Staff Report.Ambulance Agreement
PREPARED BY: Clinton Tada
Interim Police Chief
Reviewed by: Town Manager, Assistant Town Manager, Town Attorney, and Finance Director
110 E. Main Street Los Gatos, CA 95030 ● (408) 354-6832
www.losgatosca.gov
TOWN OF LOS GATOS
COUNCIL AGENDA REPORT
MEETING DATE: 10/19/2021 ITEM NO: 4
DATE: October 11, 2021
TO: Mayor and Town Council
FROM: Laurel Prevetti, Town Manager
SUBJECT: Authorize the Town Manager to Execute a Service Agreement with Silicon
Valley Ambulance, Inc. as a One-Year Pilot Program for Transportation
Services of Juvenile Patients Placed on an Involuntary Mental Health
Evaluation Hold
RECOMMENDATION:
Authorize the Town Manager to execute a service agreement with Silicon Valley Ambulance,
Inc. as a one-year pilot program for transportation services of juvenile patients placed on an
involuntary mental health evaluation hold.
BACKGROUND:
The issue of initiating a police response to mental health calls for service continues to be a topic
of discussion on a national and local level. While many recognize that a police presence may
not always be the best option for those experiencing a mental health crisis, the lack of available
clinicians and the need to maintain a balance of public safety while addressing the needs of the
person in crisis typically requires a law enforcement response.
In August 2021, the Police Department provided Town Council with some recommendations to
further explore compassionate care options of mental health response and the way Officers
deal with those in crisis when a law enforcement response is necessary. Of the several options
supported by the Town Council, the Council directed that staff explore contracting with a
private ambulance company.
An ambulance company would provide dedicated service for the transportation of juveniles
placed on involuntary mental health holds (under 5150 of the Welfare and Institutions Code) to
psychiatric treatment facilities instead of an Officer transporting the juvenile in crisis in a
marked patrol vehicle.
PAGE 2 OF 4 SUBJECT: Authorize the Town Manager to Execute a Service Agreement with Silicon Valley Ambulance, Inc. as a One-Year Pilot Program for Transportation Services of Juvenile Patients Placed on an Involuntary Mental Health Evaluation Hold DATE: October 11, 2021
BACKGROUND (continued):
Police protocol dictates that when a juvenile or adult is transported in a police vehicle, the
individual is placed in handcuffs for safety reasons, placed in the rear prisoner area of the patrol
vehicle, and transported to a local stabilization facility or emergency psychiatric medical facility
for further evaluation and treatment. The Police Department recognizes that this practice may
not be optimal, even with the coordination of services with other entities such as the County’s
Mobile Crisis Response Team.
DISCUSSION:
The Town currently utilizes the ambulance services of the County of Santa Clara Emergency
Medical Services (EMS), under an existing service contract with Rural Metro Ambulance
Company for all emergency and non-emergency medical service calls in Santa Clara County.
However, the EMS ambulance services in the County will only transport individuals placed on a
5150 WI involuntary mental health hold when there is a medical or intoxication co-morbidity
alongside the mental health crisis.
The Police Department utilizes the in-field response of mental health services available through
the County Behavioral Health Mobile Crisis Response Team and Uplift Family Services Mobile
Crisis Stabilization Unit Response Team. While these services are valuable during in field
assessments and evaluations and after-care, neither of these in-field services provide
transportation to emergency psychiatric facilities for acute treatment.
Staff conducted further research with four regional private ambulance companies to determine
service options in providing transportation of juveniles placed on involuntary mental health
evaluation holds, with no dual diagnosis. Due to ambulance headquarters location and staffing
models for several of the companies, it was determined that some providers would be excluded
due to the extended response times.
Staff identified Silicon Valley Ambulance Inc., headquartered out of south San Jose, as being a
local private ambulance company that is adequately staffed with both Emergency Medical
Technician and Paramedic transportation with established services throughout the South Bay
area. Silicon Valley Ambulance Inc. provides private transportation services for individuals
(including juveniles) experiencing a mental health crisis or for those placed on an involuntary
psychiatric evaluation hold upon request. Calls are triaged by priority, availability, and demand.
Attachment 1 contains a draft of an agreement with Silicon Valley Ambulance Inc., which, if the
Council approves this item, would need additional legal review prior to execution. Under the
draft provisions, the patient’s primary health insurance provider would be billed for
transportation services as the first default option. If the patient is not covered under a health
PAGE 3 OF 4 SUBJECT: Authorize the Town Manager to Execute a Service Agreement with Silicon Valley Ambulance, Inc. as a One-Year Pilot Program for Transportation Services of Juvenile Patients Placed on an Involuntary Mental Health Evaluation Hold DATE: October 11, 2021
DISCUSSION (continued):
insurance policy, the Town would be billed for services by Silicon Valley Ambulance Inc. at the
federal Medi-Care rates ($300.00 to $500.00 for the initial response and transport, plus $10.00
per mile of transportation).
Based on treatment services and availability, juveniles are primarily transported to Uplift Family
Services Emergency Psychiatric Care facility in Campbell. The option to transport to other local
emergency psychiatric evaluation facilities or hospitals can be accommodated at the request of
the parents and if applicable insurance coverage is available.
From January 2021 to October 2021, approximately twenty-seven involuntary mental health
holds were issued on juveniles, who were transported to a local facility for further treatment.
Staff does not request juvenile patients or parents confirm primary health insurance coverage
prior to transportation under the existing model. Therefore, the overall fiscal impact this pilot
program may incur is to be determined. Staff will continue to evaluate the program if
authorized, and routinely monitor the ongoing cost to the Town for the “pay as needed
services” on a monthly basis for transports where patients are uninsured. Ongoing program
evaluation assessments will also monitor program participation.
Silicon Valley Ambulance Inc. currently provides ambulance transportation services for
individuals (including juveniles) on mental health holds for the City of Morgan Hill and provides
inter-facility transfers.
CONCLUSION:
For the reasons mentioned in this report, staff is recommending that the Town Council
authorize the Town Manager to execute a service agreement with Silicon Valley Ambulance,
Inc. as a One-Year Pilot Program for transportation services of juvenile patients placed on an
involuntary mental health evaluation hold.
In addition, the Police Department is pursuing the other items as directed by the Town Council
at the August meeting, including but not limited to therapy dogs and coordination with County
leadership regarding additional mental health services. Staff will return to Council with updates
on these other measures at future meetings.
PAGE 4 OF 4 SUBJECT: Authorize the Town Manager to Execute a Service Agreement with Silicon Valley Ambulance, Inc. as a One-Year Pilot Program for Transportation Services of Juvenile Patients Placed on an Involuntary Mental Health Evaluation Hold DATE: October 11, 2021
FISCAL IMPACT:
The fiscal impact of this one-year pilot program will need to continually be evaluated on a
monthly basis based on frequency of use and payment responsibility of the Town as outlined in
the service agreement. The fiscal impact to the Town will be based on per use of services only
when patients are not covered by their own private health insurance. There are no recurring or
annual costs to the Town for this agreement of services by Silicon Valley Ambulance Inc.
ENVIRONMENTAL ASSESSMENT:
This is not a project defined under CEQA, and no further action is required.
Attachments:
1. Silicon Valley Ambulance Agreement