Costa Mesa to discuss public vs. private ambulance service

The Costa Mesa City Council on Tuesday will consider a proposal to alter how severely injured people are transported to the hospital — a move that could bring roughly $2.5 million annually into city coffers.

In July 2015, the city hired an outside consultant to identify the best use of private ambulance companies and the city's ambulances during medical emergency calls.

The city has contracted with Care Ambulance Service since 2008 to provide ambulance support services to the fire department.

In a 50-page feasibility study published in November, the consultant presented four models that the city could employ, ranging from the city taking on all medical emergency calls, to a public-private partnership between the city and a private ambulance company, like Care, that would allow them to split the calls depending on the severity of the injury.

Fire Chief Dan Stefano and city CEO Tom Hatch are recommending that the council approve the public-private partnership model between the city and an outside ambulance provider.

Under the model, the city would provide advanced life support for patients with severe injuries, while a private ambulance provider would offer emergency transportation for basic life support calls, which are generally non-life threatening, and provide back up support for more severe, life-threatening injuries. This would result in city ambulances transporting more people to the hospital instead of simply assisting on calls.

Currently, when a medical emergency call comes in, the fire department sends out an engine or a truck and a rescue ambulance along with a private ambulance, which ends up transporting all patients to the emergency room.

AP Triton LLC wrote in its report to the city that the type of response is not typical when taking best practices into account.

"Simply stated, this deployment model is not the most efficient for an urban city, operationally or financially," the report stated. "It is the opinion of this consultant that the response of multiple ambulances to the same incident is not in the best interest of the community, nor is it the most efficient use of resources."

Also, since the private ambulance company is the one taking the patient to the hospital, the company ends up receiving the bulk of the payment from the patient's insurance company, according to Fire Chief Dan Stefano.

Currently, the city receives $645,372 annually in recovery costs from ambulance rides. If the council approves the recommended model, it could receive about $2.5 million annually, according to the report.

The proposed change wouldn't impact the level of care a patient receives on the way to the hospital, according to Stefano.

"The care is going to be the same," Stefano said. "You're going to get a high level of care."

The ambulance transportation plan is just one piece of a larger effort by the city to streamline fire department services to reduce costs.

During the recession, the city began making cuts to departments and reviewing outsourcing certain city services as a cost saving measure. The idea of having the Orange County Fire Authority take over Costa Mesa's fire needs was discussed, but ultimately the council voted to keep its own fire department and instructed then-interim Fire Chief Tom Arnold to come up with a cost-savings plan.

The council approved a revised version of Arnold's restructuring plan in 2013 that's intended to streamline services to reduce costs to the city through several measures including reducing the number of fire personnel and instead redeploying them to respond to emergency medical calls, which make up a large portion of the calls for service.

The plan also suggested closing a fire station, purchasing rescue ambulances and ultimately restructuring the city's ambulance transportation strategy.

In 2013, the council voted unanimously to move forward with plans to close Fire Station 6, 3350 Sakioka Drive, after an analysis found that it had the fewest number of calls for service and nearby fire stations could be used to provide service to the area.

Mayor Steve Mensinger and Mayor Pro Tem Jim Righeimer have recently voiced their support for keeping the station open.

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