A multimillion-dollar decision on one of San Diego’s most vital services is coming early this week.

Interim mayor Todd Gloria is expected to announce whether the city will immediately put its ambulance service contract out to bid. We’ve estimated the contract’s value to be about $55 million a year, and the fire union is pushing to be considered along with private ambulance companies. But because the Fire-Rescue Department helped write the existing contract proposal, the city would have to start all over to develop a contract the department could bid on.

Gloria hasn’t given any public indication of the way he’s going to go, but his spokeswoman said the decision will come before a City Council committee hearing on Wednesday.

Some Council members have expressed support for the city running the ambulance system – Scottsdale, Ariz.-based Rural/Metro provides ambulances now.

But switching to a city-run ambulance service could cost almost $70 million in the first year, and almost $50 million annually after that, argues a study released Monday by the business-backed San Diego County Taxpayers Association.

The first-year numbers include the cost of buying enough ambulances to house one in each of the city’s 47 fire stations, as the fire union is saying it will do.

But in future years, the $55 million revenue projection would mean that city-run ambulance services would make more than what the study predicts it would cost. Felipe Monroig, the Taxpayers Association president, said the city would still face significant risks.

The city would have to cover ambulance-related lawsuits, and the new federal Affordable Care Act adds substantial uncertainties. For instance, Monroig said, the health care law should increase the number of patients on Medi-Cal, the state-run insurance for those with low incomes. Medi-Cal patients pay far less than the sticker price for ambulance trips, meaning enough revenue might not materialize to cover costs.

“There’s a big chance to be a loss there,” Monroig said.

The Taxpayers Association study also took aim at the fire union’s claim that the department could provide a more reliable service. Currently, the department falls far short of its goal to arrive at high-priority medical emergencies within 7 minutes and 30 seconds as a first responder. Rural/Metro meets the standard in its contract of putting an ambulance on scene within 12 minutes, though that excludes some especially busy times.

The study argues that it doesn’t make sense to trust the Fire-Rescue Department to meet an ambulance response time target when the department can’t meet its own goals now.

Frank De Clercq, the head of the fire union, said that the city has admitted it doesn’t have enough fire stations to handle the demand for timely first response.

“That’s a systemic problem that we’re dealing with,” De Clercq said.

He said the department’s plan to have more ambulances on the street, at least 11 more than Rural/Metro does at the busiest times of the day, means that ambulances will arrive faster than they do now.

De Clercq also said he plans to take a closer look at the study’s numbers before Wednesday’s committee hearing.

“There’s no way those costs are accurate,” he said.

Members of the Taxpayers Association also have an interest in Gloria’s decision. Representatives from each of the three private ambulance providers who might bid on the city’s contract – Rural/Metro, Falck and American Medical Response – all sit on the association’s board. So do lobbyists for at least two of the companies.

Monroig said the report didn’t mention the affiliations of the association’s board members because the report didn’t make a policy recommendation.

Liam Dillon was formerly a senior reporter and assistant editor for Voice of San Diego. He led VOSD’s investigations and wrote about how regular people...

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