County officials demand EMS contract
Alameda County health care officials are saying they’re prepared to strip the Alameda Fire Department of its exclusive right to provide ambulance service on the Island – and of its ability to provide care beyond basic first aid and CPR – if the city doesn’t ink an emergency medical services contract with the county by January 3, 2011.
“We do not wish to take these actions, but we have no other way to maintain EMS service in Alameda in the face of the present impasse,” Alameda County Health Care Services Agency’s acting director, Alex Briscoe, wrote to the city on September 3.
Briscoe wrote that the county had hammered out an agreement with Alameda’s fire chief that would allow the fire department to continue as Alameda’s exclusive ambulance service provider, but that Interim City Manager Ann Marie Gallant’s office said they are not ready to submit it to the City Council for consideration.
Gallant, who will providing an update to the council on the status of the contract on Tuesday, told The Island she’s held off “due to cost and other issues under consideration, which were discussed in closed session with the City Council these past months under potential litigation, and which are not disclosable at this point.”
Briscoe also said the city has in recent months failed to provide required reports detailing 911 medical response times, cardiac arrest and intubation success rates.
“Without these data, county EMS is unable to perform the quality management functions required by the state EMS Authority, which may put the citizens of Alameda at risk,” Briscoe wrote.
Briscoe said the county’s trauma system has served 914 Alameda residents and people injured here on the Island since the expiration of its contract with the city.
The city’s last contract with the county – which under state law is responsible for coordinating trauma care, providing oversight and paramedic certification services, and dispatch services and for collecting fees for those services – lapsed in October 2005. The city and county have since haggled over what the city, which provides its own ambulance service, should pay. If approved in its current form, city officials estimate the contract would cost the city $840,000 a year.
Gallant is set to relay options that will include signing the contract with the county, which she said will increase the city’s costs; letting the county take over provision of advanced life support services, which she said will decrease costs; or creating an assessment district to pay the county EMS fees, which would keep the city’s costs the same. In his letter, Briscoe advanced a fourth option: annexing the city into the county’s EMS assessment district, a move he said would save the city the cost of a ballot measure and also from paying the contract cost out of its general fund.
The council is not set to act on options Tuesday.
Gallant said the city now lays out $6.6 million a year to provide advanced life support services, which include cardiac care, intravenous therapy and drug administration and advanced airway management, and earns $2.3 million to help defray that cost.
City officials decided in 1983 not to join the county’s newly formed EMS assessment district, but to instead provide their own basic life support and transport services through the fire department. The department began providing advanced life support services in 1997.
The city had asked county EMS officials to be included in the county’s efforts to establish a new ambulance contract. The winner of that contract, Paramedics Plus, wrote Gallant and the City Council to urge them to keep the fire department as the city’s ambulance service provider.
“One of the processes we go through when preparing a proposal is to evaluate the surrounding systems to determine their level of relative sophistication and cost effectiveness. Our evaluation of the City of Alameda shows that the city has a well run, cost effective system that provides an outstanding level of care at a reasonable cost,” Paramedics Plus president Anthony J. Myers wrote. “As an island community with limited access, we came to the conclusion that Paramedics Plus would not be able to provide a level of service to the City of Alameda that is comparable to what is currently being delivered by the Fire Department and it is our opinion that no other provider could either.”