# AMR will continue to hold the contract in Riverside, Ca



## exodus (Feb 12, 2014)

http://blog.pe.com/political-empire...ervisors-stick-with-status-quo-on-ambulances/



> The board eventually voted 4-1 with Supervisor Kevin Jeffries opposed to maintain the status quo and negotiate a contract extension with AMR. The current deal expires June 30, 2015.
> 
> Supervisors also praised AMR’s performance – it meets the response time standards spelled out in its contract – and said they didn’t want to disrupt the continuity or quality of a vital public safety service.


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## Amberlamps916 (Feb 12, 2014)

Nice. Let's see what happens with AMR's San Bernardino County contracts that are up soon as well. It's a much more volatile situation than Riverside's.


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## onrope (Feb 12, 2014)

I am no AMR lover but they do a decent job considering how big Riverside and San Bernardino are. Everyone thinks they have a better way of doing things. When it comes to EMS and making money there is no reason to reinvent the wheel.


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## CALEMT (Feb 12, 2014)

Well thats good news considering I just got hired there haha


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## DesertMedic66 (Feb 12, 2014)

Addrobo said:


> Nice. Let's see what happens with AMR's San Bernardino County contracts that are up soon as well. It's a much more volatile situation than Riverside's.



Rumor has it that SB county fire wants to take over transport for all of SB county.


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## Amberlamps916 (Feb 12, 2014)

DesertEMT66 said:


> Rumor has it that SB county fire wants to take over transport for all of SB county.



It's very true. County fire is in a legal battle with the state over it right now. Tension is super high on scene between County fire and AMR as a result. The same consultant group, Abaris, that did the Riverside study, voluntarily withdrew from the San Bernardino County study because of the insane amounts of pressure to put AMR in a bad light. Rumors are their study was too AMR friendly and County fire and Tom Lynch, ICEMA'S administrator (who is responsible for AMR losing key contracts in Northern California) didn't like that.


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## socalmedic (Feb 13, 2014)

Addrobo said:


> It's very true. County fire is in a legal battle with the state over it right now. Tension is super high on scene between County fire and AMR as a result. The same consultant group, Abaris, that did the Riverside study, voluntarily withdrew from the San Bernardino County study because of the insane amounts of pressure to put AMR in a bad light. Rumors are their study was too AMR friendly and County fire and Tom Lynch, ICEMA'S administrator (who is responsible for AMR losing key contracts in Northern California) didn't like that.



AMR doesnt often (read: EVER) loose 1797.201 battles. for SBcoFD to takeover transports the county will have to go to competative bid and SBcoFD will have to be the winning bidder for each and every EOA it wants.

I invite you to look into:

VALLEY MEDICAL TRANSPORT INC v. APPLE VALLEY FIRE PROTECTION DISTRICT

Schaefer's Ambulance Service v. County of San Bernardino (1998)
68 Cal. App. 4th 581 [80 Cal. Rptr. 2]

and

County of San Bernardino v. City of San Bernardino, supra, 15 Cal. 4th at p. 921, fn. 1.

as AMR has been the continuous provider of EMS services since prior to 1981 and has continued to provide the same services to all of its EOAs which were awarded in 1985 (the only time they have been awarded) the only way to re-award any of the EOAs held by AMR is for a competitive bid.

additionally if the county allows the department to assume transport under the auspice of universal service to the county and county rights they may be violating federal anti-trust laws, similar cases can be read here:

County of San Bernardino v. City of San Bernardino, supra, 15 Cal. 4th at pp. 917-918
 Memorial Hospitals Assn. v. Randol (1995) 38 Cal. App. 4th 1300, 1308-1309 [45 Cal.Rptr.2d 547]
 A-1 Ambulance Service, Inc. v. County of Monterey (9th Cir. 1996) 90 F.3d 333, 335-337.)

only time will tell what route the county plans on taking, I predict that AMR will continue to hold the 'berdu contract as well because the county is broke and doesn't have the pockets to fight a court case of such magnitude.


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## UnkiEMT (Feb 13, 2014)

socalmedic said:


> AMR doesnt often (read: EVER) loose 1797.201 battles. for SBcoFD to takeover transports the county will have to go to competative bid and SBcoFD will have to be the winning bidder for each and every EOA it wants.



Now, I'm just a street medic, you obviously know WAY more about this than me, so it's possibly you'll tell me I'm completely wrong and I'll just accept that.

It seems to me, though, that a county department could easily underbid (and still remain profitable against) a private company for any contract they wanted. Now, granted, AMR is the extreme example of "private company", but still, a county department has a bunch of the support structure that they have to provide no matter what

The flip side, of course, is that AMR could always bid at a loss, but I don't really see that happening, though there could be political payoffs that I'm oblivious to.


