DATE:
May 23, 2023
19
TO:
Board of Supervisors
SUBJECT
Title
REIMAGINING AMBULANCE TRANSPORTATION SERVICES IN THE COUNTY'S RURAL COMMUNITIES (DISTRICTS: ALL)
Body
OVERVIEW
On December 5, 2017 (5), the Board of Supervisors approved a revised ambulance transportation model in the County's unincorporated communities known as the Unified Service Area (USA). The programmatic changes consolidated the three (3) Exclusive Operating Areas and seven (7) undesignated or non-exclusive operating areas where the County has the responsibility to ensure ambulance services, into one service area wherein a provider(s) could be contracted. The County contracted with one private ambulance vendor to provide at least ten (10) paramedic, Advanced Life Support (ALS) ambulances and one part-time ALS ambulance. Despite the enhancements that came with unifying and expanding service, the remote location of communities, low transport revenue, and paramedic staffing challenges still hinder the viability of the current ambulance transportation model.
On October 4, 2021, the State of California enacted Assembly Bill (AB) 389 which included provisions for a county Board of Supervisors to contract with a fire agency for ambulance services and for the fire agency to subcontract service, in whole or in part, to a private provider, as codified into California Health and Safety Code (HSC) Sections 1797.230-231. On December 13, 2022 (1), the Board directed the Chief Administrative Officer to hire a consultant to evaluate the optimal ambulance transportation service model(s) within the USA given the statutory change, along with, as of January 1, 2023, increased Medi-Cal payments to government-provided ambulance services. San Diego County Fire completed a competitive procurement for a consultant and contracted with Citygate Associates, LLC (Citygate) to conduct the review. Citygate was tasked with evaluating fiscal sustainability, patient care, and operational objectives of a future am...
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