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Firefighter unions criticize EMT service
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LAS VEGAS REVIEW-JOURNAL
Updated: Oct. 5, 2010 | 7:47 a.m.
Southern Nevada firefighters took aim at a private ambulance service Monday, saying they wanted to "sound the alarm" over the services provided under contract to Clark County, Las Vegas and North Las Vegas residents.
It was the latest salvo in what is turning into a legal battle between American Medical Response and the firefighter unions -- who work together in the field but are now opponents in the legal system.
And it comes at a time when first responders are in the spotlight over wages and benefits, emergency medical services are seen as an area ripe for privatization and some fire departments are transporting more patients, which is a source of revenue.
AMR officials called the allegations "unfounded political attacks of distortion."
County officials said AMR met with requirements of the contract.
The skirmish started with a news release last month.
"Southern Nevada Residents had no Ambulance Service Over the Weekend" blared the headline over the release, which said American Medical Response sent a "service level zero" signal at 2:30 a.m. Sept. 12. That would mean no private ambulances were available for service. The firefighters say that status continued for several hours; AMR officials said there was no service outage.
In the release, Dean Fletcher, president of the Las Vegas firefighters union, and Jeff Hurley, head of the North Las Vegas firefighters union, accused the company of "trying to minimize overhead" and of having "no invested interest in the care and well-being of Southern Nevadans."
The release said the company's ambulances were not meeting a 12-minute response time, "and in some cases their response times have exceeded 20 minutes." Fletcher called the situation "utterly ridiculous," adding, "Southern Nevada is not a Third World country."
On Monday, Fletcher acknowledged that fire department crews were available that night to answer medical emergencies.
Mercy Inc., the parent company of AMR and Medic West, fired off a letter Sept. 16 calling the release "simply false" and "defamatory." The company -- which operates under the AMR name in Las Vegas -- demanded a public retraction and said, "AMR will take such further action as it deems necessary" if the retraction is not made.
"The firefighters' association should not make private companies such as AMR its victims in its ongoing public relations battle with local governments," the letter said.
The firefighters unions from Las Vegas, North Las Vegas and Clark County placed an ad in Monday's Review-Journal demanding an apology from AMR and Medic West. The company is an "out of state multibillion-dollar Wall Street-traded firm" that "tried to shut us up with a lawsuit," the ad said.
"I made those statements that they were late and that they didn't have units to respond and they sometimes have calls that were longer than 20 minutes," Fletcher said. "I was threatened to be sued. That's why we did what we did."
AMR files monthly reports documenting its calls, and those show that AMR is meeting its contractual obligations by responding on time to more than 90 percent of calls. Most calls must be answered in under 12 minutes, although some calls come with a response time of under 20 minutes. There were late responses to both types of calls.
County spokesman Dan Kulin released a statement saying, "The ambulance companies' performance is closely monitored by the local governments. The companies continue to exceed the county's performance standards."
Fletcher said he is not disputing the numbers. He said Monday's action was a response to an AMR claim that its ambulances are always on time.
"They do meet their compliance," Fletcher said. "But they said they were never late."
He pointed to a live television news report in which a reporter, not someone from the ambulance company, said the company "always" meets response targets.
AMR issued a statement Monday night saying it has consistently met contract requirements and has maintained 100 percent contract compliance, averaging approximately 7 minutes to reach patients. With more than 150,000 calls a year for emergency ambulance services, AMR operates in one of the largest high-performance systems in the nation, it said.
"AMR is disappointed with what we believe are unfounded political attacks of distortion by the Fire Unions to drive its agenda and to take away private sector jobs. We are extremely proud of our EMTs and paramedics. Our EMTs and paramedics serve the citizens and area professionally, honorably, and provide excellent clinical care," General Manager Mike Gorman said.
"AMR has provided emergency ambulance services in Clark County for decades and has consistently provided superior performance," Gorman said. "Our crews live in this County, their families live in this County and they would never let their community down."
The three jurisdictions involved have a dual-response emergency medical system. When a medical call comes in, teams are dispatched from the nearest fire department, and a private ambulance is dispatched too. The fire department's response time goals are faster: four minutes to eight minutes.
The system allows fire department ambulances to return to duty instead of having to transport patients to the hospital, which can take up a lot of time. But if a patient is in need of immediate care, the fire department will do the transporting.
The recession has put firefighters in the spotlight. A sour economy has cut public revenues, and workers are being asked to take cuts. Because of overtime, firefighters average more than $100,000 in salary annually.
Clark County firefighters are headed to arbitration after a dispute over a new labor contract. Las Vegas' firefighters went through a similar process before agreeing to some cuts, and part of their compromise includes a promise from city officials that they will not study privatizing emergency medical services in the city for the next two years. And the Las Vegas Fire Department has been transporting more patients, Fletcher said.
A county panel proposed outsourcing emergency medical services as a cost-saving measure, and North Las Vegas came up with a plan for its responders to transport more patients so the city could bill for the services. The North Las Vegas City Council put that plan on hold.
Contact reporter Alan Choate at achoate@reviewjournal.com or 702-229-6435.
