Contra Costa County Fire Ambulance Transport Program “The Alliance” Contra Costa County Fire Ambulance Transport Program

The Backstory Why a fire based ambulance program? AP Triton Consulting, LLC The Backstory Why a fire based ambulance program? Ambulance service and fire service were two parallel EMS providers Could no longer afford redundancy Inefficient dispatch practices Disjointed CQI efforts Separate training programs Inconsistent medical direction No teamwork in the field Fitch study(s)

The Process Discussions with CAO, Board Feasibility Study AP Triton Consulting, LLC The Process How do we get there? Discussions with CAO, Board Feasibility Study No GEMT included Discussion with County Fire Chiefs Developed the concept Chose subcontractor Developed “work groups” Labor Management Completed RFP response

The Award of Contract Only bidder in process 3rd party financial study AP Triton Consulting, LLC The Award of Contract Now the work begins! Only bidder in process 3rd party financial study Lots of work to do in short time period Align AMR and billing contractor Needed approval for insurance reimbursement Consolidate communication centers and technology

First Year Performance “One year does not indicate success” AP Triton Consulting, LLC First Year Performance “One year does not indicate success” Reduced call-processing time by 59 seconds Consistent CQI, medical direction Efficient resource allocation LEMSA relationship Teamwork

Response Time Performance Requirement 3- Year Performance AP Triton Consulting, LLC Response Area Response Time Performance Requirement High Density (Code 3) Alliance Performance 2016 2017 2018 Average Response Time (in minutes) Zone A (Richmond) 10:00 minutes 90% of the time 94% 96% 5:35 Zone B (West) 11:45 minutes 95% 6:29 Zone C (Central) 6:35 Zone D** (East) 6:42

AP Triton Consulting, LLC Ambulance Response Time Performance The Outlier Improvement Initiative Average 7,889 ambulance responses/month

Finances 24% collection rate Delinquent collections AP Triton Consulting, LLC Savings & Revenue 24% collection rate AMR = 26% Delinquent collections +/- $300,000 to date Alpha/ Bravo ambulance only 6% call volume reduction $6.2 million saved 1st year $7.5 million in revenue 2nd/ 3rd year $9 million in revenue GEMT = approx. $700,000 QAF estimated approx. $2 million Reinvestment back in the system $1.5 million additional ambulances $3 million in comm center Full-time medical director Helicopter medic program $18 million in reserve fund

The Controversy CAA files complaint AP Triton Consulting, LLC A threat to the empire! CAA files complaint EMSA speaks negatively about the Alliance model EMSA refuses to discuss system AlCo EMS RFP issues Letter strips Contra Costa County of exclusivity Attorney General investigation Underground regulations

The Future LEMSA recommends 5-year contract extension AP Triton Consulting, LLC The Future Threats & Uncertainties LEMSA recommends 5-year contract extension AMR concerned about diminishing profit margin Other bids revealing lower rates Underground regulation fallout

What’s next? ConFire/ REACH Multi-mission Program AP Triton Consulting, LLC What’s next? ConFire/ REACH Multi-mission Program Sharing of firefighter/ paramedic personnel Air ambulance missions Aerial firefighting Search & Rescue missions Aerial command platform

Thank You. Kurt Henke and Mike DuRee 707.266.4309 and 562.307.4335 KHenke@APTriton.com and MDuRee@APTriton.com www.APTriton.com