AB 389 – Authorizes Counties To Contract For Emergency Ambulance Services With A Fire Agency That Subcontracts With A Private Ambulance Service Through Competitive Bidding Process

AB 389 is intended to override draft regulations proposed by the Emergency Medical Services Authority (EMSA) which would prohibit the currently-approved public-private partnership model regarding subcontracting for emergency ambulance services. AB 389 permits counties to retain independent statutory contracting authority regarding subcontracting for emergency services.

Specifically, AB 389 authorizes, in pertinent part, a county to contract for emergency ambulance services with a fire agency that will provide those services, in whole or in part, through a written subcontract with a private ambulance service, and permits the fire agency to enter into such a subcontract.

However, AB 389 also imposes restrictions on such contract. As of January 1, 2022, a county may not enter into or renew such a contract unless the county’s board of supervisors adopts, by ordinance or resolution, a written policy describing issues to be addressed in the county’s contract for emergency ambulance services. AB 389 indicates such a policy may include, but is not limited to, all of the following:

1. Employment retention requirements for the employees of the incumbent ambulance service;
2. Demonstrated experience serving similar populations and geographic areas;
3. Diversity and equity efforts addressing the unique needs of vulnerable and underserved populations of the service area;
4. Financial requirements, including requiring a private ambulance service provider to show proof of insurance and bonding; and
5. A description of the ambulance service provider’s public information and education activities and community involvement.

If a county subcontracts for emergency ambulance services, AB 389 also requires the County to demonstrate:

1. How the contract will provide for the payment of comparable wages and benefits to all ambulance service employees consistent with those provided to ambulance service employees in the same region; and
2. That the staffing levels for ambulance service employees will be comparable to the staffing levels under the county’s previous contract.

Additionally, AB 389 requires the contracting fire agency to adopt a written policy that requires the written subcontract to be awarded pursuant to a competitive bidding process consistent with Section 20812 of the Public Contract Code. The fire agency’s written policy shall set forth issues to be considered during the competitive bidding process, which may include, but are not limited to, all of the following:

1. Whether safeguards are in place to prevent an entity submitting a bid from participating in the deliberations of the fire agency in awarding the subcontract;
2. Whether consideration for awarding the written subcontract is given only to bidders who submit complete applications in response to a written request for proposals, written request for qualifications, or other similar written request for bids. The written request shall not be prepared in whole or in part by any entity submitting a bid in the competitive bidding process.
3. Whether the written request adequately describes criteria to evaluate a bidder’s demonstrated ability and commitment to providing cost-efficient and high-quality services, which may include, but are not limited to, the following:

(A) Experience and history providing emergency ambulance services in a safe and efficient manner;

(B) Managerial experience and qualifications of key personnel;

(C) Effectiveness of operational processes and assets, including quality of ambulance fleet and equipment, dispatch, customer service, and working conditions of ambulance personnel;

(D) Performance monitoring and quality control;

(E) Reasonable service rates and charges; and

(F) Financial stability to maintain an uninterrupted and consistent level of service.

AB 389 also requires a fire agency that enters into a subcontract with a private ambulance service to provide the ambulance service provider with reasonable advance written notice of any operational changes under the subcontract.

Finally, AB 389 requires the fire agency to use best efforts to address concerns raised by the ambulance service provider employees regarding any operational changes under the subcontract and to communicate its written responses to those concerns to the ambulance service provider. AB 389 describes additional requirements for bidding ambulance services to include certain information in written requests for bids.

(AB 389 adds Sections 1797.230 and 1797.231 to the Health and Safety Code.)