Resupplying Of Washington Ambulances May End

The Spokane Fire Department's practice of restocking a private ambulance company with 911 medical supplies without documentation may soon end, a City Council subcommittee was told Friday.

Since 2003, Fire Department paramedics have resupplied American Medic Response (AMR) ambulances with various supplies, including narcotics, used for medical emergencies in the city of Spokane.

The Fire Department buys the supplies - such things as IV setups, trauma pads, oxygen masks and syringes and vials of drugs - using taxpayer funds from a 50-cents-per-$1,000 EMS tax.

But neither the department nor the ambulance company keeps any kind of records about how many taxpayer-purchased medical supplies are flowing from the fire paramedics to AMR crews, usually at emergency scenes, Fire Chief Bobby Williams and AMR executive Randy Strozyk told the subcommittee.

Williams later said department paramedics fill out reports when narcotics are used, but those reports don't differentiate between drugs actually used on a patient and those given to AMR crews for resupply.

In some cases, AMR apparently has billed private patients living in Spokane for supplies that were resupplied to the ambulance company at no charge by the Fire Department, the subcommittee has been told.

City Councilman Bob Apple said the practice raises questions about "gifting," or using public resources for the benefit of a private company.

The private ambulance company, which has an exclusive five-year contract to provide services in the city, is under scrutiny by a three-member City Council subcommittee.

The resupply issue, along with reported overbilling of patients and response times exceeding contract limits, are topics being explored by the subcommittee. The issues are expected to linger into the new year.

In response to a question from City Councilman Al French, Strozyk said 60 percent of ambulance bills in the city are paid for under Medicaid or Medicare.

Issues associated with overbilling weren't addressed at Friday's meeting, just three days after a class-action lawsuit was filed against AMR for those alleged practices. The suit by two patients billed for ambulance services alleges AMR, the nation's largest ambulance company, is violating the state's Consumer Protection Act.

"We publicly can't discuss litigation issues," Strozyk told the subcommittee. He is AMR's regional vice president of operations, based in Seattle.

Apple said he expects to give a brief interim report on the ambulance contract issues at Monday's meeting of the City Council's Public Safety Committee. The councilman said he wants to hear from citizens with questions or concerns about the city's sole ambulance provider.

City Councilwoman Mary Verner, who said she still has assorted concerns about the city's five-year contract with AMR, said she would like to see a full City Council public hearing on the ambulance issues.

"We need to have an opportunity for people to speak about some of these issues," Verner said after Friday's meeting.

At the session, the fire chief and AMR executive Strozyk both said the resupply practice could be halted in light of questions being raised by the subcommittee.

"If they're offering to do that without having to increase rates, that's worth doing," the fire chief said when the AMR executive said he was willing to quit taking Fire Department supplies.

But ending the resupply practice may not be in the best interest of Spokane taxpayers, who are paying $100,000 to $125,000 a year for those supplies with the EMS levy, Lt. Greg Borg, president of the firefighters union, said later in the day.

"The practice was put into place to save citizens money," Borg said. "We resupply the ambulance company and AMR isn't supposed to charge patients to keep bills low."

"It's our feeling that AMR is charging citizens for supplies even though we replaced them, and the chief knows that," Borg said.

"There is no inventory and control that I know of," Borg said of the resupply practice. "They should have a tracking system on each call we go on and those medical supplies from the Fire Department should not show up on the patient's bill."

The union, which represents the city's 292 firefighters, previously has raised the issue of AMR overcharging with Williams and emergency services chief Richard Kness, Borg said.

Williams said he passed bills involving alleged overcharges along to AMR and directed the company to respond.

But Borg said answers haven't been provided.

In one instance, the union president said, a man went to an accident scene in Spokane where his child was injured in an auto accident. The man was sent a bill for Advanced Life Support services for himself, even though he wasn't injured and wasn't transported in an AMR ambulance, Borg said.

"We believe it's important that the citizens of Spokane have confidence in the Fire Department, that they're being treated fairly on Fire Department medical calls," the union president said.

"The taxpayers are paying the bills for us to be there and we want to make sure AMR is treating them fairly," Borg said. "This doesn't have anything to do with AMR employees or the employees union. The AMR employees do a great job and work well with our medics."

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