The Vancouver City Council on Monday agreed to put a contract amendment giving American Medical Response two extra minutes to reach emergency calls to a vote later this month.
AMR, the privately-owned company that contracts with EMS District 2 for ambulance transport, has faced steeply declining revenue as Medicare and Medicaid cut reimbursement rates and the slumping economy has affected others’ ability to pay.
So in January, the company asked for a “stop the clock” agreement to give it two more minutes to get to a call, if another first responder (the Vancouver Fire Department or Clark County Fire & Rescue, for example) arrives on scene first. In urban areas, AMR must be on scene within 7 minutes and 59 seconds 90 percent of the time, or face fines under its contract.
The “stop the clock” agreement would give it 9 minutes and 59 seconds to arrive and allow it to save money by making staffing changes.
All other jurisdictions in the EMS district have already agreed to the contract amendment, but Vancouver has remained a holdout as councilors express concerns about the potential risk to patients.
On Monday, Fire Chief Joe Molina and Clark Regional Emergency Services Agency EMS Manager Doug Smith-Lee assured the council that there won’t be any change to the amount of time a critical patient spends on scene before being transported to the hospital.
“We’re not impacting that patient journey,” Smith-Lee said, adding the response times that are set were “arbitrary” and not based on scientific evidence. VFD trucks arrive on the scene first about 70 percent of the time anyway, he said, meaning not too much will really change.
The emergency officials stressed that the extension is needed to get EMS District 2 through a complete redesign of emergency response. Molina said he was “confident” a similar arrangement will be included in any new contracts as well.
“I’m considering it a stop gap measure,” Councilor Jeanne Stewart said.
But Councilor Jeanne Harris chafed at the idea that AMR could see the terms of its current contract changed.
She said she doesn’t like the idea that the amendment would essentially say, “It’s OK, you don’t have to do what you said you would do in the original contract.”
Councilor Bart Hansen reiterated a point he made in January — that it’s possible a Vancouver fire unit that doesn’t have a paramedic on board may arrive first, meaning advanced life support may be delayed in arrival.
Molina said that his department strives to have every station staffed with a paramedic at all times, and only about 1 percent of the time does that not happen. He called it an “intelligent risk.”
“I’d be completely fine with this if I knew all units were rolling (advanced life support),” Hansen said.
The change would allow AMR to more strategically place its ambulances around the area, General Manager Dave Fuller said after the meeting. Now, AMR units are often right next to VFD units, creating an overlap in service. This will allow the company to put its units farther away from VFD stations for better deployment, he said.
The move would allow AMR to cut 12 staff hours a day from its schedule, at an estimated savings of $262,780 a year. The company will avoid rate increases and also will give 50 percent of the savings to local public agencies who may be the first responders on scene. Vancouver expects about $76,062 in returns.
The amendment will be formally discussed at the Vancouver City Council’s Feb. 27 meeting.