Although Calaveras County’s contract with American Legion Ambulance (ALA) expires in June of 2020, and no other ambulance providers put in bids for the north and south response zones by the Dec. 2, 2019, deadline, there’s no reason to panic, local officials say.
The Mountain Valley Emergency Medical Services Authority (MVEMSA) coordinates and regulates local emergency services for Calaveras County, in addition to the counties of Alpine, Amador, Mariposa and Stanislaus.
Calaveras County is divided into three ambulance response zones. Ebbetts Pass Fire District is the current provider for the east zone, which covers everything east of Forest Meadows to the county line (along with mutual aid into Alpine and Tuolumne counties typically during winter months), and the district has submitted a bid for another five-year contract.
The north zone (including the towns of West Point, Valley Springs, Mokelumne Hill, Jenny Lind and San Andreas) and the south zone (including the towns of Murphys, Copperopolis, Altaville, Milton and the city of Angels Camp) have been covered by ALA since it expanded from Amador County in 2005.
The nonprofit declined to submit a bid for a five-year contract that would start in July of 2020 due to added costs in the MVEMSA’s request for proposal (RFP), according to ALA President Alan McNany.
In particular, he referenced increases in liquidated damages on response time penalties and increases in dispatch fees, along with new requirements for subsidizing Advanced Life Support fire districts.
McNany said the agency may be considering a one-year extension of the current contract with ALA, given the circumstances.
“Since (MVEMSA) had no bidders in those two zones I have been in contact with them and reassured that we’re not going to go anywhere,” McNany said. “We will be in Calaveras until the contract expires (and) until they can write another request for proposal.”
On a Jan. 8 phone call, Calaveras County District 1 Supervisor Gary Tofanelli, the county representative on the MVEMSA board, said the agency is working on a new RFP that it hopes to get in front of the board by March.
“If we don’t meet the timeline, we can go for an extension” with ALA, Tofanelli said.
He said several ambulance providers have inquired about the new RFP.
The Copperopolis Fire Protection District is the only fire district in ALA’s service area that provides advanced life support services.
ALA currently has a mutual aid agreement with Copperopolis Fire to transport patients when the company has a long-estimated time of arrival and the patient’s condition warrants immediate transportation, according to the RFP. In those instances, Copperopolis Fire may transport the patient to either a nearby hospital or to a landing site for air transport.
Under new requirements in the RFP, an ambulance service would compensate the district for being the first responder to an emergency in its response zone at a rate based upon “the estimated net annual savings for reduced ambulance unit hours as a result of this partnership.” The goal would be to decrease response time to the patient and give the ambulance provider more time to get to the call.
“That’s a new cost to us,” McNany said.
The RFP also adjusts the current standard flat response times to match population densities. Code 3 emergency response times to most of the “urban” areas in the county would be decreased to 12 minutes, with the exception of hard-to-reach urban response areas surrounded by continuous rural and wilderness zones. Otherwise described as “urban islands,” those include the communities of Dorrington, Mokelumne Hill and West Point, according to MVEMSA Executive Director Lance Doyle, via transcripts of the Oct. 9, 2019, bidder’s conference.
“There is not enough call volume to put a car there,” Doyle said of the three communities. “And to be able to hit those zones from anywhere that makes sense to station a car even if we were to move our posts … We’re not going to hit it in, say a 12-minute response time just because of the distance. So we took those three areas and we came up with a methodology that allowed us to bump those down to a suburban response, which gives us a 20-minute response time into those urban pockets.”
Regarding the proposed agreement with Copperopolis Fire Protection District, Doyle said, “We can’t hit a 12-minute response time from Angels into Copper. So in conversations with Copper Fire, they said they can hit any call within their district 90% of the time in 10 minutes. So we’re shortening by two minutes the response to the citizen, but then we’re giving … the ambulance provider an additional six minutes to be able to hit that call.”
ALA currently staffs three 24-hour units at posts across Valley Springs, San Andreas and Angels Camp, along with a 12-hour day car in San Andreas that provides added support.
Over the 2018-2019 fiscal year, the company responded to 3,714 calls for service in Calaveras County, 2,645 of which resulted in medical transports.
McNany estimated that ALA’s per-call charges range from about $2,000 to approximately $2,400, depending on the level of service, although out-of-pocket expenses can vary per patient due to differences in insurance coverage.
ALA recently renewed its contract with Amador County, where the company has provided ambulance services since it originated in 1929.
“We want to continue operation there for a long time,” McNany said of Calaveras County. “The county’s great to work with, but we can’t lose money … Our goal is to break even.”