By Cindy Ramirez
El Paso Times
EL PASO, Calif. — A private ambulance company looking to compete for a county contract is fueling discussions on whether emergency medical services should be put out to competitive bid, questioning why the current provider has had the contract for nearly 30 years.
Life Ambulance Service Inc. has been the county’s medical services provider since 1985, receiving a number of renewals since it was first awarded the contract. Under Texas law, a county contract for ambulance services may be exempted from the competitive bidding process by order of commissioners court as a matter affecting public health or safety.
The latest discussion comes as County Judge Veronica Escobar is exploring alternative ways to fund and manage emergency medical services, including whether county residents can shoulder the burden completely or if the county’s Emergency Services Districts can take over the responsibility.
The composition of the county’s two emergency districts, one of which oversees fire protection and the other ambulance services, is being restructured so its board commissioners are better qualified, have no conflicts of interest and serve staggered terms. The Emergency Service Districts are government entities that collect taxes bases on property values in the areas they serve.
“The question at hand, first of all, is how we can adequately evaluate whether or not we should still be subsidizing this, and if so, to what level,” Escobar said.
If the county is to continue securing ambulance service for people who live outside the city limits, then it makes good business sense to put out a request for proposals and allow companies to compete for the contract, Escobar said.
“I’m still a proponent of going out to bid for those services,” Escobar said. “If it gives us options on service and cost, then it’s worth exploring.”
The county’s contract with Life Ambulance Service Inc. expires in September 2013, but has a one-year renewal option.
Life Ambulance President Rachel B. Harricksingh said bidding is not only not required, it hasn’t been necessary because her company is meeting the county’s demands.
The company has 25 ambulances that dispatch from five sites across the county, including in Canutillo, Socorro, Fabens, Horizon and East Montana. Life Ambulance provides basic life support and some advanced life support response to areas outside the city limits.
Life Ambulance responded to 2,770 calls countywide during its last reporting period, going from Oct. 1, 2011 to Jan. 25, 2012.
“As the county has grown, we’ve grown with it to provide the best service we could,” Harricksingh said, citing that the company was founded 28 years ago.
However, Michael Shabkie, president of Elite Medical Transport, said it’s the county and its residents -- not just his company -- that could stand to win if the contract were to go out to bid.
“Of course we’d love the business, but it’s also about providing competitive prices for the taxpayers and the patients,” Shabkie said. “You can’t really say you’re doing that if you don’t compare bids and services every now and then.”
Whether to put the ambulance service out to bid was a point of contention for commissioners court more than four years ago. After months of discussions and delays, commissioners in October 2007 voted to renegotiate with Life Ambulance and not go out to bid. Escobar, then a commissioner, voted against renegotiating the contract.
“I was a proponent of going out to bid,” Escobar said, “and I remember being rather upset that others didn’t agree with me.”
In Sept. 29, 2008, commissioners, including Escobar, unanimously approved a new, three-year contract with Life Ambulance. Escobar said she was satisfied with a county audit of Life Ambulance and Harricksingh’s cooperation with the county’s request for access to their financial documents at the time.
Under the contract, the county pays Life Ambulance nearly $38,000 a month for its services. The ambulance company also bills customers and their insurance companies and, when applicable, Medicaid. The company provides quarterly reports to the county, including statistics on its number of calls and average response times, but not its revenues.
The ambulance bidding issue arose again in 2010, when Escobar became the county judge and Anna Perez became a commissioner.
In a special budget meeting on Feb. 9, 2010, commissioners, including Perez, approved moving forward with a two-year contract extension with Life Ambulance. Escobar was not present for the vote, though she had been at the meeting.
Harricksingh said the extension was a point of negotiation because Life Ambulance had agreed to take a 10 percent cut in funding from the county, which was looking to close the Montana Vista station.
“They wanted to eliminate the Montana Vista station and we didn’t want them to eliminate it and were willing to take a cut,” Harricksingh said. “We didn’t want it to affect our response times.”
Elite’s Shabkie said he believes Perez had unfair influence in the decision to extend Life Ambulance’s contract because her husband, Art Fierro, took a job with the company just two months after the vote.
Perez and Fierro, however, call Shabkie’s claims disparaging and disappointing.
“These are ugly allegations that are being made by a company who wants this business,” said Fierro, who serves on the board of trustees of the El Paso Community College. “There wasn’t any sinister plot, just an opportunity for (Life Ambulance) to fill a vacancy they had and that I happened to be qualified to fill.”
Fierro, who is running for a state representative seat, said Life Ambulance was vying for a contract with the city of El Paso at the time. He was hired to lobby on behalf of the company for his experience in government and public relations.
Elite Medical, which merged with Rio Grande Ambulance in 2007, landed the city contract in July 2011. Elite also has a contract with the county’s medical examiner’s office and University Medical Center.
“This is not a political process for us,” Shabkie said. “This is about competition, and competition ensures the community is getting the best service at the best price.”
Fierro said Shabkie’s accusations are nothing more than a ploy to stir controversy. He said he and Perez have followed the law and worked diligently to be transparent about their affiliations.
Perez, who is an attorney, helped draft Fierro’s contract with Life Ambulance to ensure that it would explicitly outline that he could and would not lobby the county or EPCC on behalf of the company, the commissioner said.
“They’re making character assassinations on a good corporate citizen and on me and (Perez) that are untrue,” Fierro said. “If those are (Elite’s) tactics now, what kind of tactics will they use to win a (request for proposals)?”
Harricksingh made $400 and $500 campaign contributions to Perez and Fierro, respectively -- a practice she said is not uncommon. Harricksingh and her husband have long donated to the political campaigns of candidates at the local, state and national levels.
Perez, who is running for a district judge position, said she filed a conflict of interest affidavit “out of abundance of caution.” The affidavit is dated July 25, 2011. Commissioners met that day and voted 4-0 to authorize the county judge, Escobar, to sign the contract extension. Perez abstained from the vote.
“I have not voted on any related issue since (Fierro) took a job with Life Ambulance, and I have never approached commissioners or the purchasing agent about it,” said Perez, who has advocated for government transparency during her term as commissioner.
“I stand on my record and by my actions,” Perez said. “I stand on the laws that allow us to do what we do with transparency.”
Copyright 2012 El Paso Times, a MediaNews Group Newspaper
All Rights Reserved