Ambulance operators chase lucrative Scottsdale 9-1-1 response contract

Scottsdale City Hall is at 3939 N. Drinkwater Blvd. in downtown Scottsdale (File photo)

Scottsdale officials say they will soon be accepting bids from third-party ambulance outfits seeking to be the municipality’s medical emergency transport vendor of choice.

But on May 9, 2017 the city entered into an agreement with American Medical Response Transport — the parent company of what is known locally as Rural/Metro among others — but it appears the ambulance transport contract is now up for grabs.

What remains unclear is if the pending call for bids will replace the existing contract that expires with American Medical early in 2018.

Both Scottsdale Mayor Jim Lane and Councilman Guy Phillips did not respond to requests for comment.

“In order to ensure an open, fair and transparent process, it is the city’s policy to make the RFP available to everyone at the same time, so we cannot provide any draft language,” said Scottsdale Communications and Public Affairs Director Kelly Corsette in a May 25 statement to the Independent.

“We do not know exactly when it will go out but it will be on the purchasing department’s website when it does become available. City council action is not required to initiate this process. Once the RFP process is concluded, the city expects to have a preferred vendor selected by September, at which time a contract will be taken to the city council for final approval.”

Historically, the Rural/Metro ambulance service was the dominant provider in Scottsdale and in other parts of the Valley of the Sun, but in recent years the third-party emergency services provider has changed ownership a few times with American Medical taking the reins in 2015.

American Medical is the corporate owner of PMT Ambulance, Life Line Ambulance and Rural/Metro, city records show.

Jim Thompson

Scottsdale City Manager Jim Thompson says the city is reopening the bid process for the 9-1-1 Transport Services contract due to a new player emerging in the marketplace.

“At least when I talked with the chief there really has only been one provider until recently,” he said in a May 30 phone interview.

“Last year they (the city) went out to bid and there was a secondary provider that showed up and they wanted an opportunity to bid on the contract.”

Mr. Thompson, who is in his first year of service at the city of Scottsdale, points out he was not aware of the secondary provider but he says good government ought to be searching for the best deal for its citizens.

“I just know that there is a second provider now that has received its approval from the state,” he said. “Now you truly can do an RFP and get the best possible deal.”

For any third-party ambulatory service to be able to operate on Arizona streets, the Arizona Department of Health Services must issue a “Certificate of Necessity.”

The Certificate of Necessity outlines the geographic service area, level of service, hours of operation, response times, effective date, expiration date and any limiting or special provisions for emergency medical services to be provided by the third-party ambulance effort, according to the Department of Health Services.

According to the Arizona Ground Ambulance Service Rate Schedule adopted in October 2015, the Certificate of Necessity for District 71, which is held by American Response and covers the city of Scottsdale, charges a rate of $898 per advanced life support ambulance transport and $800 per basic life support ambulance transport.

The city of Scottsdale responds to thousands of calls for medical emergency transport annually, records show.

While this is a mock emergency situation, it’s occurrences like this that make ambulance services vital to the city of Scottsdale. (Photo courtesy of the SFD)

The politics of care

Maricopa Ambulance has emerged in contention for the Scottsdale 9-1-1 Transport Services contract.

“Maricopa Ambulance was developed to bring choice and high quality ambulance services to Maricopa County cities and hospitals,” said Bryan Gibson, CEO of Maricopa Ambulance, in a May 31 statement to the Independent.

“AMR-Rural/Metro attempted to intervene in us providing a choice in medical transport services to Scottsdale and around the Valley. The administrative law judge and the Arizona Department of Health Services agreed with us that citizens in the area would benefit from competition for ambulance services and issued Maricopa Ambulance a Certificate of Necessity in Maricopa County.”

John Karolzak, an American Medical Response government and public affairs representative, says while the entity known as Rural/Metro has changed hands, the effectiveness of emergency medical transports handled by the company has not.

“I have been with the company for 30 years and there has been a couple of transactions, that is correct,” he said in a May 30 phone interview.

“We have had a long partnership with the city of Scottsdale. We are currently the partner of the city of Scottsdale for ambulance transportation services. We have the contract, the contract was approaching a period of being expired and so the current contract has been extended.”

The contract shows the agreement with American Medical extends until Feb. 16, 2018, according to records obtained by the Independent. But it appears that term may be an extension from the previous contract.

Mr. Gibson points out city contracts make the difference for ambulatory outfits in the Valley of the Sun.

“Most Valley cities operate with a public-private model for ambulance service in which a city contracts with a private ambulance service rather than own and operate a city service,” he explained.

“About 65 percent of ambulance service requests come from calls to 9-1-1, and the remainder are transports between health care facilities. Maricopa Ambulance serves hospitals and medical facilities in Maricopa County, and the Scottsdale 9-1-1 contract would be a significant foundation to expand our exceptional patient care to more citizens in Scottsdale.”

Everyone agrees a competitive bid process ensures the best product deliverabiltiy for residents of a given municipality.

“A competitive bid process benefits the city of Scottsdale in keeping its service providers accountable and in guaranteeing the city is receiving the best service available at the best value,” Mr. Gibson said. “Just as Scottsdale’s emergency services was improved through a provider change about a decade ago, Scottsdale services would again be improved with a change away from the incumbent.”

While American Medical holds 13 Certificates of Necessity throughout Arizona, Mr. Karolzak points out Scottsdale is a top-tier contract for the organization.

“We anticipate the opportunity to review what is in included in the request for proposal,” he said of the coming RFP issuance.

“Obviously, we anticipated a continued partnership, but we have not yet seen what the request for proposal is. Until we have an opportunity to analyze it that is when we will move forward with responding to that request.”

Mr. Gibson echoed a similar sentiment.

“The bottom line is very simple: the company is selected that can provide the best service with the best system to provide care to residents when they need it most,” he said of the purpose of city ambulance contracts. “A company like Maricopa Ambulance with deep local roots, including our regional headquarters based in Scottsdale, will yield the best result.”

Strictly transport

Scottsdale Deputy Chief of Operations and Emergency Medical Services Steve Randall says the third-party ambulance contract is strictly for medical transport — not service.

“First of all, the fire department is the primary provider of emergency medical care,” Deputy Chief Randall said in a May 30 phone interview.

“We rely on the 9-1-1 contract for the transport and 99 percent of the time our paramedic will accompany the patient to the hospital. We are not just turning them over to another entity.”

Deputy Chief Randall says the 9-1-1 Transport Services contract is measured through performance.

“The state established what rates they can charge. Our primary focus is looking at response times,” he said.
Deputy Chief Randall points out response times — under eight minutes for an emergency medical call — for ambulance services arriving at the scene of an emergency on time is a paramount tenet of the existing contract.

“The Certificate of Necessity doesn’t quite meet what the appropriate response times for a 9-1-1 call is,” he said of local demands beyond state guidelines. “We have established that they have to be on the scene in 7 minutes and 59 seconds.”

Deputy Chief Randall says American Medical has been meeting the tenets of the adopted standards for response times.

Northeast Valley Managing Editor Terrance Thornton can be contacted at tthornton@newszap.com

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