Public Utility Model and Exclusive Contracts

[chazmedic]

I have attached an article in todays paper about our service, the public utility model idea, and the sudden appearance of American Medical Response and how this is effecting the process. The service and and the county judge, who is the main supporter of the idea, are in a panic about AMR.

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."

Any opinions? :?: I will say our director wants the contract now to prevent AMR from getting a foothold.

[Dustdevil]

Find out who did the study. Chances are it was one of two "consultants" who make the exact same recommendation to everybody who hires them. That's like hiring Motorola to tell you whose radios you should buy. It's a one size fits all bill of goods. Consequently, the "study" results are suspect. The politicians need to ask for independent evidence to support these idiots claims and go over it with a fine tooth comb. Hell, just asking the "consultants" how much time they have personally spent as paramedics should immediately discredit them.

The list of drawbacks to the PUM is too numerous for me to even want to get into right now, but I got a good start on it in the other topic about AMR. There are definite positives to it, but they are clearly outweighed by the negatives. And most of the positives they promise never materialise.

It doesn't matter who runs it -- AMR, Rural Metro, Paramedics Plus, CEMS, or Abdul's Ambulance -- working for a PUM sucks arse. For your sake, I hope it doesn't go that way. But it seems that usually when politicians blow $50k on a pointless study, they tend to want to follow the recommendations they get from it, so chances are you're buggered.

[chazmedic]

It's going to be either a PUM or Fire Department. Our county Department of Homeland Security and Emergency Management director is drooling at the chance to establish a county wide paid department no matter what it takes. As long as he and his buddies are in control. The mayor of Fayetteville (pop 70,000, daytime swell to 100,000) and the county judge want control of EMS. Bear in mind, the company brought this on with bad management decisions (routinely sending 4 of 7 on duty trucks on long distance transfers then saying he wasn't doing it, saying he was a private company so f--- off, refusing to answer any questions the city and county had).

Actually, our new fire chief in Fayetteville does not want EMS. He has gone out of his way to show our taking over is a financially bad idea. He has told the council this.

I'll get the name of the consultant. I know he is a former paramedic. The funny thing about the 2 studies, both showed the FD taking over is a bad idea. A council member then asked "so let's do a study to see if the FD should take over."