CO Fire Department Eyes ALS Services

Aug. 29 -- Boulder's fire department will keep moving forward with plans to take over more emergency medical services from a private contractor, which City Council encouraged in a Tuesday study session.

As part of an update of the city's fire-rescue master plan, the department has been exploring increasing the level of medical services it provides. Already, 81 percent of the department's calls are medical.

The department can provide basic life support services when responding to calls: things like administering CPR or oxygen, splinting broken bones and other "first aid-type care," said Fire Chief Mike Calderazzo. Advanced life support — the use of cardiac devices and administering of IVs or medications — are contracted out to a private company, American Medical Response.

Making those latter services internal would shorten response times, from just over six minutes (per American Medical Response) to four minutes. A white paper commissioned by the department has estimated that doing so would cost the city an additional $177,669 per year, though that report is two years old and might need to be updated.

City Manager Jane Brautigam pushed back on the estimates, saying the white paper "presented a rosy picture" about the financial reality. A consultant is working on a newer analysis now.

Some of the costs might be recouped by charging patients, but Dr. Shannon Sovndal, the fire department's medical director, said the city needs to think of providing internal advanced life support as a service, not a revenue-generator.

"I would never say this is a good business decision," he said. "It's a community choice to say, what kind of service do we want and are we willing to pay for it."

American Medical Response could still be contracted for transporting patients to hospitals. Moving advanced life support under city control is more about getting the paramedics on-scene to do whatever is medically necessary.

As part of a push for living wages in 2016, Boulder began subsidizing the salaries of American Medical Response emergency medical technicians to bring them up to $15.67 per hour, to the tune of $535,000 per year. During contract renegotiations in 2016, the company was "encouraged" to pay their EMTs more, council member Aaron Brockett said, but declined.

At the time, American Medical Response was owned by publicly traded Envision Healthcare, which posted net revenues of $1.39 billion that year, according to a release from the company. The company is now controlled by private equity firm KKR, which manages $39 billion in assets and reported 2017 net income of $1.02 billion, according to Market Watch.

American Medical Response declined to provide information on salaries. The company has 45 full-time employees and 40 part-time employees. Indeed.com gives the average salary for EMTs in Colorado as $13.20 per hour.

Longmont also contracts with American Medical Response for emergency response, and Fire Services Chief Jerrod Vanlandingham said while the arrangement — in which the company pays Longmont for its contract, which expires in 2019 — is working, he, too, would like to hire in-house emergency medical technicians. Hiring firefighter EMTs would help when the department responds to larger emergencies, he said.

The department has enough staff to handle residential fires, "but when it comes to a commercial fire" at a place like Target, they "fall short," Vanlandingham said.

Hiring the new staff would be a large commitment for Longmont, though. It would mean paying salaries and benefits for 18 more people, Vanlandingham said.

Right now, there are no active plans to find a way to do so, he said.

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