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BACKGROUND The County of Alameda (County) has existing agreements with cities of Livermore and Pleasanton for the LPFD to provide First Responder Advance Life Support (FRALS) services. As part of its provision of FRALS, LPFD uses cardiac monitors to assess and, if necessary, treat people with medical emergencies. LPFD currently possesses 15- monitors; ten monitors on FRALS engines, four reserve units (used for special events, strike team deployment and during repair), and one training unit. The current monitors were purchased in 2002, and have reached the end of their useful life due to changes in technology and based on the manufacturer's recommended lifespan of the equipment. The County recently awarded a new multi-year contract for Advanced Life Support (ALS) transport services to Paramedics Plus. As part of the contract, Paramedics Plus is providing monitors to every FRALS unit in Alameda County through an equipment loan agreement at no cost to the receiving FRALS Agencies. LPFD will be receiving ten LP15s through this loan agreement, but the loan agreement does not cover reserves or training units; therefore, necessitating the need for the additional units. DISCUSSION In order to maintain consistency throughout the County, LPFD needs to purchase additional units to maintain an appropriate reserve cache. After re-evaluating the needs of the department, and making some operational changes, LPFD feels that it can manage with three additional units, rather than five. These units include the newest technology that will allow the paramedics to monitor 3-lead and 12-lead cardiac rhythms, blood pressures, body temperature, carbon monoxide and carbon dioxide levels, as well as perform cardiac pacing. LPFD is recommending that the three additional units be obtained from Physiocontrol. This particular sole source provider is recommended because they are the manufacturer of the product that Paramedics Plus has selected for the ALS and FRALS programs; by purchasing the additional three units through PhysioControl all units will be compatible. Also, PhysioControl is extending their discount pricing to all FRALS Agencies within Alameda County. There are two options for the purchase of the cardiac monitor/defibrillator equipment: Option 1 Purchase three cardiac monitor/defibrillators at a cost of $103,711. This option would have a negative fiscal impact on both cities; because the approved LPFD budget for fiscal years 2011/12 and 2012/13 does not include sufficient funds to cover the entire cost of such a purchase. The LPFD Consolidated Budget would need to bridge a funding gap of $83,461; an amount too significant to be covered through budget transfers from other LPFD accounts. Page 2 of 3