AMR takeover tactics

[chazmedic]

Here is an update with this. It appears the county and city are going to try to lock out AMR. I believe that the city and county do not want to give up "local control" of EMS. Since this meeting, we have heard that now AMR is reducing the amount of ambulances they are going to run and are focusing on the county north of us. They don't want to come across as the "bad guys".[/font:b1d1749b77]

Council to consider offering exclusive ambulance contract

BY MARSHA L. MELNICHAK Northwest Arkansas Times

Posted on Wednesday, March 29, 2006

URL: http://www.nwanews.com/nwat/News/38958/

The Fayetteville City Council will soon consider whether the city should have an "exclusive provider" for ambulance services beginning Jan. 1, 2007 or Jan. 1, 2008.

At the request of Mayor Dan Coody, a resolution to express the council’s intent to contract exclusively for emergency medical and ambulance services for the City of Fayetteville was added to the council’s agenda for April 4.

American Medical Response, also known as AMR, has indicated it expects to be in service in Washington and Benton counties by the end of April, which will put them in direct competition with Central Emergency Medical Services, the current provider of ambulance service to Washington County and the city.

According to Coody in a memo to council members, that competition "will have a potentially serious affect upon CEMS’s ability to remain financially viable."

And that, he indicated, would result in one of two scenarios: no emergency ambulance service or the city and county paying more money to fund the resulting cash shortfall for Central EMS. "The $300,000 budged for 2006 will not be sufficient to sustain the service even if there is only a marginal expense/revenue impact due to the loss of a portion of the non-emergency transfer market," Coody wrote.

A study paid for by the city and county recommends a public utility model to reduce taxpayer subsidies. The recommendation is for one exclusive provider so the fees from non-emergency transport help pay for emergency transports, which often go unpaid.

Washington County administrators would like the city to make Central EMS the exclusive provider immediately, then request bids for services beginning in 2008, explained Gary Dumas, director of operations for Fayetteville.

Coody prefers to start sooner.

He suggests the city immediately begin the process of soliciting proposals for an exclusive provider for all ambulance services through a public utility model to be operational by Jan. 1, 2007.

City Attorney Kit Williams explained that the city must comply with state statutes to limit itself to one provider for emergency and non-emergency services. "We can’t just do that. … There’s no way just to write an ordinance immediately and immediately let CEMS have it. That’s not allowed," he said.

The proposed resolution would just express the intent that the city wants to limit to a single provider, whoever the best provider will be, Williams explained.

Hugh Earnest, facilitator of the study, said AMR’s focus will be non-emergency service. He said the company is positioning itself to be in the market when bids are requested.

He said the Jan. 1, 2007, target date could be met. The county wants to continue a regional service, such as is provided now by Central EMS, he said.

According to Earnest, Fayetteville’s interest in being part of a regional public utility model is crucial. "Sixty-five to 70 percent of the business for emergency comes out of Fayetteville," he said.

Russ Kelly, president of the Central EMS board, said they are concerned about the financials with AMR coming into the area, but they are also concerned about losing qualified people to other providers. "It looks like without an exclusive contract, we’re going to lose most of that (nonemergency) business," Kelly said.

At Tuesday’s agenda session, Alderman Bobby Ferrell asked other council members to "remember what happens when we rush into things."

Copyright © 2001-2006 Arkansas Democrat-Gazette, Inc. All rights reserved. Contact: webmaster@nwanews.com

[Dustdevil]

What I do have a problem with is a municipality outsourcing their EMS to a company like AMR...and not providing a clause that AMR or whomever must allow existing employees a position w/ comparable benifits, etc.

They need those local people and are quite happy to hire them when possible. I have yet to see an instance of AMR coming in and cleaning house of all the locals. Bad business all the way around.

On the other hand, AMR quite commonly has higher standards than the existing provider. Consequently, not all of them can be hired. Nor should they be expected to hire every 300 pound basic EMT who can't pass an agility test or exam over medical knowledge. They'd be retarded to do so, and the local government would be retarded to stipulate it. If they wanted more of the same old sub-standard crap they are currently unhappy with, they wouldn't bring in AMR in the first place.

[Rescue0ne]

They need those local people and are quite happy to hire them when possible. I have yet to see an instance of AMR coming in and cleaning house of all the locals. Bad business all the way around.

On the other hand, AMR quite commonly has higher standards than the existing provider. Consequently, not all of them can be hired. Nor should they be expected to hire every 300 pound basic EMT who can't pass an agility test or exam over medical knowledge. They'd be retarded to do so, and the local government would be retarded to stipulate it. If they wanted more of the same old sub-standard crap they are currently unhappy with, they wouldn't bring in AMR in the first place.

Devil, I agree completely, in regards to the physical fitness, medical knowledge, and standards or professionalism. Really, if they weren't in shape, and weren't professional, they have no business in a Career EMS position to begin with, in my opinion. ESPECIALLY not, if they aren't up to par on medical knowledge equal to their level of training.

Now sure, if the individual is a Basic, and AMR/whomever only wants EMT-I & EMT-P...then of course, they're a no go.

If the provider is 300 lbs and 5' 4" tall...then yeah, they'd have to be passed over.