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Ken O, Most everything I've talked about AMR is a result of management problems. Like I said before I'll let AMR's employees speak for me.
http://www.glassdoor.com/Reviews/American-Medical-Response-Reviews-E2224.htm
http://www.glassdoor.com/Reviews/American-Medical-Response-Reviews-E2224.htm
Sac, glad to hear you are not a medic, and are just stating your personal opinion. Also, don't quote numbers in the medical field if you do not have a study to prove it, there are too many variables in each case. Now, why don't you take the time to explain that it is because of the ICS system that fire has scene control. It is not because of better training or more skill. I also know several FD medics that won't work with each other unless they must. Every EMS service in this county has medics that are borderline at best, that includes every single FD here. Last must not least, you may have made arrival first this shift, but we both know that is an anomaly at best. The public foots the bill to have FD stations every few miles, and you should arrive first the majority of the time. The public is paying HUGE amounts to have stations and personnel every few miles. For the money we are spending, I would hope you guys could be first on scene more often! I would hate to think my tax money is being wasted!
Hey Ken O, never said I was a medic. I never said there was a study. That was quoted from Slaughterys class with City Fire and our Medics send AMR medics home all the time. We are the lead agency. When we say you’re done, they are done with patient care. That usually is followed up with a call from one of our chiefs to their supervisors, but not all the time. One of our medics will not let a few of AMR medics practice on scene unless he has no choice. You can cancel us and we will if we choose to do so. We do practice HCT, but most laymen would not know what that meant. I think we have been doing it for over a year now as the CITY medics are FULLY trained. Our Survivability rate is if I remember right) close to 23%, very close to Seattle who leads the nation.
PS. 20 plus calls last shift, AMR never arrived before any of our units from our station.
Sac, you are kidding right? Number one, I truly doubt you are a medic, it is obvious you are borderline illiterate from your postings. Number two, it is called hypothermic cardiac therapy, not cooling for heart attacks. It's use is very limited, and the only EMS service in southern Nevada that does not use it is Clark County Fire. I am told they are being trained on it's use now, and will soon be up to speed with AMR/Medicwest, and the other services. Number three, you do not supervise AMR/Medicwest medics on scene, that's purely BS. Number four, AMR/Medicwest sends FD off scene all the time too when they are not needed. Number five, please post the study showing a doubling in the AMI survivors rate in the last year, you can't, because it is a lie.
Our medics enough are better trained. We under go training all the time. New cutting edge stuff like cooling for heart attacks. Recently in the past year we have more than doubled our survivability rate for heart attacks. Even in the job review web sites in AMR employees own words, describe the lack of training and poor equipment. AMR’s largest problem is their management. AMR does have some outstanding employees, but over all we are the best and we are in charge. Our medics send AMR medics off calls quite often. We supervise them on calls.
Yes, jealous indeed. Who wouldn't want to get paid outrageous amounts for practically nothing. Instead I have to work to pay for your salary. WOW WHAT A DEAL!
Sounds like some jealous emt's out there writing on the blog.
Some facts for some of you: Response times are very important. Its the difference between clinical death and biological death. After 8 to 10 minutes with no intervention i.e. CPR, defib, drugs you are dead, with almost no chance of being brought back. Same thing with fires. About 8 minutes into a fire it turns from a room in content fire to the entire floor, also becomes nearly unsurvivalable. The 12 minute requirement for AMR is for transport, not an acceptable standard for patient care. "averaging approximately 7 minutes to reach patients" what does approximately mean? 7 minutes 59 sec? Lastly, its been proven time and again fire based ems is more cost effective and provides better care for patients. And don't forget AMR is a for profit company. Which means if it comes down to patient care and their bottom line......its the shareholders who will prevail. After all, any CEO will tell you, thats priority number 1 in any company.
Sac, please please explain to me how FD medics are better trained........ You all are so pumped up on your own ego's that you no longer are able to see the truth. Most of the firemen in this valley have no idea what to do with a patient after they have first responded, thats what most of you are, first responders(if you make it to the call first-otherwise you are an overbearing fool who cares only about puffing out your chest and showing your dominance).... It is an absolute joke and ridiculous to say any one is more qualified. What ever happened to caring for the community? Now all anyone can care about is stroking their own ego, letting the world know exactly how wonderful they are. You are a bunch of over-inflated pompous fools that have watched too many movies depicting firemen in the heroic light of Hollywood. Perhaps one day when you realize that patient care doesn't get a "take two" and your mistakes can no longer be placed on the cutting room floor, you will open your eyes and see the big picture. It always turns into a p!$$!ng contest with you guys. You firemen have nothing more than the mentality of elementary school childern running through the streets singing "I'm better that you are". Need I bring up the fact that some of you are unable to recognize a live vs dead body? Yes please lets all call 911, let the "better trained FD" arrive. Hopefully when they arrive you are conscious enough to tell them you aren't dead-otherwise they may not know.
It's so funny how no one here has justified why firemen should be paid so much money. They keep rambling on about response time and BS fear factor crap that only firemen on the brink of layoffs care about. They refuse to understand that we the taxpayers do not want to spend this much money on this service. It is mind boggling that they feel that they are entitled to our tax money. No matter if we have to change rules about response, or buy used equipment. We don't care! FIRE SERVICE IS NOT IMPORTANT TO US. NO MATTER HOW MANY DIFFERENT WAYS YOU EXPLAIN IT. WE DON'T WANT TO WASTE ANYMORE OF OUR TAX MONEY ON FIRE SERVICE AND FIREMEN. We'll squirt out our own little fires, and let the private ambulances show up to medical calls. Yes even if it takes a couple more minutes. This isn't rocket science. We the tax payer are willing to take the "enormous risk" to get the cost of this service down. GET IT THROUGH YOUR LITTLE BRAINS, YOU ARE NOT INDISPENSIBLE AND "YOUR" EQUIPMENT BELONGS TO THE TAXPAYERS ALONG WITH THE STATIONS AND THE HOSES. WE WILL CHOOSE WHO WORKS THERE NOT YOU. SORRY THAT IS THE WAY IT GOES.