CARE AMBULANCE SERVICES, INC. (2)

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PROPOSAL TO PROVIDE FIRE/EMS EMERGENCY TRANSPORTATION & RELATED SERVICES CITY OF SANTA ANA With the U.S. healthcare system rapidly transforming, ambulance service executives are increasingly focused on how existing service lines can be adapted to provide better patient outcomes at a lower cost. Municipal ambulance services are facing the same level of scrutiny. Today in the City of Santa Ana, the City accepts all financial responsibility for the provision of ambulance services, both Basic Life Support (BLS) and Advanced Life Support (ALS). The City, through its third -party contracted billing agency, bills for the provided services, and hopes those recovered fees are sufficient to pay for the contracted ambulance services. The entire risk of ambulance revenue rests with the City of Santa Ana. An ambulance organization, public or private, must weigh a number of factors when deciding whether to provide ambulance services themselves or contract ambulance services. On the Municipal side that decision to provide ambulance services or contract for services also must include a review of California legislation covering ambulance contracting._ _ In California, the relevant legislation governing City and County ambulance contracting is found in California Health and Safety Code Sections 1797.201 and 1797.224. These sections provide a "grandfathering" of service rights to those cities or fire districts that contracted for or provided prehospital EMS on June 1, 1980; in these cases, the administration of those services shall be retained by those cities or fire districts. The City of Santa Ana has contracted or provided EMS services prior to June 1, 1980, and so retains the right to continue to contract for EMS services. Having established a legal authority to contract or provide for EMS services presents the City of Santa Ana with the flexibility to contract services in a manner most beneficial to the City. In this "Appendix" to our proposal, Care Ambulance offers the following general overview of an optional alternative contracting opportunity with our organization. Care Ambulance currently serves the Orange County Fire Authority (OCFA) and other local cities/fire agencies, with a number of similar "Public/Private" partnerships. These models include an assumption by Care Ambulance of the risk for payment of services and revenue recovery methodology to reimburse the City for cost of ALS services. Specifically, for the City of Santa Ana, Care Ambulance is offering the option to provide all emergency ambulance services in the City of Santa Ana at no cost to the City. Care Ambulance would bill for services using rates already established by the Orange County Board of Supervisors. Care Ambulance would then retain the revenue collected to pay for these services and completely relieve the City of Santa Ana of the risk for non-payment. In addition, Care Ambulance offers to bill for the City's ALS transport services, currently provided in concert with OCFA, and pay that collected ALS revenue directly to the City of Santa RFP # 18-059 — CARE AMBULANCE SERVICE 54