Emergency service pact erases district's red ink Emergency service pact erases district's red ink (December 24, 2003)

By Renee Batti

Almanac News Editor

After years of losing money as a partner in the countywide emergency medical services (EMS) ambulance/paramedic program, the Menlo Park Fire Protection District has won new contract terms that should erase the red ink, effective January 2005.

The district estimates it will net about $234,000 in 2005 under the new agreement. That's a dramatic change: Officials estimate the district has lost $2 million-plus since the current EMS contract was signed in 1998.

Since that year, fire agencies throughout the county -- including the Menlo Park district -- have partnered with the for-profit American Medical Response (AMR) ambulance firm to provide the "first response" component of emergency medical care. That means a fire truck with a paramedic responds to all significant emergency medical calls, usually arriving first on the scene to care for patients until an AMR ambulance arrives to take over care and, if needed, transport the patient to the hospital.

In addition, the Menlo Park district and three other fire agencies, including the Woodside fire district, have had a larger role in the partnership: Along with providing first-response aid, they also operate ambulances. The bulk of the Menlo district's loss was a result of its ambulance operation -- a loss estimated at about $570,000 last fiscal year.

The contract is set to expire at the end of 2004, but the San Mateo County Board of Supervisors will almost certainly extend it for two to four years early next year.

The county contracts with AMR for emergency medical services. AMR subcontracts with a joint powers authority (JPA) made up of fire districts and cities with fire departments for the first-response service. It also subcontracts with Menlo Park and the other three agencies that operate ambulances.

When the supervisors extend the AMR contract, the subcontracts are also extended, but the JPA and the Menlo district recently have negotiated with AMR for the revenue-generating changes.

Under the changes some fire agencies, including the Menlo district, will receive more money for paramedic training. For the initial contract period, Menlo Park and three other agencies that already had a paramedic program before 1998 received no reimbursement for training, while agencies with no program received a significant payment.

The biggest cost-savings for the Menlo district will occur because of a change in its ambulance agreement. After June, the district will no longer operate its own ambulance; it will continue to provide first-response paramedic service, and will house an ambulance staffed by AMR.

Freeing itself from that contract obligation wasn't cost-free: The district must pay AMR a penalty of more than $166,000 annually until the extended contract expires. But even with that cost, the district comes out ahead because it is cutting its annual losses incurred by operating the ambulance by about $400,000.

Also, with the changes effective in 2005, it will receive an annual paramedic-training reimbursement of more than $103,000.

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