Emergency Response : Ambulance Firms Face Prospect of Bidding Fights for County Contracts

Ventura County’s three private ambulance companies have enjoyed exclusive contracts with the county for two decades.

But that may change when the Board of Supervisors later this month considers opening up the bidding process to others, including the county Fire Department.

“We’re very interested in providing ambulance service,” Fire Chief James Sewell said. “We feel we can provide better service and better response for less money.”

The city of Ventura will receive a report today on starting up its own paramedic program and establishing a partnership with CareLine California, the county’s largest ambulance company, to provide hospital transportation.

CareLine, which serves Ventura, recently purchased Pruner Health Services Inc., an ambulance company that drew complaints from fire officials about slow response times. CareLine now also serves the east county cities of Simi Valley, Thousand Oaks and Moorpark.

The firefighters, who say they typically arrive at accidents before ambulances, argue that the county could cut costly duplication and respond to emergencies more quickly by turning the job over to a public agency.

But ambulance companies argue that the firefighters could end up shifting more cost to the public, rather than the private fees now paid by the people who use the ambulances.

Representatives for CareLine, Ojai Ambulance and Gold Coast Ambulance Service believe that they are providing top-quality service and are moving to protect their lucrative county contracts.

“For us to support (open bidding) is a major gamble,” said Robert Higham, paramedic supervisor with Oxnard-based Gold Coast. “We feel it’s not in the best interest of the county.”

Higham said he believes that his company, which has served Oxnard and surrounding areas since 1949, has an excellent record. He said its average response time over the past year was 4.28 minutes, far below the maximum 10 minutes required by the county in urban areas.

“We don’t think anybody can come in here and do a better job,” Higham said.

Rather than open bidding, Higham said his firm would favor moving to performance-based contracts that would impose fines on those ambulance companies that did not meet specific response times or other requirements.

For months, Gold Coast has flooded county supervisors with letters and postcards signed by people opposed to open bidding or establishment of a county firefighter paramedic program. The company has provided stamped postcards to supporters to sign with the following prepared message:

“Dear Ventura County Supervisor . . . Do not allow public agencies to take jobs away from small businesses and do not allow my taxes to be raised to support fire paramedics. In these economic times we should be looking at reducing governmental budgets not increasing them.”

County Supervisors Judy Mikels and Frank Schillo, for the most part, agree with that philosophy. They said they see nothing wrong with the present ambulance system and are leaning against the county getting into the ambulance and paramedic business.

“I have yet to find any reason for making changes to a system that seems to be working,” Schillo said.

“What’s going to happen from a financial standpoint is that taxpayers are going to end up paying for all ambulance service,” he added. “Right now, only the people who use it pay for it.”

Mikels took a similar position.

“I’m not convinced by the numbers that we can give better service by having the county Fire Department do it,” she said. “My feeling is why fix something if it ain’t broke.”

The county Fire Department for years has pushed to establish its own paramedic and ambulance program.

Sewell estimates that it would cost $1.5 million to $2 million to get a county system up and running. Most of that money would go toward paramedic training and the purchase of ambulance vehicles--which can run from $45,000 to more than $100,000 each.

Once a county system is established, however, Sewell said he believes that firefighters could provide paramedic and ambulance service at a lower cost. Paramedic bills now range from a low of $240 to a maximum of $725, including transportation.

“We believe we can do it for less money,” Sewell said.

With its own emergency care service, he said the county would have more control over its operations. More importantly, he said, the system would not be driven by profit but by firefighters dedicated to public service.

But some ambulance company representatives said the real motive for firefighters wanting to get into the paramedic business is job security. They said sprinkler systems, strict fire and building codes, and fire-prevention campaigns have reduced the workload of firefighters who must now find ways to justify their department’s budget.

“They’re struggling to survive,” said Stephen Frank, owner of Ojai Ambulance. “If I was in the Fire Department, I’d probably be doing the same thing. They’re looking to save their jobs.”

Frank said he does not believe that officials or the public will support creation of a public system at a time when county government, which is facing a $38-million deficit, is looking to cut expenses.

“The private sector has proven they can do the job and at no cost to the taxpayer,” he said. “For 20 years, we’ve been providing service under this auspices; to suddenly yank out the rug from under us I think is unfair.”

Fire Capt. Ken Maffei, president of the county firefighters union, said firefighters in many cases are the first to arrive at emergencies and therefore can provide quicker medical attention.

While acknowledging that fire calls have dropped considerably over the past decade, Maffei said firefighters are still needed and so it makes more sense for them to develop their own paramedic program.

“The fact of the matter is we’re going to be here,” he said.

Firefighters in the city of Ventura have taken a similar position. In fact, Fire Chief Dennis Downs today will recommend that the city drop out of the county’s joint-powers agreement with the three ambulance companies so that it can establish its own firefighter paramedic program. Fire officials have long complained of slow response times by CareLine.

“The primary objective of the Fire Department’s proposed advanced life support program is to increase the level and quality of (paramedic service),” Downs wrote in a report to the City Council.

The department’s goal is to reduce paramedic response time from 10 minutes to six minutes 90% of the time, according to the report. “To the most critically ill, the difference of a few minutes can have serious consequences and affect overall patient outcome,” Downs wrote.

One option being proposed would be to set up a joint public-private partnership, where firefighters would serve as paramedics while CareLine would provide hospital transportation.

Downs was unavailable for comment. And Ventura Mayor Tom Buford and other council members said they wanted to wait until today’s council meeting before commenting on the proposal.

Barry Fisher, operations manager for CareLine, said his company is open to working with the city to establish a joint partnership with the Fire Department. But Fisher maintained that his company has not had problems responding to emergency calls in Ventura.

“We’ve got excellent response times in all areas we serve,” he said.

The three ambulance providers’ contracts with the county expire in June next year. So the county must decide now, officials said, if it is going to go to competitive bidding so that county Fire Department or outside contractors would have enough time to set up their own paramedic programs.