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N.Y. county officials look at AMR data in search for replacement ambulance service

Cayuga County considers what ambulance service to select based on call data since AMR announced departure



By David Wilcox
The Citizen

CAYUGA COUNTY, N.Y. — Cayuga County is looking for “an immediate solution” after being told by American Medical Response last week that it will cease ambulance services in the area at the end of the year.

Riley Shurtleff, the county’s director of emergency services, told The Citizen on Monday that the medical transportation provider responds to about 3,000 emergency and nonemergency calls annually.

To begin figuring out how to fill that void, Shurtleff has asked AMR to provide the county more detailed call response data. The provider operates one 24-hour rig and one 12-hour daytime rig from its Auburn station, he explained. Sometimes it responds with a full rig and sometimes with advanced life support intercept services for smaller providers, riding in their ambulances to the hospital.

That data will help the county “determine a path forward,” Shurtleff said, in partnership with Auburn City Ambulance and the handful of other ambulance providers that will be left in the area.

“Those are conversations that will have to happen with agency chiefs and leaders in the very near future,” he said. “We need to find an immediate solution in order to handle the call volume.”

AMR, a subsidiary of Global Medical Response, confirmed in a statement to The Citizen on Monday that its Auburn operations will close effective Dec. 31. The private provider has served Cayuga County for more than 40 years. All local employees will be offered positions at its Syracuse operations, and AMR said it is “committed to a successful transition of services as determined by the county.”

AMR said its decision to leave the county was made due to “stagnant reimbursement rates, rising costs of apparatus and medical supplies and the cost of a qualified workforce in a post-pandemic society.”

Emergency medical services providers nationwide face similar problems, Shurtleff said. The fact New York state does not classify EMS as essential — meaning that municipalities don’t have to provide them like fire and police services — exacerbates those problems, in his opinion. But he hopes that will change with a bill introduced to the state Senate in 2021 that would classify EMS as essential.

“There’s potential for a reworked system out of this,” he said, “but truly Cayuga County is seeing the local effect of health care and EMS systems struggling at a national scale.”

What didn’t play a role in AMR’s decision, Shurtleff continued, was Auburn’s creation of a municipal ambulance service in 2021.

Lon Fricano, who served as director of operations for the city service’s predecessor, TLC Emergency Medical Services, said in a letter to the editor in The Citizen this week that the change “destabilized” local ambulance service and led to AMR’s decision. He also accused the city service of “traveling to distant facilities while you may be waiting for an ambulance and AMR was being underutilized.”

According to data received from the city of Auburn through a Freedom of Information Law request by The Citizen, however, city ambulance hospital-to-hospital transports have decreased since the creation of the new service. TLC averaged 70.7 transports a month in the 10 months of 2021 prior to the change, while Auburn City Ambulance has averaged 55.2 transports a month since.

Shurtleff said he thought the city’s service “worked well” with AMR.

“I would actually say there were a number of times when AMR was covered by the city, and the city was covered by AMR,” he said. “You can’t predict when people have heart attacks.”

The city service, and other ambulance providers in Cayuga County, now have a little more than two months to figure out how to work best together in the absence of AMR.

“EMS is a unique animal,” Shurtleff said. “These additional agencies will have to look at their own structures to see where they can pick it up to move forward and continue serving the public.”

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