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## socalmedic (Feb 13, 2014)

UnkiEMT said:


> Now, I'm just a street medic, you obviously know WAY more about this than me, so it's possibly you'll tell me I'm completely wrong and I'll just accept that.
> 
> It seems to me, though, that a county department could easily underbid (and still remain profitable against) a private company for any contract they wanted. Now, granted, AMR is the extreme example of "private company", but still, a county department has a bunch of the support structure that they have to provide no matter what
> 
> The flip side, of course, is that AMR could always bid at a loss, but I don't really see that happening, though there could be political payoffs that I'm oblivious to.



okay, bear with me here its 4am and I have been awake for 36 hours. I will attempt to stay on topic and keep spelling and grammatical errors to a minimum. but the question you ask has far too many facets to even attempt a cohesive written response.

you are not "Just a street medic", you are a Paramedic. and you are correct that a county department could bid lower than AMR based on their size (in business its called economies of scale). however AMR or Envision Healthcare, the parent company, has a much larger benefit when it comes to economies of scale because of the vast size of the company and how much stuff they purchase yearly.

the following numbers are arbitrary as I have no clue what the real numbers are.

here is an example AMR and SBCO both put in an order to McKesson for a case of gloves and 4x4's. because SBco may only order 100 cases of gloves per year and 10 cases of 4x4's McKesson bills them $3000.00 and then $50 for shipping. however beacuse this will be just a small part of AMRs order for the year lets say 10,000 cases of gloves and 1000 cases of 4x4s AMR will be billed at a negotiated rate of lets say cost +10%, or $2000.00 for the same order that the county placed because the supplier knows that AMR will order more and they want to keep them as a customer. the same goes for ambulances... AMR pays much less than anyone else for the same stuff because of their purchasing power.

then we have to look at the personnel cost, lets assume the county will run the ambulances with non-union, non-classified, non-firemen with the same hourly rate as AMR, the overhead staff needed by the county would cost considerably more than AMR because they would have to up staff HR, and Administration to accommodate the approximately 1000 new county employees, whereas AMR already has the HR and Admin staffing for 18,000 employees the 1000 or so berdo employees are merely a drop in the bucket.

and then finally we run back into the anti-trust laws, its illegal to knowingly bid at a loss for the purposes of underbidding. working for a loss is not sustainable for the county unless they plan on subsidizing the cost with increased taxes or special district fees which I doubt the voters (ie, tax payers) would approve of. 

so to answer your question, in theory yes the county could possibly submit a bid that is lower cost but in reality there is no way the county could operate at a lower cost.

now the plot thickens with one last detail, a competitive bid does not necessarily mean the LOWEST bid, it means the BEST bid. It is the county board of commissioners who decides what is BEST bid, not the fire department. Now I will say that bribery is illegal and AMR would never do that... but making campaign contributions is not illegal, and AMR loves to support politicians....


one last tidbit in support of AMRs political machine.

I think it would be interesting to know who tipped Dr. Backer (CA EMSA Director) off to OCFA and their "bidding process" for ambulances in which the highest ranked bids some how don't get selected. seeing how Care who may or may not have been the benefactor of these "competitive" bids, was recently bought by Faulk AMRs biggest threat, and AMR recently bought Doctor's ambulance which happens to be one of the other two ambulances who could win the new bidding process if controlled by the county... and does anybody remember that silly bill that the firefighters tried to get passed that would require private employees to remove all county names from their uniform? yea that didn't pass either, oddly enough it was the OCFA union that wrote that bill... how the world turns...


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## UnkiEMT (Feb 13, 2014)

Fair enough, I bow to your superior knowledge of the subject, and congratulate you on your cohesiveness, given that I doubt I could have done so well 24 hours ago when I was in your position.

For what it's worth, btw, when I said I'm just a street medic, what I meant is that I provide damn fine care in the back of a truck, but resist vigorously every time someone tries to put me behind a desk. I discovered the hard way when I owned a bakery that my business skills are so poor, they actually make random business I walk past lose money.


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## DesertMedic66 (Feb 14, 2014)

Hoggie16 said:


> There is no word that describes this but corruption, and it is king in Riverside. The FBI will have a field day on this one, if they are already are!



How so?


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## SandpitMedic (Feb 14, 2014)

Sometimes it's not what you know, but who you know. 

Also, deep pockets will get you pretty far, and you can know a lot of people if you have deep pockets.


