ConFire Ambulance Proposal Passes First Test

Two fire agencies in Contra Costa County provide their own emergency ambulance service. Jeff Carman, chief of the Contra Costa County Fire Protection District, wants to make it three. But Carman does not envision a model similar to the service provided by the Moraga-Orinda Fire District or the San Ramon Valley Fire Protection District; he intends to pitch for the entire county ambulance contract, up for renewal next year. On Sept. 9 he made his case before the Board of Supervisors, acting as the ConFire board of directors, which gave him thumbs up to bid on the deal.

Carman based the financial calculations of his proposal on a presentation by The Ludwig Group, a Missouri-based fire and emergency medical services consultant. If ConFire won the ambulance contract, the report projected that the district will collect $31.6 million in additional annual revenue. After $29.3 million in expenses, the district would realize nearly $2.3 million in excess revenue over expenses. "That was using conservative numbers," said company principal Gary Ludwig. "We used the highest payroll figures, the largest number of ambulances and the lowest collection rate per transport." He added that in the second year, ConFire could count on $7.5 million more in federally backed reimbursements under the Ground Emergency Medical Transport program.

"Your estimates are too high," cautioned Supervisor John Gioia, who noted that Los Angeles County receives only $7.5 million annually in GEMT funds, as does Sacramento. "This report does not establish to me that this project makes money. The level of detail here does not provide certainty that it will not be a drain on the general fund."

American Medical Response holds the current county ambulance service contract and is a likely competitor in the bidding for the new one. Erik Rohde, AMR general manager for Contra Costa County, expressed skepticism over ConFire's proposed business model. "The plan overestimates the revenue and understates the expenses," he said. "It also calls for a reduction in the number of ambulances by nine. The system will be understaffed."

Despite the warnings, the supervisors voted 4-0 (Mary Piepho absent) for Carman to proceed with responding to the county request for proposals. The RFP process is expected to commence in January.

"I intend to take Ludwig's information and refine it," said Carman. "I will be sure to have the information be as specific as it can get by the time the RFP comes out."



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