City Paramedics Cheaper, Says Fire Department

Glendale could improve emergency services and save at least $130,000 a year in fees paid to a private ambulance company if the city operated its own paramedic rescue teams, says a report by six members of the Glendale Fire Department.

The Glendale City Council will consider the study when it decides whether the city should continue a practice of contracting with a private firm or return to using its own firefighters for ambulance calls as it did from 1937 to 1975.

The study found that Fire Department paramedic service could cover its own costs, said Capt. David Starr, a member of the Fire Department research team that wrote the report. Unlike people who call police or firefighters, users of paramedics are charged.

However, Rand Brooks, owner of Professional Ambulance Service Inc., which has held the paramedic contract since 1975, contends that it would be impossible for the Glendale Fire Department to duplicate his company’s service as cheaply or efficiently.

Former Fire Chief

“A municipal service could never afford to give what we can give to the city,” Brooks said.

The company’s president, Allan Stone, was Glendale’s fire chief when Professional Ambulance replaced the city service. Although Stone originally opposed private paramedic service, he says now that the system saves the city money. Stone went to Professional Ambulance as its president after his retirement from the city in 1984.

In 1974, while Stone was fire chief, the city added special training and life-saving equipment, but the paramedic project was abandoned a year later.

The expiration of Glendale’s current five-year contract with Professional Ambulance on Nov. 30 will reopen discussion of what emergency rescue service should cost and who should provide it to the city’s 140,000 residents, said Glendale Fire Chief John Montenero.

“It’s logical at this time that the city reassess what it is doing and evaluate the cost of private service versus its benefits and the cost of public service versus its benefits,” Montenero said.

Study Called Inconclusive

“But right now the study is not conclusive,” he said. “Whether one is better than the other, I can’t say at this point.”

The study assesses four options--three paramedic systems that would be operated by the city and a fourth that would continue contracting.

The first, and likely to be the one most challenged by private companies bidding for a new contract, calls for a city paramedic service manned by firefighters. Similar systems are operated by Burbank, Pasadena, South Pasadena and Long Beach. As proposed for Glendale, the plan calls for three two-man paramedic teams of firefighters trained to administer medicine and life-support procedures such as cardiopulmonary resuscitation.

Transportation of patients to hospitals, which Brooks agreed is the most lucrative part of the business, would become a city service and revenue source.

The report concludes that current rates would not have to be raised and that quality of service would not have to drop to keep a Fire Department service in the black, Starr said. Besides, the city would be able to monitor the service more closely than it can under a private contract, he said.

By dropping the contract, the city could save the $48,000 a year it pays Professional Ambulance for police custody cases, false alarms and the rescue of city employees hurt on the job. The city also pays about $82,000 a year to the company under a contract provision that requires the city to cover uncollected bills of private patients.

Costs to Patients

The company charges patients $210 or $107 per call, depending on what kind of service is provided. The mileage charge for transportation to hospitals is $6.25 a mile. Additional charges include oxygen at $14.50 a tank and waiting time at $14.50 for every 15 minutes after the first 15 minutes. Rescues at night, on weekends and on holidays carry a $14.50 surcharge.

Also saved would be in-kind services provided to the company, such as use of the city’s 911 emergency dispatch operators and its $1-a-year rent on a city-owned property in Montrose that is used for a paramedic station, the report says.

The fee structure and volume of business, said owner Brooks, allows for “maybe a little better than break-even.” He would not reveal his firm’s annual revenue from the Glendale contract.

“I don’t say we’re losing, but we’re not getting rich on the paramedic business,” he said.

City Takes Calls

Emergency calls are received by the city and forwarded to Professional Ambulance operators, who dispatch one of four paramedic and ambulance teams that serve the city 24 hours a day. If necessary, city dispatchers can also send a city fire truck to help with rescues.

Brooks said he expects the city to hesitate in creating an in-house paramedic squad because it would cost about $1.5 million for equipment and training comparable to what his company provides. Because of that, Brooks said, city revenues could never cover its costs.

He has kept his own costs down because more than 80% of the firm’s business is in ambulance transportation for patients in Glendale, Pasadena and areas of the San Fernando Valley such as Burbank and Van Nuys, Brooks said. Less than 20% of his business is in the less-profitable emergency paramedic rescue work, Brooks said.

Lower Pay

Ambulance drivers, or emergency medical technicians, are paid less than fully trained paramedics.

Brooks saidhis paramedics earn less than city firefighters and that he does not have to pay retirement benefits because, generally, his employees seek employment elsewhere after four or five years.

A second option that requires the city to provide paramedic rescue and to contract to private firms for transportation of patients to hospitals would be a windfall for private companies. Los Angeles County and Torrance use this system, which sometimes involves first the paramedic and then the ambulance arriving at the scene.

This would be a less likely option, assuming the city is reluctant to pay the most expensive part of the paramedic operation while giving up the most lucrative, the report said.

3rd Possibility

The third option, the report says, is for the city to hire paramedics who are not firefighters for rescue and transportation. A similar system is used by Los Angeles. However, the report says, hiring new employees rather than training current firefighters would be less efficient.

The last alternative is to continue with private contract service but with greater city review and controls.

Montenero said more research is needed before he can comment on the study. He has yet to decide what new services will be expected of firms bidding for the contract, or how much it would cost the Fire Department to provide the same service. Bid requests and requirements have not been written, he said.

The City Council is not expected to decide before next year whether it will continue private contracting or reinstitute a city service for emergency rescues and transportation. In the meantime, the city is likely to extend its contract with Professional Ambulance, Montenero said.

The five-volume report was published in July but has not been released.