On Tuesday, Feb. 11, the Riverside County Board of Supervisors decided to renegotiate the county’s current ambulance contract with American Medical Response rather than considering competitive bids for the whole or parts of the county. The current AMR contract expires June 30, 2015.

One of the principal reasons was the experience of Alameda, Monterey and Santa Clara counties, who all recently competed their countywide ambulance service contract and then regretted the decision. In one case, officials had to ask the previous provider, AMR, to return. The goal was to save money but in the end, the decision is costing each of these counties more money than remaining with AMR.

“You don’t want to see a system broken up. You want consistency in a system that is so critical to the lives of your families and friends,” said Riverside County 2nd District Supervisor John Tavaglione. “As the study indicated, AMR is doing the job they’re supposed to be doing and they’re doing it without glitches. Can they do better and can they do more? Yes. … There’s nothing wrong with the system.”

The ultimate implementation of the Affordable Care Act also preyed on the supervisors’ decision. That is an unknown but it will affect emergency medical services. The board was reluctant to bring in a new ambulance provider while the law’s impacts are unknown.

Board Chair Jeff Stone instructed Bruce Barton, director of the county’s Emergency Medical Services Agency, to begin negotiations with AMR.

Stone also explicitly tasked Barton with finding a way to include service for Pine Cove in the negotiations.

“Our residents [in Riverside County] call for ambulance and they get an ambulance. It comes along with the taxes they pay,” Stone stated. “But I have constituents in Idyllwild and Pine Cove, especially Pine Cove, that pay a fee for ambulance services.

“If we go with [this option], is it assumed that we will be working with AMR to provide for ambulance coverage in that underserved area?” Stone posed to Barton. “How can we help those mountain communities if we go [with this option]?”

In response, Barton said he would explore serving Pine Cove and Zone 3 (the area north of Pine Cove) with AMR and reminded the board that Idyllwild Fire Protection District currently serves both areas; however, that contract also expires June 30, 2015.

Barton stressed, “AMR has indicated a number times that they’re very willing to work with us [on this serving these areas].”

While all the supervisors were reluctant to enter into an extensive competitive bidding process while the ACA was in the early stages of implementation, the length of an extension of the current AMR contract was the one issue that appeared to divide the Board. Supervisor Kevin Jeffries was lone vote against renegotiating the contract, but he favored only a two-year extension rather than the five to ten years that the other Supervisors supported.

Although the Board made the decision about extending the ambulance contract, there are many other recommendations in the report issued by Abaris, the consultant who has been reviewing the county’s emergency medical system. Susan Harrington, director of the county’s Department of Public Health, said these recommendations need further evaluation and she will return to the board with options and costs.

Examples of the other issues include examination of whether to consolidate all ambulance dispatching functions for all 9-1-1 requests within a single, high-performance communication center and fully deploy Emergency Medical Dispatch services to all EMS requests.

After the meeting, IFPD Fire Chief Patrick Reitz said he would have supported any option that the Board chose.