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## SandpitMedic (Feb 14, 2014)

Physical challenge:

Someone find a real world example of any Envision (AMR or subsidiary) ambulance service getting completely booted out of an EOA and was replaced by a government transporting entity.

Ready? Set. GO!


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## DesertMedic66 (Feb 19, 2014)

Hoggie16 said:


> _** Removed as spam **_



Yep, already got that from your last post (saying the exact same thing). Care to elaborate?

Don't quite understand the hidden link your post but ok


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## ffemt8978 (Feb 20, 2014)

DesertEMT66 said:


> Yep, already got that from your last post (saying the exact same thing). Care to elaborate?
> 
> Don't quite understand the hidden link your post but ok



If any one notices hidden links in posts, please report them to the Community Leaders so we can deal with it.


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## terrible one (Feb 20, 2014)

AMR in RivCo?!?!? End of the world!!!! - according to those areas fire departments.


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## DesertMedic66 (Feb 20, 2014)

terrible one said:


> AMR in RivCo?!?!? End of the world!!!! - according to those areas fire departments.



Mostly heard from Murrieta fire


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## terrible one (Feb 20, 2014)

DesertEMT66 said:


> Mostly heard from Murrieta fire



This is true. I love the quote by their chief about a competitive bidding process makes the service cheaper. Why not put a bid out to Cal Fire and see how much the citizens of Murrieta save instead of running their own department.


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## socalmedic (Feb 20, 2014)

terrible one said:


> This is true. I love the quote by their chief about a competitive bidding process makes the service cheaper. Why not put a bid out to Cal Fire and see how much the citizens of Murrieta save instead of running their own department.



how dare you... +1


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## terrible one (Feb 20, 2014)

socalmedic said:


> how dare you... +1



You are right AMR should actually pay that department because they cannot function without fire first responders as stated in the article. Haha


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## Medic496 (Feb 21, 2014)

*got one*



SandpitMedic said:


> Physical challenge:
> 
> Someone find a real world example of any Envision (AMR or subsidiary) ambulance service getting completely booted out of an EOA and was replaced by a government transporting entity.
> 
> Ready? Set. GO!



Newport Beach, CA.


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## socalmedic (Feb 27, 2014)

OCEMThopeful said:


> Newport Beach, CA.



actually, Newport Beach has always been the paramedic provider since 1975. as stated in CA HSC 1979.201 they have the exclusive authority to administer the EMS service under the policies and protocols of the LEMSA.


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## SandpitMedic (Feb 27, 2014)

Anybody else...


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## Medic496 (Mar 2, 2014)

*AMR Booted Out*

I do believe I answered the question correctly.  Having 201 does not give the city the right to kick out AMR and declare exclusivity.  AMR or a predecessor was covering Newport until 1990's.  Newport then wrote an RFP but cancelled the process and awarded themselves the anointed transport providers.  AMR got booted, and Newport created a big fat monopoly just waiting for some rambunctious private company to come along and put their hat in the ring for transport.   It'll be just like San Francisco, non-exclusive.


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## jgmedic (Mar 3, 2014)

DesertEMT66 said:


> Mostly heard from Murrieta fire



Hilarious to me, seeing as he was the chief of Hemet Fire prior, and you never heard whining about Hemet becoming a transport agency. Granted they aren't even an ALS dept, but when he moves to Murrieta, all of the sudden AMR sucks? I'm not surprised AMR kept this contract, Riverside division has its problems, but Desert and Hemet have some of the highest collection rates nationwide for AMR and it is their biggest contract in the US now, Ever since talk of RFP began, they have been pushing really hard out here,


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## socalmedic (Mar 3, 2014)

OCEMThopeful said:


> I  Having 201 does not give the city the right to kick out AMR and declare exclusivity.



Actually that is exactly what it does. The fire Agency having jurisdiction can handle the EMS service how it sees fit, including providing the service themselves.

in September of 2010 the County of Orange declared that Newport Beach does in fact have 201 rights, link here, as such they have the sole authority to contract for or terminate a contract for ambulance services. thank you for participating.


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## Medic496 (Mar 3, 2014)

*Sniveling City*

Simply because a whiny city writes a letter to EMSA and submits comments pleading that the Ch. 13 regulations reflect their cause, doesn't mean they have exclusivity.  Maybe you missed the latest submission of 2014 OCEMS EMS plan, Newport is non-exclusive to ambulance transport.  Oh yeah also, the EMSA document provided below will take you to EMSA's documented proof that Newport Beach is non-exclusive.  Has been since they kicked out AMR.  

http://emsa.ca.gov/Media/Default/PDF/Ambulance_Zones_2013.pdf

BTW, we are talking about 1797.224.  In your earlier post you listed 1979.201 as your HSC reference.  The actual HSC reference that deals with obligations to continue service provided prior to June 1, 1980 until an agreement is reached is known as 1797.201.  Some lesser informed individuals regard it as "201 rights". 

