Calif. officials to vote on controversial ambulance contract

The vote comes days after a judge dropped Alameda County from a federal lawsuit alleging it accepted illegal kickbacks

By Matthias Gafni
East Bay Times

ALAMEDA COUNTY, Calif. — In a deal upsetting East Bay firefighters, Alameda County supervisors are set Tuesday to vote on a three-year contract extension for ambulance provider Paramedics Plus that lessens fines for response delays and includes other givebacks.

The vote comes days after a judge dropped Alameda County from a federal lawsuit alleging it accepted illegal kickbacks from Paramedics Plus. The county was dropped from the suit because it agreed in April to pay $50,000 to the feds and $21,000 in attorney fees for accepting payments from the ambulance company.

Sean Burrows, Alameda County Firefighters union president, said the proposed extension is being granted with no bids from competitors and no change to the service delivery which he said has suffered.

“Service delivery of ambulances has been chaotic the last two to three years. We’re waiting an exorbitant amount of time with firefighter paramedics on scene and no ambulance,” Burrows said.

Paramedics Plus services the entire county except for Berkeley, Alameda, Piedmont and Albany, which have their own ambulance service.

Dale Feldhauser, the company’s chief operating officer, said firefighters want a shared model like Contra Costa County where firefighters work together with the ambulance provider and share the contract. His company wants to work toward that as well, but he said that is not allowed by the county at this moment.

“The extension will get them the security to allow for a system redesign,” Feldhauser said. “The fire guys want that to happen sooner than three years.”

Paramedics Plus was originally awarded a five-year contract in November 2011, expiring in October 2016. A request for proposal process was suspended in October 2016 by the county, and the contract has been extended until Oct. 31, 2017.

“Ambulance system economics are under considerable strain, not only in Alameda County, but in many California counties and across America due to a marked decline in private and public reimbursements for services,” according to a report to county supervisors by Rebecca Gebhart, interim director of Alameda County Health Care Services Agency.

The company lost nearly $5 million last contract year, according to Gebhart, and Feldhauser said it has lost $48 million in six years. The company operates 63 ambulances throughout the county, with 140,000 responses each year and 102,000 patient transports.

The new contract would provide cost relief measures for Paramedics Plus:

A continued break from paying First Responder Advanced Life Support Fees totaling about $5.5 million annually.

A reduction in response time fines of $3.5 million.

A reimbursement by the county to Paramedics Plus for 5150 transport services in the cities of Alameda, Albany, Berkeley and Piedmont, totaling almost $600,000.

“The county is in a spot now where it has to have an ambulance provider,” Burrows said. “They should’ve had an RFP out already, but they weren’t able to execute that.”

Burrows said the number of times that no ambulances were available to respond to an emergency call has increased in the county. That means firefighters must stabilize a patient and wait until someone arrives to deliver them to the hospital. He said in December alone, such an event happened 222 times.

“That happens almost daily,” Feldhauser acknowledged, adding that the blame is spread around the whole system as his ambulances are often stuck sitting at hospitals with patients as they wait for beds to open up.

As for the break on fines?

“(The county) recognized it was rather draconian. They will provide us some release for the size of the fines,” he said, adding the response time standards remain the same.

Last year, Feldhauser said his company paid $2.3 million in fines despite hitting its response time requirements 94 percent of the time.

The Paramedics Plus executive also defended its role in the federal kickbacks case, which was sparked by an earlier agreement to pay the county any money the company received from federal health reimbursements over a 7 percent “profit cap.”

“We still believe it is not illegal. It makes no sense that providing money back should be illegal,” Feldhauser said. “We are still in the process of defending ourselves and we’re trying to get the whole case dismissed.”

The supervisors will discuss the proposed extension at 9:30 a.m. Tuesday in the Alameda County Board of Supervisors chamber, 1221 Oak St., 5th floor, Room 512, Oakland.

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