Big changes are coming to ambulance service in Santa Barbara County, after a lot of angst.
The company which served the county for a half century is out, and the Santa Barbara County Fire Department is going to take over the job.
"I think the Board of Supervisors has said all along we want to reimagine this, not because the system is broken, but because it can be better," said Santa Barbara County Supervisor Bob Nelson.
American Medical Response handled ambulance services for most of the county for more than 50 years. But, the county decided to open the door to bids. That led to a proverbial can of worms.
The county hired a consultant to evaluate the bids, which came from AMR, and the Santa Barbara County Fire Department. The consultant recommended AMR get the new contract. But, after hearing an appeal from the County Fire Department, County Supervisors rejected the recommendation.
They decided to go with a non-exclusive contract situation, getting permit applications from the County Fire Department, and AMR.
The whole situation left some county leaders uneasy.
"I was uncomfortable moving away from the RFP process, once we set it in motion. I come from a purchasing background, and that's not a normal way of doing business," said Santa Barbara County Supervisor Steve Lavagnino. "Now we have two qualified applicants, pursuing the same permit, with both applicants telling us they need 100% of the pie to make it work financially. My local hospital administration has told me their position is they don't want two providers."
It gets a little more complex. The county set up three permit categories. The big one is to provide emergency service countywide. The second is to transport people between medical facilities, and provide standby services at special events, like a football game.
And, the third is to transport seriously injured, or sick people between medical facilities.
The County Fire Department bid on all three categories, while AMR sought just one, the big one, for emergency services. The Fire Department was so confident it would get at least part of the deal, it preordered more than 30 ambulances, saying it could sell them if it didn’t end up needing them. On Tuesday, it was decision day for County Supervisors.
"AMR is your current experienced provider in the county. We've been in the county for over five decades with an unblemished history of providing great service," said Mike Sanders, with AMR.
But, AMR said it would need to get all of the emergency services contract, and not split it for it to work financially.
"We certainly feel that way, yes, but that's not to say if its given to multiple providers we won't sit down and try to understand how it's going to be broken up," said Sanders.
"Our plan to improve critical medical services to the public for the people of Santa Barbara County is built on four pillars: Innovation, integration, clinical commitment and financial strength," said Santa Barbara County Fire Chief Mark Hartwig.
County Fire officials acknowledged that AMR has done a great job over the years. But, they said because they are first responders on emergency calls it make sense that they also handle ambulance services. And, they said with more than three dozen fire stations, they can better position ambulances to respond faster in emergencies.
Fire officials added that instead of being a for-profit business like AMR, they could use extra revenue for more equipment, and services.
The Fire Department isn't starting from scratch. It already provides ambulance services in a few rural areas of the county, like the Cuyama Valley.
County Supervisors liked, and accepted the County Fire Department proposals, but rejected AMR’s as incomplete, They said it lacked visibility on some key system components, and failed to address how it would serve some rural areas of the county like the Cuyama Valley.
They voted to reject the AMR plan, in effect setting the stage for the company's relationship with the county to end next year.
While the change is supposed to happen next March, Lavagnino worries the county might need to be ready sooner. He said that once AMR employees realized what's happened, they could start leaving for other jobs, with the company unable to staff all of its ambulances.
But, Hartwig says the Fire Department will be ready. He said they will open the door to AMR employees who might want to be a part of the county's new ambulance service.
