Merced County decision on ambulance expected Tuesday

rgiwargis@mercedsunstar.comJanuary 26, 2013 

— Heated debates, public outcry and passionate pleas have all led to one day. On Tuesday, the Merced County Board of Supervisors is expected to decide on the county's emergency ambulance service contract.

The board’s decision potentially ends a three-month battle between 65-year provider Riggs Ambulance Service and contract winner American Medical Response -- a fight that has divided residents.

AMR won the bidding for the county's contract by four points in October after Riggs lost local preference points, which account for 5 percent of its total score.

The county removed those points after AMR appealed to the state regulatory agency, which said the local preference gave Riggs an unfair advantage. As a result, AMR ended up with a total of 364.8, compared with Riggs’ score of 360.6. The county staff then reversed course and began contract negotiations with AMR.

That decision set off a firestorm of criticism from all sides, with questions about service quality, local jobs and the bidding process at the center of the debate.

However, on Tuesday, the supervisors are scheduled to hear Riggs’ appeal and make a decision on the contract. But after months of sometimes heated and emotional debate, many of the supervisors said on Friday they’re still undecided.

"Well, I think we’ve gotten a whole lot of information and I’m waiting to see the staff report," said Hub Walsh, District 2 supervisor. "This is an important decision to make, so I'll be reviewing the staff report first. I don’t have a decision at this point in time."

John Pedrozo, District 1 supervisor, is also undecided but said he'll spend the days leading up to the meeting reviewing materials from both Riggs and AMR.

"This weekend, I’m going to study all the information that I have once again," Pedrozo said. "I think they're both quality companies, and we’ll see where it takes us on Tuesday."

District 5 Supervisor Jerry O'Banion said he’s leaning in one direction, but will still keep an open mind at Tuesday’s meeting. "Yes, I have some feelings in regard to it, but I’m not going to make that decision until I hear all the information come Tuesday," O'Banion said. "I'm going to go to the meeting with an open mind, and I'm going to keep my options open until we start discussing the issues at the meeting."

Linn Davis, District 3 supervisor, said he's undecided at this point, but feels a few key questions that are deciding factors haven't been answered.

"All the information has not been presented to me, and I have no idea which way I will go," Davis said. "I don't know if I've received all the documentation regarding how many jobs will be lost. That seems to be an issue that's been brought up, and that's always a consideration of mine."

Riggs Ambulance Service General Manager Don Vonarx said 32 Riggs employees will lose their jobs if AMR takes over, and they're all county residents.

Vonarx said Riggs estimated 45 lost jobs at the beginning of the process, because they were unclear if AMR would hire dispatchers.

AMR officials have since announced plans to hire all qualified EMTs, paramedics and dispatchers.

The 32 Riggs employees at risk of losing their jobs work in administration, billing, community service, mechanic, human relations and management positions, Vonarx said.

Although Riggs' second protest was denied this week by county staff, the supervisors will hear a 15-minute appeal from Riggs officials during Tuesday's meeting, before deciding to deny or uphold the protest.

AMR also will get 15 minutes to explain why it feels the process has been fair and how it plans to improve the current system.

Immediately following both presentations, members of the public will have a maximum of three minutes to speak on the topic before a decision is made.

If the Riggs protest is denied by the board, then the supervisors will have two choices: approve the contract with AMR, or cancel the bid and consult with an evaluation team to start over, county officials said.

If the board upholds the Riggs protest, then the supervisors would make a decision to reissue the bid to provide ambulance service for the county.

Chairwoman and District 4 Supervisor Deidre Kelsey said a simple majority vote -- three votes or more -- is all that's needed Tuesday.

Kelsey said she plans to run a "polite" meeting and there likely won't be board discussion before the vote. The supervisors received a packet on Friday with answers to questions raised during December's public meeting.

Kelsey said Tuesday's decision is going to be a "tough call" but said she feels the bidding process has been fair so far.

"From my perspective, I think the process has been fair. And that's my opinion," she said. "I oftentimes go into the meeting thinking one thing, then when I hear the issue again, I can change my mind. I do think, though, the county staff has done a very good job with the request for proposal."

Tuesday's meeting will be at 10 a.m. in the board chamber on the third floor of the Merced County Administration Building, 2222 M St. in Merced.

Reporter Ramona Giwargis can be reached at (209) 385-2477 or rgiwargis@mercedsunstar.com.


AT A GLANCE

The following is a summary of some of the key issues between Riggs and AMR over Merced County's Emergency Ambulance Service contract, according to documents, interviews and public records:

IMPACT ON LOCAL JOBS

RIGGS: Approximately 32 people will lose their jobs, officials said this week. Their positions include billing, administration, community service, human relations, and management. The average longevity of the employees at risk is 13 years.

AMR: Officials say AMR will hire the entire incumbent work force, including all qualified Riggs' EMTs, paramedics and dispatchers. They'll also need to hire an unknown number of pre-billing and administration positions for their Merced operations. AMR also said it plans to hire 15 to 20 additional EMT and paramedics and offer a higher pay scale to retained Riggs employees.

COUNTY: N/A

LOCAL PROVIDER VS. OUT-OF-STATE

RIGGS: Riggs partnered with Sierra Medical Services Alliance five years ago, a not-for-profit, based out of Nevada.

AMR: AMR is a Colorado-based company that operates in 31 locations in 22 California counties.

COUNTY: N/A

PRICE FOR SERVICES

RIGGS: Average patient charge, $2,069: basic life support, $1,200, or advanced life support, $1,600; $45 per mile; $100 for oxygen; night rate: $100 from 7 p.m. to 7 a.m.; supplies billed separately; no nontransport fee; does not provide critical-care transport.

AMR: Average patient charge, $2,768.23: basic life support, $1,777.23, or advanced life support, $2,585.07; $45 per mile; $100 for oxygen; no night rate charge; no individual charge for supplies; $400 nontransport fee for advanced life-support treatment; critical-care transport: $4,125.

COUNTY: N/A

STATUS 0 AND

MUTUAL AID

(Status 0 events occur when when there are no ambulances available. Mutual aid requests are when an agency asks for help from another provider.)

RIGGS: Officials say Status 0 is not a valuable measurement, whereas on-scene response times are. Riggs maintains the company's mutual aid requests are in compliance with its contract, which they say defines "excessive" mutual aid requests as 3 percent of call volume. They say their mutual aid requests have never exceeded 2 percent.

AMR: As per AMR's contract, it's not required to report the number of mutual aid requests and Status 0 events per month to the Mountain-Valley EMS Agency, which provides oversight and regulation of AMR's service in Stanislaus County.

COUNTY: Riggs had 48 Status 0 events over five minutes and 30 Status 0 events over 10 minutes last year. Riggs requested mutual aid 147 times from Stanislaus County last year, with AMR responding to the majority of them. There were only four instances where Stanislaus County requested mutual aid from Merced.

COMMUNITY SERVICE

RIGGS: Riggs contributed $62,113 in donated ambulance services last year, and participated in 135 community service events in Merced County.

AMR: AMR's California operations contributed $1.2 million, about 12,000 unit hours, in free ambulance stand-by services last year. Locally, officials say AMR will provide free ambulances for Merced's charity events, high school sports competitions and anything else the county requires

COUNTY: N/A

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