EMSA's board of trustees approved a $247 million contract with a new ambulance service provider Wednesday, while its current contractor leveled allegations that the company's low bid appeared to be "price fixing."
The board voted unanimously Wednesday to award the five-year contract to American Medical Response, based in Greenwood, Colo.
American Medical Response, known as AMR, is a subsidiary of Envision Healthcare. The company operates in 40 states and 2,100 communities, its website states.
The new contract, which begins Nov. 1, lengthens by two minutes the maximum time ambulances have to respond to Priority 1 emergency calls. Currently, EMSA ambulances are required to respond to the most serious calls within 8 minutes and 59 seconds in Tulsa and Oklahoma City.
The contract allows calls during certain weather conditions and times of high demand to be excluded from that requirement.
EMSA is a government agency that supervises a contractor to provide ambulance service to more than 1 million people in Tulsa, Oklahoma City and surrounding cities.
Over the past year, the agency has been under fire for its spending and billing practices and alleged conflicts of interest with its contractors.
A critical state audit - sparked by a Tulsa World investigation - said EMSA spent public funds on fitness classes for employees, spa services, lavish retirement parties, first-class travel and other perks. In response, EMSA has changed many policies and revamped the bills it sends customers.
Board member Charles Foulks, a doctor, asked EMSA's medical director, Dr. Jeffrey Goodloe, if he would be comfortable with the longer response time if his mother or father needed an ambulance.
"I dial the same three numbers as anyone else when I need an ambulance," Goodloe responded. "I am completely comfortable with the change in response time standards."
In a system such as EMSA's, Goodloe said, firefighters respond to serious calls within four to five minutes about 85 percent to 90 percent of the time. Most firefighters in Oklahoma City and Tulsa have some level of medical training, and many have advanced training, he said.
EMSA commissioned a study in 2011 that reviewed scientific evidence and found no difference in patient outcomes between the 8:59 and 10:59 response times, Goodloe said. In time-sensitive cases such as heart attacks and breathing problems, firefighters are equipped to treat patients when they arrive, Goodloe said.
AMR's bid of $247 million for the contract with longer response times was $44.6 million lower than the bid by Paramedics Plus, EMSA's contractor for the past 14 years.
Vic Albert, an attorney for Texas-based Paramedics Plus, spoke to the EMSA board Wednesday. He said AMR's bid appears to be "grossly underpriced" and comes while AMR's parent company is planning an initial public offering of stock to raise funds.
Envision Healthcare filed forms with the Securities and Exchange Commission last month indicating that it planned to raise $100 million from the stock offering.
Albert said a financial analysis shows that AMR would lose $27.5 million over the five-year contract with EMSA and that patients would pay the price. He called AMR's contract bid a "potential anti-trust violation" that the SEC may investigate.
A letter of protest filed by Paramedics Plus with EMSA's board states: "The financial undercutting here is nothing more than an attempt to use the $250,000,000 EMSA contract to drive up the interest in the public offering. The EMSA contract is being used as a pawn in a financial plan of dominoes."
The letter claims that AMR will make up its operating loss "on the backs of the system employees" by requiring paramedics to work 48-hour weeks. It states that EMSA worked for a year to switch paramedics to a 42-hour week.
Under AMR's proposal, paramedics would end up working "an additional 26 days of work each year, and not being paid for it," the letter claims.
That claim could not be confirmed Wednesday.
An EMSA spokeswoman said paramedics will not lose their jobs when the new contract takes effect Nov. 1 but will have the option of working for AMR.
Several members of a nine-member selection committee that reviewed the bids of both companies said they reviewed Paramedics Plus' allegations during the process. AMR scored higher in quality, which was considered first, and price, they said.
"I truly believe the selection committee did an exceptional job of reviewing that material, and I stand by my decision," said Lillian Perryman, outgoing chairwoman of the EMSA board.
Clay Bird, also a member of the committee and Tulsa's economic development director, agreed.
"We all felt very comfortable with the outcome," he said. "We have a competitive process where we can get the best value for the citizens we serve."
EMSA CEO Steve Williamson said that if AMR is unable to fulfill the terms of its contract, EMSA would put the company on notice and give it a chance to address the issues. If problems continue, EMSA could rescind the contract and collect on AMR's $5 million performance bond, he said.
Paramedics Plus' letter points to millions of dollars in fines AMR paid in Alameda County, Calif., for failing to meet required response times. Paramedics Plus took over that contract in 2011 and has met the requirements, the letter states.
Goodloe, who advised the selection committee, said AMR had agreed to contribute $100,000 toward medical oversight of its performance. He said the process "looked out for the patients' interests."
EMSA's board voted in March to disqualify a third company, Rural/Metro Corp., from bidding due to concerns raised by Williamson.
The nine-member selection committee's report unanimously recommended that EMSA's board approve AMR as the successful bidder, based on a comparison of proposals by the two companies.
EMSA's new contract
Here are key points of the ambulance service contract EMSA's board approved Wednesday.
Winning bidder: American Medical Response, Greenwood, Colo.
Current contractor: Paramedics Plus, Tyler, Texas
Contract length: Five years, beginning Nov. 1
Cost: $247 million over five years
Number of patient transports forecast in 2014: 77,500 (west); 71,000 (east)
Response time required: 10 minutes, 59 seconds (Priority 1 calls); 24 minutes, 59 seconds (Priority 2). Transports scheduled less than 24 hours in advance: 59 minutes, 59 seconds. Transports scheduled 24 hours or more in advance: 19 minutes, 59 seconds.
Calls excluded from response times: Calls during times demand is 98 percent or higher than the average number of calls during the past 52 weeks.
Source: EMSA
Ziva Branstetter 918-581-8306
ziva.branstetter@tulsaworld.com
Original Print Headline: New paramedics provider wins EMSA contract bid
