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

2. 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)

3. 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

4. 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

5. 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

6. 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

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

8. 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

9. 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

10. 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

11. 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

12. Thank You. Kurt Henke and Mike DuRee 707.266.4309 and 562.307.4335
and