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Board extends Falck as interim ambulance provider, directs EMS to study alternative system designs
Summary
The Board approved a two-year time-only extension (with an option for a third year) to Falck (FALC) as the countys 9-1-1 ambulance transport provider, citing workforce stability, while directing the EMS agency to research alternative system designs and provide six-month updates to the full board.
After extensive public comment from frontline EMTs, union leaders, fire chiefs and executives from both Falck (FALC) and AMR, the Alameda County Board of Supervisors voted to extend the incumbent 9-1-1 transport agreement with FALC for two years with an option to renew for a third year, and directed the EMS agency to continue researching alternative system designs.
County health staff presented two interim options: a time-limited extension of the current FALC agreement (two years with an optional third year) preserving the current exclusive operating area and workforce continuity; or a new contract with AMR for a three-year term with a six-month transition that would implement the innovations detailed in the RFP (nurse navigation, enhanced clinical metrics, workforce protections).
Labor groups, firefighters and many FALC clinicians testified that transitions historically result in workforce loss and operational disruption and urged the board to choose continuity. "Extending the agreement creates no financial impact to the county and most importantly avoids the unnecessary disruption to emergency medical services," said Nathan Merritt, an EMT and union representative. FALC management and union leaders pledged cooperation in any future system redesign.
AMR representatives and some clinicians supported AMRs proposal, saying nurse-navigation and telehealth innovations reduce unnecessary EMS transports and that AMR has nationwide experience implementing such systems.
Supervisor Fortunato Bass moved to approve the FALC time-only extension, authorize the interim director to negotiate and finalize the agreement, and direct the EMS agency to research alternate system designs (including nonexclusive or third-service options) with six-month reports to the full board; supervisors voted unanimously in favor (Marquez Aye; Tam Aye; Miley Aye; Fortuna Aye; Halbert Aye). Board members said they remain committed to redesign work and asked staff to return with progress reports and to explore whether some pilot innovations can be implemented during the extension period.
The board also heard from Alameda County Fire about pilot nurse-consultation services in dispatch and discussed implementing targeted innovations during the extension to improve clinical performance and equity while avoiding a disruptive provider change.
