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Ambulance rush 

In their ongoing quest for cash, Colorado Springs officials are seeking to squeeze money from American Medical Response, the Greenwood Village-based ambulance company that runs 911 calls across El Paso County.

AMR's currently under a five-year contract with the multi-jurisdictional Emergency Services Agency. When it expires Dec. 31, 2013, or perhaps even before, the city wants AMR to pay the city from $2 million to $2.4 million a year to operate here. Otherwise, the city will look for alternatives — including its own contract for emergency ambulance service, Deputy Fire Chief Tommy Smith says in an interview.

ESA board chair Jim Reid, the county's deputy commander of emergency services, says he hadn't heard of the city's negotiations with AMR until the Independent asked him about it. If the city requires AMR to pay $2 million, he predicts, "that's probably going to triple the cost of ambulance calls in the city." Its base rate for advanced life support transport is currently among the lowest in the state, Reid says.

But Smith and Fire Chief Rich Brown — who insist the ESA board was told of the city's negotiations with the ambulance service when they began two years ago — say rates won't be affected. The city, they continue, merely wants AMR to fork over money gained through "efficiencies." They say that could mean AMR renting office space from the city, sharing dispatchers and shift supervisors, and training personnel. Laying people off, in other words.

And if the city exits the ESA agreement, the county and various rural fire districts might have a hard time finding a contractor to take on such an expansive area, where call volume is low. Roughly 85 percent of 911 medical calls come from within the city, ESA records show.

Private meetings

AMR, which won the first ESA contract in 1996, was the sole bidder in 2008 for a five-year deal that began Jan. 1, 2009; it pays the ESA $200,000 annually to administer it.

In June, the ESA board unanimously approved extending AMR's contract through Dec. 31, 2015. The board is made up of area emergency officials, and representatives from the county and city, including Smith and Councilor Merv Bennett. But neither mentioned the city's negotiations with AMR at that meeting, according to minutes and those who attended.

"We vetted this publicly," Reid says. "We vetted it across the board."

In late June, the Board of County Commissioners approved the extension. It also requires approval from Council, but it has now been pulled from Council agendas at least twice, most recently this week.

Ted Sayer, AMR's general manager in Colorado Springs, confirms the company is "in some preliminary discussion [with the city] about combined efficiencies that could lead to savings that could be passed on to the city to be used by the Fire Department." He declines to be more specific.

Council President Pro Tem Jan Martin told the Indy last week that after a private meeting with Smith, she believed "the direction they want to head is not renew the contract and begin work on their own contract." But after the Indy spoke with Smith and Brown on Monday, Martin left us a voice mail saying Smith had contacted her again — this time to say that the Fire Department wants to work a deal with AMR "under the current [ESA] contract."

Martin says she's heard the city wants to be reimbursed for firefighters' time and functions, such as starting an IV, when they arrive first on a medical scene. (AMR already resupplies fire units with materials used on medical calls.) But Reid argues that taxpayers already pay for firefighters' time. "To me," he says, "it's another way of skirting asking for a tax increase."

Separate ways

For his part, Smith says the Fire Department needs money to fund existing obligations and a "health care initiative" it wants to launch. That initiative might include, say, checking on patients even when they haven't called 911; for instance, fire personnel might drop into a local's home to check on his or her medications. The idea is to be "proactive" — maybe that would reduce the calls for which they'd need to be responsive. "One patient called 911, 45 times in one year," Smith says.

Brown adds that the city is looking for "better ways to serve the uninsured, the underinsured. How can we deliver better service in a non-emergent, non-911 atmosphere — that's really what this is."

But neither could estimate the cost of such programs, and Smith says the idea is in "the infancy stage."

Seeking payment from an ambulance contractor isn't unprecedented; companies pay franchise fees in Aurora, Pueblo and San Diego, Smith notes. And he says the city is "working with AMR to negotiate within the confines within the existing contract."

But he adds, "If we are unable to achieve something that's satisfactory, we would come back and probably have a conversation about altering the contract or possibly getting out of the contract."

County Commissioner Sallie Clark says the ESA contract has improved response times. Under the contract, AMR has shifted "response zones" to better serve areas that have seen population growth, including points on the county's west side, eastern suburban areas, Fountain and Midway.

But if the city doesn't get what it wants, those outside Colorado Springs might be left in a tough spot again.

"It's disappointing to be going backwards," Clark says. "Where does that leave the other fire districts, the other 150,000 people? We're talking about people's lives."

zubeck@csindy.com

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