Tuesday, June 30, 2015

Alameda County ambulance provider needs $5 million from taxpayers to continue services

A change in the county's payer mix since 2010 
led to mounting losses, says Paramedics Plus.
Proposal fails with Carson's no vote; Miley's recusal

BOARD OF SUPERVISORS | The exclusive provider of ambulance services in Alameda County says it needs a $5 million infusion of cash to stanch mounting loses since signing the contract five years ago.

Changes in the economics of heath care over the past few years has resulted in far fewer patients using commercially insured providers, which typically pay higher premiums for service, said county staff and a representative for Paramedics Plus, which has provided ambulance services in the county since 2010.

At the time, Paramedics Plus executives estimated nearly a quarter of its users would be paying the higher standard. Therefore, allowing the deal to financially pencil out for the company. Instead, the figure is now about 16 percent, well below the forecast and “causing a significant gap in balanced billing,” said a county staff report.

The proposed injection of $5 million in one-time funds, however, failed Tuesday to gain the required four-fifths majority vote of the Alameda County Board of Supervisors. Tony Schwartz, president of Paramedics Plus, expressed disappointment, but suggested the company and county will continue to seek a solution for propping up the ambulance service.

Despite support from a majority of the board, Supervisor Keith Carson’s strong vote in opposition was amplified by the recusal of Supervisor Nate Miley, whose daughter is employed by Paramedics Plus.

Carson questioned Schwartz at length about the company's business model in other states, in addition, to its profitability. Although Carson lauded the ambulance provider for its past performance, he also questioned yet another unbudgeted expenditure for the county, which only last Friday approved $80 million in cuts to balance its next fiscal year budget.

From debt regarding Alameda Health System and unfunded liabilities to $175 million in obligations to the Coliseum, Carson said the county is making too many disparate financial decisions in a disjointed fashion. “We’re not looking at the cumulative debt,” said Carson. “What is the impact on the future of this county?”

Controversy over Paramedics Plus acquiring the exclusive contract in 2010 instead of the previous provider centered around allegations the Texas-based company purposely underbid the contract as a pretext for entering the California market. AMR, which previously held the county contract, sued Paramedics Plus for violating the state’s predatory pricing laws. But an Alameda County jury later found in favor of Paramedics Plus.

Propping up the ambulance provider may prove cheaper for the county than any other options available, including a takeover of the company’s operations or searching for another provider, county staff said Tuesday, both of which would be cost prohibitive to taxpayers,

Schwartz told the board Tuesday afternoon. “If we’re not the providers, the cost will be more.” He added, the additional $5 million will not make the company whole, but reduce losses estimated to run as high as $10 million over the life of the current contract.

Alameda County Supervisor Wilma blamed inaction by legislators in Sacramento for failing to provide solutions for a number of similar financial failures for ambulance providers across the state. Chan said she supports the expenditure, which she noted, does not come from the general fund, but a $9.3 million EMS trust fund set aside for times like these.

The typically verbose Alameda County Supervisor Scott Haggerty said the alternative to paying $5 million in aid "will cost us three times as much,”. He predicts the southern and eastern portions of the county, which Haggerty, in part, represents, will be hit hardest by any disruption in ambulance services. If not, he later warned, “You might as well throw grandma in the trunk and drive to the hospital.”


The ambulance service in the County is a mess. Why do firefighters and PP both show up? Other cities staff ambulances out of fire stations. Why do our residents get a bill for these services when we already pay for it on our property tax bills?

Breaking news... City of Alameda Fire Department has bid to run the ambulance service for Alameda County...

By MW:

Rather than just using such vague terms as "county staff," it would be nice if articles such as this were much more specific and actually told us who these characters, in other words "county staff," really are.

For instance, I have been at public meetings put on by Alameda County government at which this or that idea is proposed, and which is normally followed by the comment that this or that department, and such as for instance the Public Works Agency or the County Counsel's office, etc, supports, and which almost always means that the AC Board of Supervisors will then rubberstamp and unanimously vote for and approve doing whatever said department suggested and supports, and meaning that the whole "discussion" and approval process was nothing but a scripted, choreographed, and prearranged charade. .

While I realize that the "county staff" is composed only of geniuses and people of the very highest honesty and integrity (for instance, everyone should read the front page article both the Daily Review and the Oakland Tribune have regarding Shawn Wilson this morning, Wednesday, July 1, 2015), however, and even in spite of all that, I would still like to know the actual names, titles, backgrounds, and qualifications of these "geniuses" who are described as "county staff." In fact, I am willing to bet that at least most of them are as "honest" and "competent" as the people in Berkeley's department in charge of inspecting balconies.

Re: Shawn Wilson

It became pretty clear that fall that Shawn Wilson was 'washing' some money for someone, with his big campaign contribution - grossly out of proportion to his county salary - to a PAC that also happened to have spent a lot of money on the Alameda council race.

sorry... "last fall" not "that fall"...

I know Shawn Wilson and he's as crooked as a three dollar bill!

He and Haggerty go to strip clubs together. Haggerty is just as crooked and that's why he hired a flunkie like Wilson. Dude as dirty as pig sty. Got shitloads of crap on him. Sooner they're both gone the better.

Why does everywhere Miley's daughter works get into financial trouble? Wonder if they are going to charge anyone with a crime here too.

By MW:

In regard to the post of 7:22PM:

Based on my previous impressions of Shawn Wilson (some years back I had the misfortune to have to deal with him), it is my opinion that comparing him to a three dollar bill is defamation against counterfeit money and three dollar bills.

However any serious investigations of Shawn Wilson could get extremely interesting, since his background and resume includes far more than his just working for various members of the AC Board of Supervisors. More specifically, he has been deeply involved in various major political campaigns, and I would not be surprised at all if he is on a first name with such characters as Feinstein, Boxer, Pelosi, Jerry Brown, and the Clintons, etc.

I seen Shawn and scott in strip clubs to always goes around pimping.

In every modern city, fire department will arrive with an ambulance because they are staffed with EMT's and maybe paramedics. Your property tax pays for the fire department, but in alameda county, the entity is private so it doesn't receive any benefit from taxes.

Interesting. Here's the contract (below.) If anything, Paramedics Plus is supposed to pay the county for services. Pretty clear statement of 'no compensation from the county' as well.


Sounds like Paramedic Plus in deed did underbid the contract. You made your bed, now sleep in it!!

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