, the Fire Chiefs within the County recommended that the cities of Oakland, Hayward, Fremont, and Livermore-Pleasanton execute a letter of intent with ACFD. The Letter of Intent recommended in this report (Attachment 2) will enable the City of Fremont to enter negotiations with the Alameda County Fire Department to develop the commitments and obligations of each city in the model described previously.
The key elements of these negotiations will include, but will not be limited to:
1. Development of the countywide ambulance deployment model to be proposed in response to the Alameda County EMS Agency RFP, including identification of alternate transport locations.
2. ACFD’s plan for deploying ambulances within the Exclusive Operating Area (EOA), including system status management strategies and ambulance numbers, types, response times, and posting locations; this may include whether, to what extent, and on what terms the city will provide ambulance services as an ACFD subcontractor
3. The extent to which ACFD and the city will provide cross-jurisdictional automatic and mutual aid for first response advanced life support (FRALS) and/or ambulance services.
4. In-kind contributions of and/or access to facilities necessary to implement the deployment model (e.g., locating ACFD’s or its subcontractors’ ambulance units within the City of Fremont and associated fees).
5. Staffing obligations and/or requirements.
6. Shared use of technology, including access and sharing of data across the agencies .
7. Amounts and mechanisms for ACFD to recover and reimburse the city costs from payors, including administration fees to be charged by ACFD.
ACFD is proceeding with this model and intends to submit a proposal in response to the Alameda County RFP for ambulance services in Spring/Summer 2023. If the cities do not engage in these negotiations, there would be limited city input into the proposal and the terms and conditions of this model would be dictated exclusively by ACFD and its proposal.
If negotiations are unsuccessful, there would be no obligation for a city to participate in the ultimate proposal, and the Alameda County EMS Agency would still be obligated to provide 911 ambulance response services to that community. However, the current service concerns and response time delays would likely continue.
Council Staff Report (ID # 4814) Meeting of February 21, 2023 Updated: 2/16/2023 11:27 PM by Susan Gauthier Page 3
The predicted timeline for this process is:
January/February 2023 City Councils authorize execution of letters of intent February 2023 Countywide ambulance RFP* released
April/May 2023
Countywide ambulance proposals (including
possible ACFD partnership) due*; State approval
required prior to Board of Supervisors award of
contract
June/July 2023 Countywide ambulance award of contract*
July 2024 New ambulance vendor assumes responsibility
* All County RFP dates estimated and subject to change
FISCAL IMPACT: None.
ENVIRONMENTAL REVIEW: Adoption of this Resolution is exempt from environmental review under the California Environmental Quality Act (CEQA) Section 15378 (not a project); and Section 15061(b)(3) (no significant environmental impact).
ATTACHMENTS:
• Draft Resolution - EMS Transport
• ACFD FFD Letter of Intent
RECOMMENDATION: Adopt a resolution authorizing the City Manager to execute a letter of intent with the Alameda County Fire Department to negotiate the terms of a proposal for ambulance services and/or emergency medical services in Alameda County.