EMS pros seek answers on five-year ambulance contract bids

Monday, April 2, 2012
Attendees at the Western Carroll County Ambulance District meeting March 28, most of whom were emergency services personnel, packed the board room at Cornerstone Bank in Holiday Island to discuss the two bids for the upcoming five-year ambulance service contract. Above, Berryville Mercy Hospital Administrator Kristy Estrem shares why Mercy bid on the contract.

HOLIDAY ISLAND -- A crowd of mostly emergency medical personnel attended a special meeting of the Western Carroll County Ambulance District (WCCAD) board March 28 to hear answers to questions about two bids received for the new upcoming five-year ambulance service contract, to start July 1.

On hand to answer questions were Kristy Estrem, administrator for Mercy Hospital in Berryville; Bob Patterson, administrative director for Mercy Central Region EMS; Kurt Cypert, program director for Air Evac Lifeteam in Springfield, Mo.; Eureka Springs Mayor Morris Pate; Eureka Springs Fire Chief Rhys Williams and Assistant Fire Chief Bob Pettus.

WCCAD is funded by a 2-mill real and personal property tax. Currently, Eureka Springs gets 85 percent of those collections, and WCCAD uses the other 15 percent to fund supplies, training and equipment for its volunteer Emergency Medical Responders (EMRs).

Mercy bid for $200,000 for the contract's first year and increases in subsequent years based on the Medical Consumer Price Index, although Patterson said they are "not married to that. We're open to other inflationary factors."

Eureka Springs bid for 90 percent of WCCAD's 2-mill real and personal property tax collections. That figure for 2012 would be $236,000.

Commissioners were quick to say their decision to put the contract out for bid was not about Eureka Springs' service record but about following the law.

Estrem and Patterson hastened to reassure the board that they are not out to supplant Eureka Springs as the provider.

"We are about service," Patterson said. "We were encouraged to submit a bid. If the community is happy with what you have, we're fine with that."

He said the two ambulance services have often provided mutual aid to each other.

Asked about emergency air flights, Patterson noted that two-thirds of the air flights on the east side of the county are handled by Air Evac Lifeteam, which offers memberships. Mercy does not.

Both services bill insurance for medical flights, but Air Evac members are exempt from deductibles and copays.

"If we're aware of a membership agreement, we'll respect that and honor that," Patterson said. "Even if we have a helicopter in the air, we'll turn them around. We have a good relationship with Air Evac."

As for hospitals, Patterson and Estrem said Mercy has a clear policy that patients would be transferred to the medically appropriate facility of their choice.

Cypert said Air Evac has 2,107 members in Carroll County, or 15.5 percent of the county households. He said well over half of them are in the Western District.

"My concern is for those members so they are not subject to financial hardship," he said.

Holiday Island has more than half of the medical calls in the Western District, due to its aging population.

Even though Mercy has pledged to station an ambulance at Holiday Island, and the other in Eureka Springs, Holiday Island Fire Chief Jack Deaton wanted to know where another ambulance would come from should both of Mercy's be busy.

Patterson said Mercy would staff another ambulance if needed.

Deaton said that although he has no complaints about working with Eureka Springs ambulance crews, "I'm very disappointed in Eureka Springs asking for 90 percent. You're taking another third of what we get to provide for our EMRs."

Pettus said the 85 percent Eureka currently receives is not enough.

"At that rate of collection, Eureka Springs loses money providing that service to the Western District. The ordinance says all funds should be for ambulance service. We're only asking for 90 percent."

Commissioner Chuck Olson handed out a sheet comparing WCCAD collections from 2008 through 2011, the contract payout at 85 percent, and what payout would have been at 90 percent. WCCAD would have been in the red every year at 90 percent.

"So my feeling is we cannot support our EMRs on 10 percent of collections," Olson said.

Pettus pointed out Olson's figures don't show other purchases, such as a Basic Life Support (BLS) ambulance for Holiday Island and the $200,000 WCCAD already has in its coffers.

The atmosphere got more testy when Olson asked why Eureka Springs had declined to purchase a non-performance bond against failure to comply with the contract. Eureka's bid says the city does not purchase such bonds, as it has tort immunity.

"Do you have a question about our ability to provide a third or fourth out (ambulance)?" Pettus asked, to which Olson replied, "No."

Commissioner Joe McClung, Jr., asked why Eureka Springs loses so much money when it receives WCCAD millage, city taxes and patient billing for its ambulance service.

Pettus answered they are a rural service, and the cost is not in actual runs but in staffing and vehicles that are "always ready to run."

He said the city makes more on non-emergency transfers, but they can't really do many of those.

Patterson said Mercy is also losing money on its ambulance service "and would continue to lose money if we take this contract" but that Mercy's mission is one of service, and they are nonprofit.

Jason Morris of the Office of Emergency Management said both Mercy and Eureka Springs "are two great services. I work with them both."

Commissioners agreed the two bids are comparable in terms of service provided, but money is the main issue.

They will ask the county attorney to research whether the contract can be rebid.

WCCAD will hold another special meeting on the ambulance contract bids on Thursday, April 5, at 3 p.m. at the Cornerstone Bank in Eureka Springs.

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  • WCCAD - Use caution dealing with Mercy EMS. They can't cover the area they have now. They are constantly calling on Eureka and North Ark in Harrison to take emergency calls in their area because they will send all of the ambulances out of the county on transfers. They say they will put two ambulances in the western district but mark my words those units will be constantly pulled out of that area to cover the eastern district and take transfers. CAUTION, CAUTION, CAUTION! If you don't trust my warning, I urge you to ask Eureka and North Ark about this issue. A large sore spot with both ambulance services.

    -- Posted by T Bone's Tibbons on Tue, Apr 3, 2012, at 3:33 PM
  • ALL EMS providers call on each other for help when needed, and we ALL help one another. As for being out on transfers, I would hazard a guess that not all are actual transfers when other providers are called for "Backup" 90% of the time another EMS is called for assistance it is because the calling provider is already tied up on other emergency calls. I wonder T-Bone would you want to wait (if you had a life threat) to be transferred to an upgraded facility to keep from calling another provider?

    -- Posted by baloney on Tue, Apr 17, 2012, at 3:58 PM
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