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Home > Topics > EMS Management

Vegas fire department to take over patient transports

More calls will be transferred to the city's fire department instead of a private ambulance service

By Conor Shine
Las Vegas Sun

LAS VEGAS, Nev. — If you’re a Las Vegas resident in need of medical care, it will be increasingly likely over the coming months that your trip to the hospital will be provided by paramedics from the city’s fire department instead of a private ambulance service.

Although Las Vegas Fire & Rescue ambulances respond to every call for medical aid in the city, they typically transport patients to the hospital about 30 percent of the time, with the rest being picked up by the city’s private contractor, American Medical Response.

Chief William McDonald says he wants to see his department pick up a greater share of those transports as a way to increase efficiency and bring in more revenue for the department.

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Starting Monday, the city’s dispatch center will stop sending ambulances from both American Medical Response and the fire department to all incidents. Instead, in many cases just an ambulance from the fire department will be dispatched and responsible for transporting the patient.

“We will reduce the amount of times that we tie up two ambulances on a call that really only needs one,” he said. “It doesn’t make sense to tie up resources unnecessarily. This will free up resources that are underutilized to be able to take on other calls.”

A 2012 report from the International City/County Management Association criticized the current system of sending fire department and private ambulances to the same incidents, often leading to a needless duplication of service. The report said the city could bring in $12 million to $14 million per year in new revenue if it handles all transports internally. Alternatively, letting American Medical Response handle all transports would save the city between $14 million and $18 million annually, according to the report.

Because a fee is paid by patients for transport, the fire department stands to earn more with increased use of its ambulances. Turning over ambulance duties to American Medical Response would allow the department to get rid of its ambulances and the costs associated with them.

McDonald’s immediate goal is to have the department transport 50 percent of patients, eventually increasing that number to 75 percent of the estimated 70,000 transports needed in Las Vegas each year.

But officials at American Medical Response are raising concerns that the chief’s plan is too ambitious and would stretch the department’s resources thin.

General Manager Scott White said American Medical Response constantly has ambulances circulating the city ready to respond quickly to the nearest call, while the fire department dispatches from fixed locations. He also criticized the chief’s plan for not clearly laying out how the changes will affect response times or deployment plans.

“If the (fire) department starts taking more transports, they won’t be available for next call because they’ll be at a hospital turning that patient over,” White said. “Today our average response time is seven minutes and seven seconds. What will it be tomorrow if American Medical Response is not responding? We haven’t been able to get that level of clarity from the fire department.”

McDonald said he’s confident the department can meet the 50 percent transport goal with its current fleet of 22 ambulance units. Going up to 75 percent might require more staffers, but McDonald said the cost would be offset by revenue from increased transports.

McDonald said the city’s contract with American Medical Response doesn’t specify a minimum or maximum number of transports the company will receive, brushing aside complaints from White that the shift in policy could violate the terms of that agreement.

McClatchy-Tribune News Service
“The council took an action back in the late 1990s to authorize the fire department to do (transports),” McDonald said. “It’s my opinion that we’re the primary provider of pre-hospital care services.”

The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Zach IS Zach IS Sunday, March 02, 2014 2:47:05 AM Yea, I don't think they'll be able to handle the call volume. Counting all the hotels and casinos then the residents, I don't see this working too well for the Department.
William Gandy William Gandy Sunday, March 02, 2014 4:46:31 PM Why is AMR in the business? Not out of the goodness of its heart. It's there to make money, and it is making what Las Vegas could make if it took over all the transports. True, it would have to invest in more trucks and crews, but there is no reason that it could not have that gravy instead of AMR.
Greig Fors Greig Fors Monday, March 03, 2014 10:25:16 AM I've seen this happen in in other urban areas and I haven't seen it turn out well for the patient. LVFD has made it clear they are doing it to bring in more revenue. Reno is doing it and is in direct competition with AMR. That has caused both AMR and RFD to not share calls or report calls to the other agency late, so as to get the call. This makes response times longer. The patient loses. Here in Vegas, AMR has the resources that LVFD does not have. The city is broke and budgets are being cut. There have already been fire stations that have closed or that will be closed. This lengthens response time. When seconds count, the FD is minutes away. Having been on both sides of the issue (as an EMT for a private company and also an EMT/firefighter ) I have seen the dedication that the responders possess, but it's not up to them, it's up to either AMR or LV to make sure patient care is served, and I'm afraid that the City of Las Vegas isn't capable of doing the right thing, both in caring and funding.
Adam Lid Adam Lid Monday, March 03, 2014 10:31:27 AM Great...nothing like a bureaucratic/agency turf war involving revenue...
Christine Lynch Christine Lynch Monday, March 03, 2014 12:14:46 PM Do not trust the government. Ever. Under any circumstances.
Jeremy Smith Jeremy Smith Monday, March 03, 2014 3:20:43 PM That's the stupidest system I have ever heard of.
Nicholas Mumford Nicholas Mumford Monday, March 03, 2014 4:25:53 PM William Gandy - do you really think LVFR is in the business out of the goodness of it's heart? I doubt you're that naive. Fire Departments got into ALS and transports for one reason... Money. AMR can provide outstanding patient care for less money than LVFR. They use common sense ambulance models and staffing. Ask the average LVFR FF. They have no interest in transporting.
Steve Dunham Steve Dunham Monday, March 03, 2014 8:08:50 PM Works great in Cincinnati. We have never used privates to transport patients. Our Medic units are staffed with Paramedic firefighters who also work on Engines and Ladder Trucks. When done correctly it serves citizens better because Ambulances are in the same neighborhood firehouses as the Engines and Ladders. It works seamlessly for us. LVFD just needs to make sure they have enough units.
Joseph Larson Joseph Larson Monday, March 03, 2014 8:41:00 PM Seems like companies all over the country are trying to push out AMR.
Dann Singleton Dann Singleton Tuesday, March 04, 2014 7:48:28 AM profit margin or tax basis its the same thing by a different name ... after all LVFD says they want the revenue, but like any government entity it will become bloated and force the tax base to pay more .... at least with AMR you only pay when you use the service, where with LVFD (or any FD) you pay for their "services" wheather you use them or not with your taxes .... thats usually called extortion when they want to prosecute it ... think outside the box
Greig Fors Greig Fors Tuesday, March 04, 2014 4:15:19 PM Unfortunately, they don't and they have been closing stations. The city doesn't have the funds. If Cinci started out with Fire handling all medicals, it probably will work much better than a city making the transition from private to city. Vegas is really messed up with their only concern being the bottom line and keeping the casinos happy. PD just stopped responding to non-injury MVAs because of budget constraints. In many places, traffic lane lines are non-existent because the city doesn't want to pay for them.

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