By Jim Nolan
Richmond Times - Dispatch
Copyright 2007 Richmond Times - Dispatch
RICHMOND, Va. — The company hired by the Richmond Ambulance Authority to respond to medical emergencies in the city has not met required response times in six of the last seven months.
As a result, the ambulance authority’s board is considering dumping its contract with American Medical Response of Richmond — worth $9 million this year — and assuming control of the operations itself.
The board met yesterday but came to no decision, said officials who attended the meeting. It is scheduled to meet again this Friday.
Jerry Overton, the ambulance authority’s executive director, said the slower-than-desired response times have had no negative impact on patient care.
Despite that, City Councilwoman Kathy C. Graziano, who sits on the board, said, “It’s very troubling.”
“And that’s why we are addressing it, trying to work with the contractor to make sure citizens’ safety is not put in harm’s way.”
A takeover of the response duties is an option, Graziano said. “We know we have a problem, and we’re trying to look at how we can fix the problem. It’s a very sensitive situation.”
Overton said responses to the 50,000 emergency and non-emergency calls made each year in Richmond — the busiest system, per capita, in the country — are still among the fastest in the nation.
“Our response times are superb,” he said. “It’s an accountability issue.”
At issue is the provision of the American Medical Response contract with the ambulance authority that an ambulance arrive within a prescribed time at least 90 percent of its runs.
The 90 percent requirement is less than nine minutes for the most critical, or life-threatening calls; less than 13 minutes for non-life-threatening emergency calls; and less than 30 minutes for urgent emergency calls.
The ambulance authority found that AMR responded within nine minutes on life-threatening emergency calls less than 90 percent of the time in March, April, May, July, August and September.
The lowest compliance rate occurred in March, when 87.4 percent of the calls were answered within nine minutes.
Overton said the problems started surfacing in November 2006, several months after AMR signed a new five-year contract with the Richmond Ambulance Authority, for which it had provided services for the previous 10 years.
At first, response times for non-emergency calls and transportation requests failed to meet requirements. In recent months, the response problem has crossed over into emergency calls.
The trouble led the ambulance authority in April to declare AMR in default of its contract.
In a letter to AMR and its Colorado-based corporate parent, Emergency Medical Services Corporation, Overton said the move was “the only recourse to protect the public health and safety of its patients and the interest of its customers.”
Overton said penalties of $500,000 have been assessed so far.
American Medical Response is the largest provider of ambulance services in the country. The company has roughly 250 contracts in 37 states and 18,000 employees, serving cities including Dallas, Houston and Colorado Springs.
In Richmond, AMR has 168 employees — including paramedics, emergency medical technicians, dispatchers and administrators — who use the equipment and facilities of the Richmond Ambulance Authority.
Tracy Thomas, head of AMR operations in Richmond, said the company is working to improve response times and has submitted a plan that addresses the problems.
Among the difficulties faced in the city, she said, is a nationwide shortage of paramedics, which earlier this year led to Richmond having 14 of its 46 paramedic positions unfilled.
Thomas said the company is also refining when and where it deploys ambulances so they can respond faster to emergency calls.
Richmond, she said, has one of the most stringent contracts of any municipality in the country when it comes to requiring swift response times by its ambulance service.
City officials said they want to keep it that way, no matter who runs the ambulances.
“We have these standards that they have contractually agreed to meet, and we’re going to enforce them,” Overton said.
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