|State law requires Yolo County to conduct a competitive process to select an exclusive emergency ambulance transportation provider for the County. In August of 2020, Yolo County entered into a professional services agreement with EndPoint EMS Consulting, LLC (EndPoint) to guide the County through the process of selecting the next emergency ambulance transportation provider. The agreement with EndPoint includes three phases. Phase one has been completed and included a comprehensive assessment of the current EMS system that provided stakeholder input and data review. Phase two builds on the EMS system assessment incorporating findings and recommendations into a request for proposal (RFP) for ambulance transportation services. Phase three includes negotiating a new high-performance agreement with the selected proposer. The EMS system assessment provides the findings and recommendations that will move Yolo County forward to the next phase.
California Health and Safety Code Section 1797.200 grants the authority to counties to develop EMS programs. Yolo County EMS Agency (YEMSA) is the designated agency responsible for ensuring equitable, high-quality emergency medical services throughout the County. Health and Safety Code Section 1797.224 authorize the designation of “Exclusive Operating Areas” (EOAs) for emergency ambulance services. The provision of emergency ambulance transportation services is a vital component of an EMS system. Section 1797.224 also requires the County to utilize a competitive process to select the organization or organizations to provide these services following the expiration of an EOA contract. The State Emergency Medical Services Authority (the Authority), which approves the procurement process, has advised that a County must select an emergency ambulance provider through a fair, open, and objective competitive bidding process. Within an EOA, the provision of Advanced Life Support (ALS) transportation services may be restricted to one or more providers. American Medical Response West holds the exclusive ambulance agreement for the Yolo County EOA. This agreement is effective through February 1, 2024.
To prepare for the competitive procurement process for emergency ambulance transportation services, EndPoint embarked on an information-gathering initiative at the request of YEMSA. This included conducting listening sessions that engaged 58 individuals and 20 organizations. The organizations that participated were fire agencies, hospitals, the contract ambulance provider, and YEMSA. EndPoint found the stakeholder listening sessions very informative, with stakeholders willing and open to sharing their opinion and suggestions about the current EMS system. Stakeholders were generally satisfied with the improvements made over the last ten years and expressed opportunities for additional improvements and enhancements. The EMS System Assessment covers all aspects of the Yolo County EMS system. It includes specific findings and recommendations that address ambulance response times, emergency medical dispatch, clinical quality improvement measures, public information and education, community paramedicine, and first responder training and education. Research and stakeholder input was the basis for EndPoint's final recommendations. It is evident the Yolo County EMS system has a solid structure and is functioning well. The recommendations provide an opportunity for continued improvement and should guide the EMS system over the next decade. Below are a few of the significant suggestions for consideration:
In September of 2021, EndPoint EMS produced a draft of the Yolo County EMS System Assessment Report. YEMSA shared the report with the various groups, including a presentation to the Emergency Medical Care Committee (EMCC), and comments were received. The information has been prepared to function as the foundational document for additional stakeholder input to prioritize system enhancement that will be included in the next Yolo County EOA ambulance RFP.
- Focus on the patient outcome rather than primarily ambulance response times,
- Fully utilize Medical Priority Dispatch System (MPDS) to ensure the right level of response at the right time meeting the medical needs of the 911 caller,
- Implement strong clinical quality oversight of Emergency Medical Dispatch utilizing MPDS performance software tools (ProQA and AQUA) at Yolo Emergency Communication Agency (YECA),
- Require clinical performance metrics as part of the next system design for all system providers,
- Implement a transparent structure for system performance oversight,
- Foster collaborative working relationships to enhance public/private partnerships for the delivery of EMS services.