Item 12 - Agreement for Standards of Coverage and Emergency Medical Services Study

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Standards of Coverage / Emergency Medical Services Study March 3, 2026 Page 2 process remains a concern; as current routing procedures illustrated below can delay ambulance deployment. Figure 1. Call Intake Workflow caller is near a 'r"' "" """" "" determines if freeway. then medical / fire- an ambulance Note: The time it takes to process a call is variable and depends on factors such as system infrastructure, call type, the amount of information needed, connectivity of the phone service, the mental/emotional state of the caller, and the experience of the dispatcher taking the call. The City's oversight structure has also created potential conflicts of interest. Under the current ambulance agreement, OCFA has some responsibility for overseeing Falck; however, the City's contract with OCFA does not include this responsibility. When the County released a 9-1-1 ambulance services RFP on March 3, 2025, both OCFA and Falck competed for the contract, which the Board of Supervisors ultimately awarded to Falck on August 12, 2025. During 2025, the City began collaborating with Orange County Emergency Medical Services (OCEMS), the regional regulatory body, to better understand EMS mandates and verify Falck compliance. To date, information from OCEMS indicates the ambulance provider is meeting its contractual obligations. Staff anticipates that a comprehensive "Standards of Coverage" study will identify the root causes of recurring concerns and provide a roadmap for regional EMS innovation. This study will include a deep legal and operational analysis of current constraints and opportunities. A critical component will be identifying sustainable funding strategies, particularly given the City's heavy reliance on Medicare and Medi-Cal, and the rising costs of service from both Falck and OCFA. Most recently, OCFA has requested $2.5 million of funding for an additional paramedic unit in the City. Beyond finances, the review will explore modernizing service delivery through telehealth and telemedicine, while developing public education initiatives on the most effective ways to utilize the ambulance system. To facilitate this study, staff issued RFP No. 25-136 on November 10, 2025, via the City's online bid management system. A summary of the vendor participation and results follows: