Supes discuss ambulance services
July 23, 2013 — The Lassen County Board of Supervisors endorsed a letter requesting not having to bid for ambulance services and extending services with the current provider for another five years.
The board approved the letter during a Tuesday, July 16 board meeting, which was written by Dan Spiess, Chief Executive Officer of Nor-Cal EMS, and will be sent to the California EMS Authority.
According to Spiess, the state can either approve the request or decide that going out to bid is necessary since there is an exclusive ambulance operator in the county.
The board originally approved a contract with Sierra Medical Services Alliance (SEMSA) in 2005 with some stipulations in performance standards. The contract was then renewed in 2009 and is set to expire July 1, 2015.
During the board meeting, Spiess said, “We’ve had some conversations among individuals in the county and with SEMSA. They are happy with the arrangement. The county is pleased with the service that they provide and we would like to renew that contract,” he said.
The letter cites reasons for not going out to bid. One reason is the number of ambulance responses compares to the county population of 33,422; the county is not a desirable market for most ambulance providers as the current provider reports 60 percent of its patient transports are either Medi-Cal or Medicaid. Medi-Cal reimburses the ambulance service only 22 percent of the actual costs to provide the service.
Another reason is any ambulance service wishing to submit a proposal would also incur expenses and given the current low margin on its Lassen County operation, the fear is SEMSA might choose to not spend the funds required in preparing a proposal and this could result in no bids being received, which would be disastrous for the county.
The board also discussed the possibility of SEMSA providing ambulance services to the Big Valley area.
Supervisor Aaron Albaugh, who represents District 4, brought up the issue regarding Modoc Medical Center discontinuing ambulance services to the northeastern part of the county.
“It may have to be a subsidized deal … or maybe some kind of community services district to help fund it. But we need something up there because having nothing and having to wait for a minimum of 45 minutes is going to be the fastest time for an ambulance to get there provided there’s that availability. There’s going to be some tragic losses up there,” he said.
Eric Ewing, chief of the office of emergency services, said maps have recently been drafted with lines and a soft boundary to identify the vacancy in Lassen County that Adin created.
The lines represent the closest resources and Ewing said the Susanville Interagency Fire Center has the burden to handle the area Lassen County that Adin in Modoc County left behind.
Ewing explained the instructions at this point are to find the closest ground ambulance, request assistance to come to that area, and if that service isn’t available, call the next closest one.
“So we have those soft boundaries that we drafted as a short-term solution to deal with the issue at hand right now while we pursue a longer term solution,” he said.
To address the long-term situation, Ewing said he and county staff had a conference call with a SEMSA representative who will discuss covering difficult rural areas.
Supervisor Bob Pyle said he thought the best thing to do is approve the contract with a high priority in seeing what can be done to move the Emergency Operating Area line to include the Big Valley area if they can afford it.
“Putting an ambulance up there is going to be a big cost,” he said.
He explained at the time the Emergency Operating Area was established, former supervisor Brian Dahle and residents wanted to be left out of it because “they had their own thing going and were happy with it.”
Supervisor Larry Wosick talked about the current SEMSA contract expiring in two years and said, “It just seems like we’re going to weaken any incentive to try and get the coverage for that area if we go ahead and send this letter.”
He suggested conducting a proper study session, getting the maps and making sure all of the community is adequately covered.
“Its really not an option for a resident of our community to have to wait an hour and die because no ambulance can get there,” he said.
Supervisor Chapman said he respectfully disagreed and thinks what they need is a strong provider who will be vested in the area for the long haul.
A request for proposal would be a long and drawn-out process and cost a lot of money and Chapman said he would rather the money go toward working with SEMSA and extending its resources into non-served areas.
“We want to make it so that we have that partnership for the long-term because if they pack up and leave then we have to go back through that same process …” he said.
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