Rural Metro Loses Atlanta Contract ?

[crotchitymedic1986]

Hearing rumors from friends in Atlanta, wonder if anyone knows the truth. Here are the rumors:

1. RM in Atlanta hired a manager who had no EMS experience, he formerly managed a burger chain. He was brought in to cut the budget and jobs by about 40%. RM had two thirds of the Atlanta 911 zones (a rich zone, and a poor zone). The plan was to pull out of the poor zone, fire the highest paid employees in the field and dispatch, and then rest comfortably on the profit from the rich zone.

2. Apparently when RM tried to get out of the zone, questions were raised as to why both zones should not be put up for bid. Now RM is faced with losing both 911 zones, and being totally out of business, thanks to the genius of the burgerking.

3. I also hear that 12 employees have filed harassment charges against the burgerking and one of his marketing reps through the corporate office. Kharma is a bitch !!!

Here is the only link I could find, is it really that bad down there ?

http://www.cbsatlanta.com/news/22536651/detail.html

[HERBIE1]

Unfortunately there are financial realities in EMS, and reimbursement is a huge issue. The poor areas make up the majority of the call volume, but it's either self pay or state aid with pennies on the dollar for a return. Unless you get subsidies for providing that service, no company will operate in the red.

This is why it is so difficult to fight fire based EMS. It's not about level or quality of care, it's about doing more with less. Lets say an area uses a 3rd service provider. A municipality sees it can save money by sending a fire company on medical calls, who then determine if transport is needed and the type of care required, thus reducing the subsidy it provides the ambo service. Then the fire service realizes it can actually generate revenue if they take over transports, and voila- we get the problems we have.

[crotchitymedic1986]

Unfortunately there are financial realities in EMS, and reimbursement is a huge issue. The poor areas make up the majority of the call volume, but it's either self pay or state aid with pennies on the dollar for a return. Unless you get subsidies for providing that service, no company will operate in the red.

This is why it is so difficult to fight fire based EMS. It's not about level or quality of care, it's about doing more with less. Lets say an area uses a 3rd service provider. A municipality sees it can save money by sending a fire company on medical calls, who then determine if transport is needed and the type of care required, thus reducing the subsidy it provides the ambo service. Then the fire service realizes it can actually generate revenue if they take over transports, and voila- we get the problems we have.

So true Herbie, but as I understand it, the Fire Department can not take over this zone as long as there is a private provider who will do it. The rumor mill states two providers have volunteered to run it if they can get both zones. Looks like alot of Rural Metro staff are about to take a huge pay-cut, if they can find a job. My buddy states that the new services will probably hire off-duty firefighters (at a much lower wage), and not use ex-RM folks because they perceive that they will have attitude or will intentionally do things to mess up and make the new company look bad. At the same time, apparently the Burgerking has declared that any employee who applies for another job will be fired on the spot (sounds like lawsuit time to me, or maybe most of their employees should suddenly get back injuries). Looks like a bad time for alot of medics due to their incompetent managers, who let this happen. I can not believe that RM would hire a GM with no EMS experience to run one of their best zones, hopefully they will wake up and fire him and the whole management team this week.

[46Young]

Unfortunately there are financial realities in EMS, and reimbursement is a huge issue. The poor areas make up the majority of the call volume, but it's either self pay or state aid with pennies on the dollar for a return. Unless you get subsidies for providing that service, no company will operate in the red.

This is why it is so difficult to fight fire based EMS. It's not about level or quality of care, it's about doing more with less. Lets say an area uses a 3rd service provider. A municipality sees it can save money by sending a fire company on medical calls, who then determine if transport is needed and the type of care required, thus reducing the subsidy it provides the ambo service. Then the fire service realizes it can actually generate revenue if they take over transports, and voila- we get the problems we have.

Yeah, pretty much.

It serves them right for trying to play the local gov't. They want to serve the affluent areas, with a greater reimbursement and less call volume. They want to drop the ghettos, where they run a high percentages of the either uninsured or those on gov't plans that reimburse poorly. You can't have your cake and eat it too in this case. Why someone would choose to make a career out of private EMS is beyond me. The whole operation could fold, as is the case in this example. These soon to be former employees would have to move to the Carolinas to get decent third service work.

The local gov't lets them work in the area because they don't want the burden of managing EMS in the area. It's naive of Rural Metro to think that the city would willingly assume the liability of running EMS in the poorer areas and leave them with only a lucrative, low volume (requiring less units naturally) district.

What Rural failed to consider is that if Atlanta was able to turn a profit from EMS, they would do it with either third service EMS or fire based. Why would they give away free money? Why would Atlanta willingly assume a poor, low reimbursement area and leave them with the "money" area? That would defeat the purpose of contracting out EMS in the first place.

As far as other privates assuming 911 EMS in the area, who would want to take over a region that runs in the red? They could always do IFT. But, if they have units that run both 911 and IFT on the same shift, that brings along it's own set of problems. That practice should not be allowed under any circumstances. Have dedicated 911 units, and dedicated IFT units.

For a career in EMS, go muni with a pension. Govts rarely fold.

[JPINFV]

As far as other privates assuming 911 EMS in the area, who would want to take over a region that runs in the red? They could always do IFT. But, if they have units that run both 911 and IFT on the same shift, that brings along it's own set of problems. That practice should not be allowed under any circumstances. Have dedicated 911 units, and dedicated IFT units.

For a career in EMS, go muni with a pension. Govts rarely fold.

