Outsourcing Your Medical Transportation - City Council to Pass With No Discussion

I was just looking over tomorrow's city council agenda and saw that Item #7 on the consent agenda is an agreement between the city and one of the largest ambulance companies in the U.S.  You can see the agenda HERE.

The item is on the "consent agenda" and that means it's deemed noncontroversial and not worth talking about. I completely disagree with the city placing this item on the consent agenda.  It belongs on the regular agenda and deserves, at a minimum, a presentation given by the Fire Chief or his staff.  This is a major step toward a complete reorganization and privatization of our ambulance services and it deserves explanation and discussion.  If the city was going to let a private firm start picking up your trash without you permission and billing you for it, there'd be some questions flying around council chambers - you can bet on that.  I don't see this being much different.

The fact that this private ambulance company is bound by a one paragraph explanation handed to council a few days before their weekly meetings scares the hell out of me.  Again, there is not contract attached to as "backup" for this item.  You might remember that the city was not willing to include Intermedix's contract with the backup after they fired a local company because they were generating the city a few million dollars to much in revenue. This company will be billing people they transport $670 and sending $143 or 20 percent of what they collect to the city.  That's great, but I have a few questions...

1.  Does this reduce the amount we spend on emergency services?  Will thesavings be reflected in the budget and will we be reducing the workforce currently responsible for this task?  After all, we're increasing the amount of people/equipment that can transport sick people, but have not increased the amount of sick people needing transport. If the budget for city ambulance services is generated out of collections, the city is reducing the amount it will collect - see Item #3.

2.  When Otto Drazd hired his golfing buddies to do the medical billing it was understood that it would bring in more money to the city even though the numbers offered by Intermedix proved they would collect less - collect less than the people who had the contract at the time and less than every company thatsubmitted a response to the Request for Proposal (RFP).  Now the city is taking billing opportunities away from that contract and handing the bulk of the cash generated from ambulance services to another private company.  The city is admittedly reducing its collection of $670 per ambulance ride to $143 (or 20 percent of what some company with no contract with the city says they collected).  This poses a problem with Intermedix projected collection numbers given they were to collect a certain amount money in a situationwhere the city was transporting all patients to the hospitals.  How does this now change that contract?  Are they going to be allowed to under-perform due to the change in city ambulance policy?  Was this planned all along?

3.  Does Intermedix have any kind of interest in the new ambulance company?  We know that Intermedix promised to only keep 10 percent of anything collected from ambulance billing.  If the ambulance ride is $670, Intermedix gets $67.  The city gets the remaining $607 collected. With this new contract the ambulance company flips the tables on the city and keeps 80 percent of anything collected and sends only twenty percent back to the city.  That means these guys keep $527 per ride while the city only gets $143.  That's around a 400 percent DROP in revenue for the city on ambulance rides.  Are we that backed up for emergency rides that we need to reduce the city's revenue by roughly 400 percent?  Again, who loses their jobs and how many ambulances do we need to sell in order to fill this budget hole?  Also, if Intermedix is any way connect to this ambulance company, they stand to make all that profit they left on the table for the ambulance billing contract.  They can reverse that 10 percent take home and end up with an 80 percent cut.

4.  Who is in charge of timing this company's response times?  Will an El Paso firefighter be sitting at the scene with a punch clock ready for them to show up?  Or, will the firefighters be doing their job and not worried about when some private ambulance service decides to show up?  Who is to say that there aren't a million excuses the ambulance company could use as excuses for being late?  Who will be the judge and jury on their tardiness?  Nobody - because the "backup" doesn't include this kind of information and the item is on the "consent agenda" where items aren't slated for discussion!

5.  What qualifications do the drivers need to have?  Are they on par with the city's ambulance crews?  I wouldn't know, because it's not in the "backup."  What about the maintenance and operation of the actual ambulance?  Is there any standards concerning what kind of jalopy with sirens they're required to haul me off in, or can they show up and toss my sick butt into the trunk of a 73' El Dorado?  I wouldn't know, that information isn't contained in the "backup."

I think it's an absolute abomination that something as important as the city's policy on ambulance services is not slated for discussion. The fact that any of the city council members would let this slide by frightens me.  You're talking about a 400 percent reductions in revenue in one of your major revenue streams!!!!!!  In the private world that usually means you are going out of business. 

It's getting really fishy to me that items like these coming out of the fire department always lack specific "backup" and they are almost always controversial to at least those closest to the issue and in this case - controversial to anyone who might need an ambulance in the future.  It looks bad. 

Comments

[Andre]

And who ever claimed that the city was not friendly to business???

[Somethingsgoingon]

These will by definition not be emergency transports. The insurance companies will pay less.

Will the Fire Department hang around while waiting for the second ambulance? How does that make sense?

And what about public safety? A paramedic is going to diagnose you and decide that you can want an extra 20 minutes?

The lawyers will love this.

[Allen]

Holy smokes ^^^what in the blue hell is that???