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Contract would increase price for ambulance ride in Oregon

Copyright 2006 The Oregonian
All Rights Reserved

By SARAH HUNSBERGER
The Oregonian (Portland, Oregon)

Clackamas County would end competitive bidding for ambulance service and increase the cost of a trip to the hospital by $133 for most patients under a proposed new contract with American Medical Response.

The contract would push most Clackamas County residents’ ambulance prices above those in Washington and Multnomah counties and would include further price increases in future years.

Some of the price increase would go toward service enhancements, and some would help make AMR’s Clackamas County operation profitable. AMR said that for the past two years it has lost money providing service to Clackamas County.

If the contract is approved, it would end a long debate over whether the county should allow competition for its next ambulance agreement or stick with AMR, the county’s longtime company.

In recent elections, both ambulance companies have made large donations to political committees in county commissioner races.

Clackamas County commissioners are expected to discuss the proposed contract at 10 a.m. next Thursday at the fourth-floor hearing room in the Public Services Building, 2051 Kaen Road, Oregon City.

In the meantime, a competing ambulance company is stepping up political pressure as it pushes for a chance to win the county contract.

Hillsboro-based Metro West Ambulance hired the heavy-hitting public relations firm Gard & Gerber as part of a campaign to change the commissioners’ course. Metro West recently bought an advertisement in The Oregonian and set up a Web site saying the company can provide a cheaper ride to the hospital. The company charges about $574 for a trip to the hospital in Washington County, compared with $762 now charged in Clackamas County.

As part of its campaign, Metro West urges residents to call Clackamas County commissioners and ask them to open the contract to competing bids.

Erin Miller, business development director for Metro West Ambulance, said a public contract worth an estimated $10 million a year in gross revenues should be subject to a competitive process.

“We don’t think the public even knows what’s going on,” Miller said. County officials “still have the option to go to bid, and so that’s what we’re hoping they do.”

Randy Lauer, AMR’s regional director of operations for Oregon, said his company’s higher price reflects a number of additional community services, including lifeguards at a popular Clackamas River swimming spot in Gladstone and a medical rescue team on Mount Hood.

He said AMR’s rates are in line with the rest of Oregon, and that a comparison of those rates helped determine the prices proposed in the Clackamas County contract.

Two responders

Emergency medical service in most of Clackamas County involves public fire departments, which show up and treat people at the scene of an emergency; and a private ambulance contractor, which treats patients at the scene and also drives them to the hospital.

American Medical Response, one of the nation’s largest private ambulance companies, now has the contract to serve most of Clackamas County, except the Molalla and Canby areas. The county does not pay AMR directly but awards it the right to be the lone provider and bill insurance companies, patients or Medicare for ambulance services.

Until recently, an ordinance required the county to use competitive bids. After a dispute in 2003 over how proposals from Metro West and AMR were scored, the county threw out the bids and has extended AMR’s contract in short increments ever since. In December, the commissioners voted 3-0 to amend the ordinance to allow the county to simply renegotiate a new long-term contract with the current provider.

A judge this month dismissed a lawsuit filed by Metro West that challenged the process.

Seven-year contract

“The system’s working. It isn’t broken . . . It doesn’t need to be fixed right now,” Commissioner Martha Schrader said in defense of the county’s relationship with AMR. “They’re giving us good value for our dollar.”

Schrader noted that AMR recently implemented a new service plan in cooperation with area fire agencies. She said there’s still the option of competition in the future.

The contract negotiated by county staff and AMR is seven years and could be renewed an additional five years. In the contract’s first year, the cost of an emergency trip to the hospital would increase from $762 to $895. AMR’s mileage charge also would increase, from $10.17 to $13.20.

A portion of the price increase would cover new service enhancements recommended by county emergency dispatchers, fire agencies and others. They include automatic vehicle locators, communications equipment and mobile data terminals for ambulances.

Some of the higher price also would help cover an increased franchise fee that covers the county’s cost of overseeing ambulance service and making sure that the private company meets minimum response time standards. The franchise fee has not changed since 1998.