Politics & Government

AMR Adds Third Ambulance Unit in Murrieta

According to American Medical Response, the county's contracted provider, an extra ambulance will be available 24 hours a day to serve the western half of the city by the end of the month.

To quicken response times, ambulance provider American Medical Response announced in a news release today it will station an additional crew in Murrieta.

This is amid calls by some city officials that the county open its amublance provider contract—held by AMR—up for bid because of costs and late arrivals. According to AMR, an extra ambulance will be available 24 hours a day to serve the western half of the city by the end of the month.

AMR officials also extended an offer to electronically link AMR's dispatch center with the Murrieta Fire Department to enable simultaneous communication and get ambulances rolling to locations faster.

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"We understand the financial challenges that the Murrieta Fire Department is facing, and we are prepared to assist the residents of Murrieta to ensure they continue to receive the highest level of care," AMR-Riverside General Manager Tom McEntee said.

McEntee noted public resistance to a proposal by the city to have residents pay a "first responder tax" to cover the cost of fire department operations, highlighting the fact that all of AMR's charges are direct fee-for-service.

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For the past three decades, Riverside County has contracted with AMR for medical calls, and under the contract, AMR serves most cities within the county.

The estimated $95-million contract was last renewed in 2009, but the compact expires June 30, and the whether to extend it.

Several Murrieta officials have publicly criticized AMR for slow response times, calling on the county to put the Denver, Colo.-based company's contract out for bid.

Cal Fire Firefighters Local 2881 Director Ray Martinez made the same request in a letter to the board last month, saying a "transparent, competitive bidding process has provided efficient and cost-effective ambulance service in our neighboring counties and has served as a catalyst for modernization and improved services."

Murrieta City Councilman Randon Lane for charging residents for ambulance transportation when city firefighters are typically first to arrive at emergencies, do the triage and stabilize patients.

But according to AMR, Murrieta fire meets its goal of reaching emergencies in 5.5 minutes less than half of the time, with an average response time of 6 minutes, 51 seconds, while AMR's average is 6 minutes, 48 seconds.

McEntee said AMR medics could be there even faster without the two-minute delay caused by the city's dispatch system, which requires AMR personnel to get location information via telephone.

Murrieta fire Chief Matt Shobert, city management and members of the City Council are backing a to support fire operations. Under the proposal, residents and business owners would have the option of paying a $48 "subscription fee" annually to cover the cost of any fire department calls to their property, or pay $350 any time firefighters are summoned there.

According to city officials, the fees would net upwards of a half-million dollars annually for public safety and help close the city's funding gap resulting from lower property tax receipts.

Some residents have asked City Council to put the proposed paramedic fee to voters. City officials have said it would be a fee, not an assessement or tax, therefore the city was not required to put it on a ballot.

"...One of the Council members mentioned the possibility [of putting it on the ballot], but there was nothing more about it than that," said City Manager Rick Dudley, in an emailed response Monday to Patch. "Unfortunately, we need to have this resolved sooner than November."

Dudley said charging the fee—which would be in the event Murrieta fire arrives on scene prior to AMR and begins paramedic treatment—is key to the fiscal situation faced by the department.

"The property tax accruing to the Fire Department has dropped so much that we cannot continue maintaining five stations without additional revenues. The paramedic subscription fee gets us part way there, but even with that, we would still have to make some adjustments to get us the rest of the way," Dudley said. "Without it, or some other increased revenue stream, I do not know how we can reduce our expenditures enough to keep all five stations open."

AMR bases its ambulance crews at Murrieta fire Stations No. 2 and 3, on California Oaks Road and Murrieta Hot Springs Road, respectively. It was not clear where the third ambulance crew would be based, but city fire station No. 5 is in the proposed vicinity, which is the northwest region of Murrieta, including the Bear Creek and Copper Canyon areas, north of Calle del Oso Oro.

Murrieta fire chief Matt Shobert said he "couldn't be happier" with the news of an additional AMR ambulance for that part of town. Shobert believes the move goes back to a conversation had during a Jan. 9 Southwest EMS Zone administrative meeting.

"Two months ago, I met with [AMR Operations Manager] Jim Price, Tom McEntee and [city of Murrieta Senior Managment Analyst] Brian Ambrose about this exact issue," Shobert said, in an email Monday to Patch.

"Bruce Barton [director of Riverside County Emergency Medical Services Agency] issued a directive at the Jan. 9 EMS zone meeting—we also talked about it at the prior zone meeting, so we’ve discussed for at least eight months—that AMR would have to provide a written corrective plan since they were only meeting their goal of 10 minutes less than 50 percent of the time in the Bear Creek/Copper Canyon/surrounding areas," Shobert continued.

Data pulled for the meeting, according to Shobert, indicated AMR had 827 late responses in one quarter in the Southwest Zone, which includes Temecula, Murrieta, Wildomar and Menifee. Of those calls, AMR was more than four minutes late for 119 arrivals, or approximately one per day at that level, Shobert said.

Fourteen were greater than nine minutes late; 92 exemptions were granted over the four-month period; and in March 2011, 95 exemptions to late responses were given in one month, Shobert said.

Since January 2008, Shobert said, AMR averages 2.26 calls of 10 minutes late per month in the Southwest zone.

"That’s greater than a 20-minute response time," Shobert said. "To date, we haven’t seen a correction plan...so I can only gather that AMR is coming under increasing pressure from REMSA rather than adding a third ambulance out of charitable good will.

"It just takes AMR awhile to implement new things…we’ve been working with Jim Price for seven months on a new reimbursement program for medical supplies, and we still don’t have the program in place yet."

County officials acknowledged the Jan. 9 meeting.

Jose Arballo Jr., spokesperson for Riverside County Department of Public Health, of which REMSA is a division of, said the outcome of the meeting, according to Barton, was direction to AMR to put together an action plan for that specifc area of Murrieta.

"An action plan can include other things beside adding an ambulance," Arballo said. "AMR was in compliance overall for its contract for that [Southwest] zone."

Arballo noted that oftentimes when an analysis is done, areas for improvement are brought to light.

"In this case, we saw a need for improvement in this area, so we requested AMR put together an action plan to improve their response time," Arballo said. "There was no directive to add an ambulance; there are other things that can be done. One thing that might improve response times would be basing an ambulance in a different location."

As for the two-minute delay AMR alleges it takes Murrieta dispatches to reach them, Shobert contended that was false information. He added the city has not received an official offer to help upgrade the Murrieta fire dispatch system.

"AMR has never offered to upgrade our dispatch system," Shobert said. "The offer has never been made."

Another Murrieta official, Senior Management Analyst Brian Ambrose, cautioned the city's push is not against AMR.

"From the very outset, this is not about AMR," Ambrose said. "This is about ambulance service response times in Riverside County. At no point did we want to attack AMR."

Shobert said the larger issue is the EMS system in place in the county.

"This system relies on local fire departments and CalFire to provide first responder paramedic services, but provides no method to reimburse local fire departments for the services other than basic medical supplies. In a way, it seems like Riverside County’s contract with the ambulance provider subsidizes a for-profit, private company without ever taking this contract out to bid," Shobert said.

—City News Service contributed to this report.


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