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.

"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.

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.

Tim92562 April 19, 2012 at 08:14 PM
Preach it Mike!
The Professor May 03, 2012 at 05:40 PM
As a long time resident of Murrieta I want the truth... AFR who do YOU work for? I'm thinking your name means "A F*&$(#G RETARD"
Private Amb Serivce-NOT AMR September 12, 2012 at 03:43 AM
Awesome that the Fire Dept arrives on scene seconds or minutes before the ambulance crew. But, no matter the care provided on scene, the patient HAS to be treated and evaluated by a doctor. An ER doctor or surgeon or cardiologist, etc. EMS personnel may provide a change in a patient's condition but they ultimately need to be transported to a hospital. Bottom line. So until the FD can figure out how staff, maintain and handle response times with their own ambulances, the private companies are needed to provide a service that the gov cannot. And they cant due to the cost. Private companies pay their ems workers far less than FD staff and despite large bills for transport, it is a small amount for what you would have to pay if it was "non-profit." Citizens will pay for it no matter what, it comes down to everyone paying through taxes whether you use the service or not or the citizens that actually use the service pay their bill from the private company. Very simple.If you want all services for free, time to look for residency in a different country.
RSL September 19, 2012 at 04:54 PM
FOOD FOR THOUGHT Service date Feb 8 2012 11:00pm .Ambulance transfer from Loma Linda Univ Med Center Murrieta to Riverside Community Hospital. The transfer considered non emergency, was ordered by the Surgeon of record at Loma Linda Med Center solely for the purpose of having him and his surgical team who normally work at Riverside Community perform a common OR surgical procedure.The patient arrived at Riverside Community at around midnight. The procedure wasn't actually performed until after10 am the next morning. Actual AMR Bill: Code Description Units Unit Charge Payments Total Charge A0426 ALS -Non Emergent Bas 1 $1,174.00 $1,174.00 A0425 Mileage 32 $32.50 $1,040.00 A0999 Night Charge 1 $152.00 $152.00 Grand Total billed to Insurance Co.........................................................$2,366.00 Patient was illegally billed by AMR........................................................ $1,862.91 AMR violated CA DMHC regulation 28 C.C.R. section 1300.71.39 (unfair billing practice) A simple Google search: {AMR Ambulance Service Complaints}, found numerous complaints of overcharging against AMR 1 case alone numbered 30,000 over billed customers! AMR a Nationwide CROOKS FOR PROFIT Company. Take a TAXI, its much CHEAPER!!!
Kevin Clark September 19, 2012 at 08:46 PM
I am sorry to hear that AMR is accused of gouging its patients in billing for trips to the hospital. But if we gave that job to the FD it would be ten times that amount. Where is the real destination of our tax dollars anyway? Post work salaries "Retirement" to public employees thats where. Some, if not all fire department personell will receive a post work salary of 90% of thier highest paid salary, for life! Most able to retire at age 55. So given the FD chiefs present day salary of 162,500 a year, this without contributing anything signiicant to his retirement( meaning 100%) or his health benefits, his post work salary is going to be 146,000 a year for life. Really !? This for doing nothing!.Come on.The out going school superintendant is also being paid in the 160,000 range, so theres another 146,000 a year for life, rediculous. and if they live to the mean average age of approx. 78 they will collect over $3,300,000.00 in "post work salary" and that doesn't include health benfit s. The imposed tax by the FD Chief and the proposed tax by the out going school super are not to provide you any better services or provide money to the "schools", no they are to fund the broke, abusive system and keep the gravey train in place. The teachers union and some of its members will always put on a sad face and pull on your heart strings and say "but its for the children" when in reality they are putting that money away for themslves. Skilled pickpockets thats all.


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