New Contract Could Extend Response Times for Okla. Ambulances
July 24--EMSA ambulances would be able to take two minutes longer to respond to emergency calls under a new contract to be considered by the agency's board Wednesday.
A selection committee has also recommended that EMSA's next five-year contract be awarded to American Medical Response instead of the agency's current provider, Paramedics Plus, which has held the contract for 14 years.
The Emergency Medical Services Authority board of trustees is expected to vote Wednesday on whether to award the new five-year ambulance contract, which is worth about $250 million.
EMSA is a government agency that supervises a contractor to provide ambulance service to more than 1 million people in Tulsa, Oklahoma City and surrounding cities.
The agency will hear a presentation from a contract selection committee appointed to review proposals from the two companies allowed to bid on the contract: Paramedics Plus and American Medical Response, or AMR. EMSA's board voted in March to disqualify a third company, Rural/Metro Corp., from bidding.
The nine-member selection committee's report unanimously recommends that EMSA's board approve AMR as the successful bidder, based on a comparison of proposals by the two companies.
The committee report also recommends that the board approve response times in the new contract that are two minutes longer than currently required. The recommended response time for Priority 1 emergency calls is 10 minutes and 59 seconds.
Priority 1 calls, the highest priority, include heart attacks, car accidents resulting in traumatic injury, and other serious medical issues.
Tulsa's city ordinance and EMSA's current contract requires ambulances to respond to those calls in Tulsa within 8 minutes and 59 seconds.
Calls are excluded from the requirement under certain weather conditions and during times of high demand.
The proposed contract would nearly double allowed response times for calls classified as not life threatening and would decrease both types of scheduled patient transport response times by one second.
EMSA CEO Steve Williamson said he has discussed the proposed increase in response times with Mayor Dewey Bartlett, City Councilor Phil Lakin and Clay Bird, the city's economic development director. Lakin and Bird are also on EMSA's board.
Williamson said the longer response times would require a change in city ordinance. Tulsa city councilors would be required to vote on any such change.
Williamson said the response time increase is supported by EMSA's Medical Control Board, which oversees the agency's medical protocols.
He noted that EMSA's system includes Tulsa firefighters with emergency medical training who respond to all emergency calls and ambulances equipped with advanced life support equipment.
"To be the best stewards of the dollar and provide the best possible care, the 10:59 response time is appropriate," Williamson said.
A study commissioned by EMSA in 2011 reviewed the impact of increased response times on patients.
"Evidence in the peer-reviewed medical literature suggests that EMSA system response times may not be a significant factor in improving clinical outcomes from acute illness or injury," the study concludes.
The study notes that decreasing response times may result in improved survival for some patients.
Those who could benefit include patients suffering from asthma and other breathing complications, heart attacks, strokes, seizures, choking, diabetic reactions, childbirth and some overdose cases, the study states.
The committee report states that the contract option that includes increased response times "offers the service at the least cost to EMSA of all the scenarios."
AMR would be paid $247 million over the five years under the proposed contract recommended by the selection committee.
If the company were required to meet the current Priority 1 response time of 8 minutes and 59 seconds, EMSA would have to pay AMR between $298 million and $302 million, depending on how excluded calls are calculated.
The proposal by Paramedics Plus ranged from $6 million to $44 million higher than AMR, depending on response times and excluded calls.
AMR, based in Greenwood Village, Colo., is a subsidiary of Envision Healthcare, a publicly held company. Its website says AMR operates in 40 states and 2,100 communities.
Paramedics Plus was created in 1998 as an expansion of the East Texas Medical Center EMS Service and EMSA, its website states.
A state audit prompted by a Tulsa World investigation raised concerns about possible conflicts of interest between EMSA and Paramedics Plus.
The audit was critical of $7.1 million in purchases made by EMSA tax-free on behalf of Paramedics Plus, including a gambling-themed party.
The company also provided a $25,000 "sponsorship" to defray some of Williamson's travel expenses as head of an ambulance industry association.
Paramedics Plus and EMSA denied conflicts of interest, and the company says it has a compliance audit done every year.
EMSA response times
Under EMSA's current contract and Tulsa city ordinance, ambulances are required to meet the following response times in Tulsa:
Priority 1 (life-threatening emergency): 8 minutes and 59 seconds
Priority 2 (nonlife-threatening emergency): 12 minutes and 59 seconds
Priority 3 (transport, unscheduled or scheduled less than 24 hours in advance): 60 minutes
Priority 4 (transport scheduled 24 hours or more in advance): 20 minutes
Under a contract recommended by an EMSA committee, ambulances would be required to meet the following response times in Tulsa:
Priority 1: 10 minutes and 59 seconds
Priority 2: 24 minutes and 59 seconds
Priority 3: 59 minutes and 59 seconds
Priority 4: 19 minutes and 59 seconds
Source: Tulsa city ordinance and EMSA contract committee report
Ziva Branstetter 918-581-8306
ziva.branstetter@tulsaworld.com
Copyright 2013 - Tulsa World, Okla.