Here's the thing with that. Why shouldn't a company with both 911 contracts and IFT contracts be able to use IFT as 911 surge capacity and 911 units as IFT surge capacity provided a minimum available 911 coverage is maintained. I will grant, however, that for a lot of companies will find reasons to need to "surge" their 911 units to help the IFT side. However, as long as non-emergent patient transport is linked to EMS, I view the relationship having the potential to be synergistic rather than antagonistic. I guess I should have gone into EMS management instead of medicine.

[46Young]

Here's the thing with that. Why shouldn't a company with both 911 contracts and IFT contracts be able to use IFT as 911 surge capacity and 911 units as IFT surge capacity provided a minimum available 911 coverage is maintained. I will grant, however, that for a lot of companies will find reasons to need to "surge" their 911 units to help the IFT side. However, as long as non-emergent patient transport is linked to EMS, I view the relationship having the potential to be synergistic rather than antagonistic. I guess I should have gone into EMS management instead of medicine.

Thats exactly why - a lot of companies look to "surge" their 911 to help out IFT, where the money is. It's not okay to just keep a minimum coverage for 911. Call volume can spike, and response times are affected. Having dedicated 911 and IFT units prevents any conflict of interest, so to speak. If the private company wants the 911 contract, then give 911 the proper amount of resources. At some point a lack of coverage will be noticed by the citizens or gov't, and then the EMS services will be reclaimed by the local gov't. If 911 needs the additional units, then the company isn't properly staffing with respect to call volume. If the company wants to run the bare minimum in their IFT division, they can't look to cannibalize their 911 ops, which results in compromised coverage. 911 does 911, and IFT does IFT. If either division has shown a trend towards higher call volume during peak hours, you can run "enhancement units", OT rigs that run for 5 or 6 hours or so, during typical periods of high call volume.

Allowing 911 to help out IFT will always present the temptation to take emergency units OOS to run the IFT money jobs. Especially if that's the only division making money.

So on the one hand, you have fire based EMS with it's abundance of units, both ambulances and ALS suppression pieces, to ensure a timely 911 response. Overkill, maybe. But certainly not understaffed. On the other end of the spectrum, you have the private company that does 911 and IFT at the same time. Being a private, for profit business, they'll naturally look to put as few rigs on the road as possible. Payroll is typically the largest part of any operating budget. When you have a 911 unit sitting in a poor area where they're running in the red, they'll think nothing of taking that unit and sending it on an IFT run that would otherwise be turfed. The question is how much of that can they get away with before someone notices and takes action? You know that this goes on all the time. The majority of privates can't be trusted. Having seperate 911 and IFT keeps them honest to some extent.

[HERBIE1]

Well, I equate this to health care reform and the public option. There is no way a private company can compete with a government run entity. Both groups may receive a subsidy from the government to help cover operating expenses, they both generate revenue with their billing, but a municipality does not need to turn a profit. BIG difference.

[ruralghettoemtatlanta]

Rumor we got is that a big broom is coming to the southeast to sweep out the bums, Glenn Miller is supposed to be taking over. And according to facebook, Grady is picking up the south zone and Metro Ambulance Service (not to be confused with Rural Metro) is picking up everything else. We are all looking for jobs.

Edited February 21, 2010 by ruralghettoemtatlanta

[46Young]

Rumor we got is that a big broom is coming to the southeast to sweep out the bums, Glenn Miller is supposed to be taking over. And according to facebook, Grady is picking up the south zone and Metro Ambulance Service (not to be confused with Rural Metro) is picking up everything else. We are all looking for jobs.

You need to get your medic and start applying to municipal third service agencies. The Carolinas have a ton of them. Get yourself a state retirement with a TERI/DROP if you want to do this for a career. There's no future in the privates, and a 401k is nothing compared to a pension, unless you put away 10k or more a year, start when you're 20, get a realistic 8%/yr on average, and retire at 65. That would get you about 4,150,000. It sounds like a lot, except that inflation averages more than 3% yearly. In those 45 years, you'll need about $3.75 for every one of today's dollars to have the same purchasing power. What does that mean? Your 4,150,000 will be worth only 1.1 million or so in purchasing power. That won't last you long, considering inflation will continue on while your principal erodes. That won't last you past 15 or 20 years tops, unless you llearn to do without more and more. What many don't realize is that you need more in retirement than in your working years. What are you going to do when you're 85 and broke? It's all about the best retirement. Get yourself a pension, DROP/TERI, and max out your 457. Live well in retirement.

[ruralghettoemtatlanta]

Thanks for the advice, but that really isnt practical in GA. The problem is that RM was the highest payer in the State. All of the municipal departments in Atl pay far less, and are currently under a hiring freeze or using furlough days to cut salaries/budget even farther. On top of that, the muni's do not pay for experience, everyone starts at the same low wage. With that being said, we all realize that a low-paying job with a muni is probably better than the private alternatives that exist. Of course the main rumor about who will take over would be great for us, as both companies pay pretty well, but the other possibility that is probably more realistic is that the zones will be divided up by the fly-by-night privates who will do it for no subsidy at all. There is a company out of Macon that is notorious for taking over 911 zones for no subsidy, then coming back to the politicians a year later (after being awarded the zone) to beg for money or pull out. Once you leave the Atlanta area, most people in our industry are working for just a little more than minimum wage. I imagine some of us will move to another state, but it is difficult to abandon your family.