Thanks for playing


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## exodus (Mar 3, 2014)

jgmedic said:


> Hilarious to me, seeing as he was the chief of Hemet Fire prior, and you never heard whining about Hemet becoming a transport agency. Granted they aren't even an ALS dept, but when he moves to Murrieta, all of the sudden AMR sucks? I'm not surprised AMR kept this contract, Riverside division has its problems, but Desert and Hemet have some of the highest collection rates nationwide for AMR and it is their biggest contract in the US now, Ever since talk of RFP began, they have been pushing really hard out here,



Do you know the status of Hemet going over to CalFire? I know they're trying to come in and take over which would be so much better than what we have now, aka all BLS.


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## CentralCalEMT (Mar 4, 2014)

Are there response time issues in Hemet for ALS to get on scene? Where I work, it is BLS fire and the private ambulance is ALS and it works just fine. I don't get this mentality that is so pervasive in CA that every vehicle with flashing lights that isn't a cop car HAS to have a medic on it?


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## DesertMedic66 (Mar 4, 2014)

CentralCalEMT said:


> Are there response time issues in Hemet for ALS to get on scene? Where I work, it is BLS fire and the private ambulance is ALS and it works just fine. I don't get this mentality that is so pervasive in CA that every vehicle with flashing lights that isn't a cop car HAS to have a medic on it?



It can take a while for AMR to arrive on scene (all depends on the call volume). Hemet fire is the only fire department in RivCo (that I know of) who does not have ALS.


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## TRSpeed (Mar 4, 2014)

exodus said:


> Do you know the status of Hemet going over to CalFire? I know they're trying to come in and take over which would be so much better than what we have now, aka all BLS.




"so much better"???

ummm, from the people that I know that work Hemet/pass area all I hear is how much they love working in that area. 




CentralCalEMT said:


> Are there response time issues in Hemet for ALS to get on scene? Where I work, it is BLS fire and the private ambulance is ALS and it works just fine. I don't get this mentality that is so pervasive in CA that every vehicle with flashing lights that isn't a cop car HAS to have a medic on it?



But haven't you herd fire medics are wayyy better than private medics. They have way more medical training. Lol jk

But yes I love kerns ems system its honestly the most efficient system I have worked in.


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## terrible one (Mar 4, 2014)

CentralCalEMT said:


> Are there response time issues in Hemet for ALS to get on scene? Where I work, it is BLS fire and the private ambulance is ALS and it works just fine. I don't get this mentality that is so pervasive in CA that every vehicle with flashing lights that isn't a cop car HAS to have a medic on it?



+ 1 

I do not understand this mentality either. Unless time is an issue (i.e. Rural areas) there shouldn't be a need to staff every single piece of equipment ALS. Imagine how much money FDs could save (staffing, training, equipment) if they only had medics in areas without a nearby hospital or medic ambulance that is on scene in 8:59 90% of the time. LAFD could probably reduce half of it's medics and save millions of dollars. I doubt you'd even see an increase in 911 mortality.


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## jgmedic (Mar 4, 2014)

TRSpeed said:


> "so much better"???
> 
> ummm, from the people that I know that work Hemet/pass area all I hear is how much they love working in that area.
> 
> ...



Having worked Kern and Hemet, they are IMO, both good places to work. I will say, there would be no benefit from CDF taking over Hemet. There are times when ambo levels get low, as Hemet, is per capita, the busiest area in the county. However, we often beat HFD on scene, and our working relationship, a few people excepted is amazing. No pissing contests over patient care, and it definitely helps our medics keep skills up. There are county areas with one medic, and with them, there are not issues either, but I fail to see how CDF moving in helps anyone.


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## gonefishing (Mar 14, 2014)

terrible one said:


> + 1
> 
> I do not understand this mentality either. Unless time is an issue (i.e. Rural areas) there shouldn't be a need to staff every single piece of equipment ALS. Imagine how much money FDs could save (staffing, training, equipment) if they only had medics in areas without a nearby hospital or medic ambulance that is on scene in 8:59 90% of the time. LAFD could probably reduce half of it's medics and save millions of dollars. I doubt you'd even see an increase in 911 mortality.



Its been brought to the table.  LAFD might give up half of transports.  Only time will tell.  But if your not in yellow pants your not real ems.lol


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