City Council
November 7, 2023
Ambulance Franchise & Operational Agreement Extension
Fire Department
Riverside Municipal Code 5.66 “Ambulances”:
Outlines how the City of Riverside Fire Department manages Franchise (911) and Interfacility Transports (IFT) ambulance transports within its jurisdiction.
Riverside County Emergency Medical Services Agency (REMSA):
REMSA and American Medical Response entered into a County wide agreement in 2015 to provide Advance Life Support ambulance services, which made AMR the solo ALS provider for Riverside County.
City of Riverside and American Medical Response:
City of Riverside & AMR 2018 Franchise Agreement has expired on June 30, 2023, with the Operational Agreement on November 8, 2023.
Legislative History & Background
Franchise Application Review:
RMC 5.66.040 Processing Application:
Prerequisites for a new Franchise Agreement or extension, the applicant (AMR) must fill out an application for review by the Administrator. After review, the Administrator shall submit a report to the Committee to consider the report and hear testimony.
Riverside County EMS Agency (REMSA) Review:
REMSA Contractual Renewal: Did not earn.
Did not meet the minimum (90%) or enhanced (91%) response time performance for the months of February, March, May and June 2022.
Did not submit of monthly compliance reports within 15-days of the end of each month.
Submitted an incomplete annual report (missing five-months of data).
Non-Compliant with ALS mandate, sending Basic Life Support (BLS) ambulances to Advance Life Support (ALS) calls outside of the Emergency Medical Dispatch program approved by REMSA.
Discussion / Application Review
Riverside City Subzone:
Within the Riverside Zone, AMR did meet the 90% adjusted compliance with the delayed response exemptions.
AMR was non-compliant with the ALS mandate, sending BLS ambulances to ALS level calls, which is outside of the current 2018 ALS First Responder Agreement (AMR & City of Riverside).
CY2022: Total of 1,403 incidents BLS ambulance responded in the City of Riverside requiring a City of Riverside Fire Department paramedic to provide ALS care with the BLS ambulance. 922 times RFD Paramedics transported with patient.
CY2023: 230 BLS ambulances to-date that have responded in the City of Riverside requiring a City of Riverside Fire Department paramedic to provide ALS care with the BLS ambulance. 140 times RFD Paramedics transport with the patient.
Delayed Responses:
AMR was delayed on 5,813 incidents per RFD Computer Aid Dispatch. REMSA found 2,198 to be delayed. AMR cited hospital delays. 44,299 total incidents with AMR responding to 37,148 in Riverside Zone.
Discussion / Application Review cont.
City of Riverside Contract Review:
Breach of Contract Letter:
March 14, 2023, Breach of Contract letter was sent to AMR due to delayed response for non-payment during the 2022 billing cycle.
AMR did not submit Response Time Standards for Services quarterly as stated in the 2018 ALS First Responder Agreement in Schedule “A” Section IV.
AMR was non-compliant with the ALS mandate, sending BLS ambulances to ALS level calls, which is outside of the current 2018 ALS First Responder Agreement.
Customer Service Surveys:
The three main area hospitals and ten convalescent hospitals were served. In all cases, facilities were satisfied with the services AMR provided.
Commission of Accreditation of Ambulance service (CAAS):
Current
Discussion / Application Review cont.
Strategic Priorities:
Strategic Priority Number 2: Community Well-Being
Goal 2.6 – Strengthen community preparedness for emergencies to ensure effective response and recovery.
Fiscal Impact:
RMC Section 5.66.030: AMR has paid the Franchise Application Fee of $1,858.00. 2018 Operational Agreement: CY 2022 $2,401,576.47, supports RFD Paramedic program.
Strategic Plan Alignment / Fiscal Impact
That the City Council:
Approve the extension Application for the Medical Transport Ambulance Franchise from American Medical Response Ambulance Service, Inc. to perform Advanced Life Support and Basic Life Support transport services.
Approval of the First Amendment to the 2018 ALS AGREEMENT for six- months—to May 8, 2024—with an option for another six-month extension approved by the City Manager or his designee—to November 8, 2024; while a new AMR operational agreement is being negotiated.
Adopt a resolution to extend the ORDINANCE to November 8, 2024.
Recommendations