TO: Board of Supervisors
FROM: Jennifer Yasumoto, Director of Health and Human Services Agency
REPORT BY: Jennifer Ivancie, Staff Services Analyst I
SUBJECT: Amendment No. 1 to Agreement No. 220120B with American Medical Response West, dba as American Medical Response
RECOMMENDATION
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Approve and authorize Amendment No. 1 to Agreement No. 220120B with American Medical Response West, dba American Medical Response, extending the agreement for the term January 1, 2026 through December 31, 2031 to provide exclusive emergency and non-emergency advanced life support ambulance transport services in Napa County. (No Fiscal Impact)
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BACKGROUND
On September 10, 2019, Napa County entered into Agreement No. 200166B with EndPoint EMS Consulting, LLC, to conduct a comprehensive Emergency Medical Services (EMS) System Assessment, draft a Request for Proposals (RFP), and oversee the County’s selection of an exclusive ambulance provider, in accordance with Health and Safety Code §1797.224.
Following approval by the Board, Napa County EMS released the system assessment in December 2019. In March 2021, after securing approval from both the Board and the California EMS Authority (EMSA), Napa County released the RFP.
In June 2021, after a thorough review of proposals and a unanimous recommendation from an independent panel of subject matter experts, Napa County issued a Notice of Intent (NOI) to negotiate with American Medical Response West dba as American Medical Response (AMR) for exclusive ambulance services. Negotiations concluded on August 11, 2021, with mutually agreed-upon terms between Napa County and AMR. On September 14, 2021, the BOS unanimously voted to approve Napa County Agreement #220120B. The resulting contract commenced on December 31, 2021, with an initial term expiring December 31, 2026.
Section 1.4 of Napa County Agreement #220120B provides:
“The EMS Agency may offer to extend this Agreement for a second 5-year term, which shall end at 23:59:58 Pacific Standard Time on December 31, 2031. County and Contractor agree that Contractor’s performance in meeting and/or exceeding the terms and conditions of the Agreement shall be the primary determining factor considered relative to the granting of an Agreement extension. Any Agreement extension shall be mutually agreed to by the parties and set forth in a signed written agreement.”
To date, AMR has met or exceeded all of its obligations under the agreement. Napa County Health and Human Services Agency (HHSA), through its Local EMS Agency (LEMSA) Administrator, provides triannual performance reports to the Napa County Emergency Medical Care Committee (EMCC) and an annual performance report to the Napa County Board of Supervisors on AMR’s contractual performance. These reports have consistently demonstrated that AMR continues to exceed its contractual requirements throughout the term of the agreement.
Throughout the first half of this agreement, Napa County and AMR worked collaboratively to identify opportunities for administrative and operational improvements that support the Napa community. During this process, both parties also recognized areas of ambiguity in the original agreement. HHSA proposes to address these issues through minor language updates in this amendment to improve clarity.
This amendment also extends the term and incorporates the following substantive updates to ensure quality of care and operational sustainability:
• Increases staffing requirements for AMR’s Community Outreach Specialist;
• Codifies obligations related to clinical compliance metrics;
• Clarifies various operational requirements; and
• Allows for a one-time rate adjustment beyond the standard Consumer Price Index (CPI) based increase.
Requested Action:
Approve and authorize Amendment No. 1 to Agreement No. 220120B with American Medical Response West, dba American Medical Response, extending the agreement for the term January 1, 2026 through December 31, 2031 to provide exclusive emergency and non-emergency advanced life support ambulance transport services in Napa County.
FISCAL IMPACT
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Is there a Fiscal Impact? |
No |
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Is it Mandatory or Discretionary? |
Mandatory |
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Is the general fund affected? |
No |
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Future fiscal impact: |
This Agreement ends on December 31, 2031, Appropriations are included in the approved Fiscal Year 2025-2026 budget and future fiscal years will be budgeted accordingly. |
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Consequences if not approved: |
Failure to approve this Agreement would result in a lack of an emergency ambulance services in Napa County. |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.