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Ambulance Contract Annual Report
May 16, 2016 Vancouver City Council Workshop
Chief Joe Molina, Vancouver Fire Department
Deputy Chief Dan Olson, Vancouver Fire Department Rocco Roncarati, AMR
Tom Somers, Fitch & Associates Dr. Wittwer, Clark County MPD
5/11/2016 11:28 AM
Objectives of Presentation:
• Background
• Update Council and community on the results of the first year
ambulance services agreement.
• City’s overview of performance benchmarks
• Provider’s perspective
• Third-party evaluation of ambulance contract administration –
Fitch & Associates
• Clinical performance assessment
Presentation Overview
Ambulance Contract Annual Report - 2
• 2013 – 2014 Council policy direction to establish an ambulance service
contract reporting to the City of Vancouver
• Council adopts VMC 5.85 to contract directly for the provision of
ambulance transport services
• After extensive evaluation, Council awarded ambulance contract to
AMR
Prior Council Review
Ambulance Contract Annual Report - 3
Major Performance Benchmarks
Ambulance Contract Annual Report - 4
• Response time performance standard
• Innovation
• Public Relations & Community Education
• Financial
Response Time Performance
Ambulance Contract Annual Report - 6
Alarm Type
Standard
2015 Actual
2015 Count
Priority 1 and 2 – High Density 9:59 09:30 21,161
Priority 1 and 2 – Low Density 19:59 17:12 1,545
Priority 3 and 4 – High Density 12:59 12:30 16,292
Priority 3 and 4 – Low Density 19:59 19:25 1,062
Priority 5 and 6 – High Density 17:59 14:51 10,725
Priority 5 and 6 – Low Density 29:59 20:49 563
Routine – EMSD2 Area Only – Scheduled (12 hr pre-scheduled)
≤ 15 mins 04:21 348
Routine – EMSD2 Area Only – Non Scheduled (less than 12 hr pre-scheduled)
≤ 60 mins 43:57 2,675
• Pit Crew CPR
• DOC Integration
• Bariatric Program
• Sim Man Training
• AMR Mobile Training Unit
Innovation
Ambulance Contract Annual Report - 7
Public Relations / Community Education
Ambulance Contract Annual Report - 8
Topic Attendance Hours County
Community Events
Hands Only CPR 4,818 43.5 Clark
Health Fairs 525 16 Clark
Car Seat Installation Clinics 216 58.5 Clark
Fall Prevention 130 17.5 Clark
Ambulance Show and Tells 85 3.5 Clark
Car Seat Tech Class 21 59 Clark
Safe Kids 13 81 Clark
Total 5,808 279
Financial Review
Ambulance Contract Annual Report - 9
• Financial Considerations • Franchise Fee for Oversight
• Viable & sustainable
• Patient Charges
• One Year Results • Franchise fee did not increase from 2015 to 2016
• First year financial results indicate the contract with the City is financially sustainable for
the provider.
• Patient rates increased by a lower amount than agreed to in the contract due to
willingness of both parties to work together on a value based recommendation
benefiting the community.
Clinical Performance Assessment – Dr. Wittwer
Ambulance Contract Annual Report - 20
• Medical Program Director (MPD) – Responsibilities
o County Medical Control
o Supervise Training and Audit Performance
o Certification of Personnel
o Counseling and Remedial Action
o QI Program Development and Implementation
• Medical Director’s perspective on major changes resulting from the City
administering the AMR contract
Cardiac Arrest
o WACARES
o Citizen CPR
Pulsepoint
o EMD CPR
o AED Program
PAD
Law Enforcement
o Pit Crew CPR
Cardiac Arrest
Ambulance Contract Annual Report - 21
Cardiac Arrest
Ambulance Contract Annual Report - 22
26.7%
40.7% 43.5%
52.5%
2012 2013 2014 2015
National
WA State
Clark
49.4% 47.6%
18.0% 17.2%
National
WA State
Clark County(233)
UTSTEIN Overall OHCA Survival 2015
Clinical Performance Assessment – Conclusion
Ambulance Contract Annual Report - 23
• Continued Enhancements o Integrated Data
First Response – Transport
EMS - Hospital
o PULSARA
o Improved OHCA Survival
o Patient Outcome
o KPI Monitoring
• Perspective on major changes resulting from the City administering the AMR
contract
• Brief other jurisdictions within the contract service area on contract performance in
2015.
• Deliver a published annual report of contract performance to Council by the end of
May 2016.
• Continue the City’s approach to working closely with AMR to ensure delivery of the
best results for the residents.
• Continue monthly monitoring of performance results.
• End of 2016, evaluate franchise fee and patient charges for 2017.
• In early 2017, provide comparable assessment to Council on contract performance.
Next Steps/Timeline
Ambulance Contract Annual Report - 24
Questions and Discussion
• Joe Molina, Vancouver Fire Chief
• 487-7201, [email protected]
• Dan Olson, Deputy Fire Chief
• 487-7203, [email protected]
Ambulance Contract Annual Report - 25