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Calif. county supervisors weigh price, service in ambulance contract

Currently, Sunnyvale is the only city in the county without in-house first response paramedic services; contracted paramedics are the only first responders in the city

By Stephen Baxter
The San Jose Mercury News

SANTA CLARA COUNTY, Calif. — Details are emerging about a new ambulance contract for Santa Clara County and its potential impact on residents, and Sunnyvale public safety officers could receive paramedic training as a result.

Currently, Sunnyvale is the only city in the county without in-house first response paramedic services; contracted paramedics are the only first responders in the city. If county supervisors approve a new contract with Rural/Metro Corp. to be the county’s new ambulance provider, Sunnyvale DPS members would be trained as paramedics, which could decrease medical emergency response times in the city.

In August, county supervisors considered ambulance service proposals from Arizona-based Rural/Metro Corp. and American Medical Response, the county’s current provider. Supervisors delayed the decision to November, but county officials now say the decision is likely to be made in early 2011.

In the meantime, county staff is expected to provide more information on the firms’ proposals. The staff initially favored Rural/Metro because of its lower price and other factors. Rural/Metro has proposed training 15 members of the Sunnyvale Department of Public Safety as paramedics within the first two years of the contract, which would “eliminate the gap in paramedic coverage within the county,” according to a report from the county Public Health Department.

AMR has held the Santa Clara County ambulance contract since at least 1979, according to county documents.

Although fewer than 4 percent of county residents ride in ambulances in a typical year, the trips can separate life and death.

“I think any citizen could be subject to illness or injury at any moment,” said Tom Lynch, Santa Clara County EMS director, adding, “It is absolutely critical,” hat the response system meets the needs of residents.

When a San Jose resident calls 911 with a medical problem, an AMR ambulance and a San Jose Fire Department vehicle are dispatched virtually simultaneously, Lynch said. Which unit shows up first depends on the origin of their dispatch, traffic and other factors.

In Sunnyvale, however, only an AMR ambulance is dispatched. Rural/Metro’s proposal would train DPS members to respond to such calls and mimic the San Jose system.

Ambulances also practice “posting,” which means they are spread across the county based on a history of where problems exist, such as heavy traffic at rush hour. Posting allows ambulances to be dispatched from the locations that make the most sense in terms of history and geography.

In the county staff analysis of AMR and Rural/Metro bids, Rural/Metro scored better on price, its vehicle fleet, technology and employee satisfaction. AMR scored better on its financial record.

At an Aug. 24 meeting, three supervisors called into question the financial viability of Rural/Metro, and some indicated that the lower price might not be worth it.

County officials have asked AMR and Rural/Metro representatives not to speak to the media until the contract is awarded.

Rural/Metro operates emergency services in roughly 400 communities across the country. The firm lost several ambulance contracts to competitors around 2008, and it has struggled with debt and questionable billing practices, according to the Arizona Republic newspaper. It hired a new CEO in May.

Lynch said that if Rural/Metro won the Santa Clara County contract, it would likely hire many of the AMR employees, as the request for proposals strongly suggests.

“We certainly don’t want to bring in a couple hundred people from out of state who don’t know the area,” Lynch said.

Both companies scored “good” on customer satisfaction, but Rural/Metro’s cost is 12.8 percent less than AMR. The five-year contract is worth roughly $375 million.

In 2009, AMR’s response times exceeded goals in every month. It has to respond to emergencies in fewer than 12 minutes 90 percent of the time.

John Dugan contributed to this article.

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