My deal with it all, is that if you're going to have Career EMS in place, then don't outsource individual employees from jumpstreet. Existing providers need to be given ample opportunity for employment. If they don't meet criteria, then great. Keep on looking.

I know of one instance when AMR was contracted to run a municipal EMS service. They're still in place today. A Nationally Registered Critical Care Paramedic, who I am familiar with, was a supervisor with the existing system. When AMR took over, they brought with them a whole management team, and fired the previously mentioned CCEMT-P. Now, if the guy had been shady, or out of shape, of unknowledgable, or an inept supervisor, then fine. Can his butt. However, this Medic has his act together, he's a great leader, supervisor, preceptor, and all around excellent provider. AMR wanted their people in place, and to hell with everyone else. they didn't even offer him a regular Paramedic's position. Just "Don't let the door hitya..."

Really quick, I'll state that the medic in question is/was not me. The medic in question was not my friend, coworker, or supervisor. This wasn't even someone I personally liked...but they were a helluva Paramedic & Supervisor.

Turns out, there Is justice in the world. The Medic in question is now the Operations Officer/Senior Flight Paramedic with a kick-@#& Level One Trauma Center-based Medevac System.

That's my only problem with AMR & outfits like it. To me, it's like we're outsourcing MEDICAL CARE just like our country outsources everything else these days. I've always considered those outfits to be mercenary in nature. No disprespect to anyone who may work for AMR, etc. You may be a kick@$& provider yourself, but your company's policies just really suck a big ol' uvula.

[Dustdevil]

Ah, well then we're on the same page.

I do wonder if the supervisor in question was even offered a field position. After all, I do believe that a company is well within justification to put its own management and supervision in place and is not in any way obligated to keep old management. Again, it is the whole concept of replacing what the city obviously didn't like with something new and hoping for better results. But I would certainly be disappointed if he wasn't offered the opportunity to stay in some capacity.

[Rescue0ne]

Nope, he wasn't in this case, and that's what REALLY set me off in the first place.

Really appreciate you sharing your experience / lnowledge.

[chazmedic]

We have heard that all supervisors would be let go if they took over. This seems to be a common trend when they take over. All other employees would take a pay cut.

Now, the thing to remember is, they were not invited in. The PUM board sees their presence as a destabilizing force of the existing system. The fear is that they are going to force the RFP on their terms. Efforts are occurring to lock them out of the region, see the article I posted above. The county judge has already indicated that all employees retain their jobs.

The other thing at issue is 3 counties in NW Arkansas (which we are a part of) operate under a common protocol system, the "Northwest Arkansas Protocols". This was put in place so that all 9 EMS systems operated on the same page. This was a collaboration between the systems and the area hospitals. The PUM is going to mandate adherence to this protocol system.

The main thing is the PUM, city mayors, and county judge appear that they are not going to let local "hands-on" control slip an "outside" company. The PUM board agrees that it's not an issue of substandard care, rather a funding issue.[/font:b0fe1c7574]

[mtblillie]

Im in an area where the regional hospital handles EMS so Im not totally sure, but all I remember about AMR is that they had taken over like the entire bay area for ALS and like almost all 911 contracts. I guess AMR is a hostile takeover busniness lol

[speed graphic]

I understand that being a victim of a takeover sucks, but it's kind of hard to blame AMR. They're in a business where you can't really have "competitors" most of the time, so the only way to break into a market is to take it over...

"Thank you for dialing 911. To choose AMR, press 1. To choose Rural/Metro, press 2. To choose..."

[1aCe3]

LoL

Well, Over here AMR is mainly a transport service with a couple competitors, however some people will choose to call them even when it's an emergency. The reasons for this may be...

1. For some reason nurses at NH's who screw up call transport services because they may think that they will get into some sort of trouble if they call the city's primary 911 service. (Why I don't know, but it's just something I heard) Or they may have a contract with company's such as AMR and think to call them anyways even if it's a dire emergency.

2. Some patients will refuse to go to the closest hospital (due to their own opinions of the level of care/conditions of a hospital), and will call private services thinking they will be able to choose the destination. (Sometimes they do get away with it) Local 911 services will usually refuse to do this, especially if the emergency calls for it - which is something that is completely agreeable with.)

3. http://www.nydailynews.com/boroughs/story/...3p-341305c.html

Maybe it's a language barrier, dispatchers may be able to get translators (I think) but EMS crews don't have that luxary, and care may be impeded. Private services sometimes offer specialized units to deal with people who don't speak english. (This article also talks a little bit about the problem with competition, it can get messy.)

Like the article says... sometimes the magic 911 number isnt the way to go... So they'd choose to "1"

It may be true that they have a higher level of standard for hiring, thus it may be construed as being hostile when firing the previous that didn't make the cut. As for replacing even the good ones - it's business, of course they would want their own people in place. They want to make sure things are run their way. But keeping some of the previous workers in management would help the rest cope with the change, but since it's such a large corporation, I highly doubt that's a high priority for them.

[Peanut81]

I am not an EMT (yet) but I was looking into AMR as a possible place to apply - Seeing this thread makes me wonder if thats a bad idea? Or is it simply because they are taking over smaller companies?

I live in Las Vegas and the main options I've seen are AMR or Clark County Fire..

Ideas? Suggestions?

Thanks!

Christy 8)