AMR Will 'Reassess' Murrieta Ambulance Coverage

American Medical Response said it has not come to a final conclusion on where it will house--if at all--its two ambulances that have parked at Murrieta fire stations for more than a decade.

AMR emailed a statement to Patch regarding its lease after Murrieta Fire Chief Matt Shobert

Jason Sorrick, director of communications and government relations for AMR, said the company was reassessing the lease because typically, they only use static--or stationary--locations in rural areas or in those that have limited access.

"Since the beginning of this lease agreement with Murrieta Fire, the City has grown, and roads have been added or improved, thus we needed to reassess the efficiency of our deployment in this location," Sorrick said.

"The fire department has grown as well and our ambulances are generally parked outside; this creates a delay in crews getting to their vehicle quickly."

Sorrick contended that the ambulances park outside of the stations; therefore, he wrote, the wear and tear of the garage doors that Shobert claimed was not applicable to the rent increase sought.

Shobert confirmed Thursday, however, that the ambulances do park inside the station, contratry to what Sorrick said. There was a period of about two months in 2010 when the ambulances parked outside, while Fire Station No. 5 was being completed, Shobert said.

Seventeen ambulances are assigned to the Southwest Zone, according to Zorrick, which includes Murrieta. It would be preferable to have all those ambulance crews mobile, able to station themselves near historically high call volume areas, such as during commutes, he said.

Unlike fire service, Sorrick said private ambulance services work on "system status deployment, very similar to how police departments patrol."

"In addition, system status avoids the 'chute time' because the crew is already inside the ambulance, and does not need to run from the station house out to the ambulance when a call comes in," Sorrick said.

"Our No. 1 goal is to ensure the best possible service for the citizens we serve, and if we determine after further assessment and discussions with the City that positioning an ambulance at a fire station serves that purpose, then we will reconsider this option," he said.

"However, certain policy issues, such as the requirement that AMR follow behind the fire truck on the way to calls--which can delay our response--crew schedules and where our crews and vehicles are positioned at the fire stations would need to be addressed if we decide to utilize this posting option.

"In addition, the rent increase would have to be justified and compared to prevailing commercial rents."

According to Shobert, comparable leases were going for $1,600 to $2,500. Shobert also said AMR is not required to follow behind Murrieta fire engines.

"The issue of following is not a policy--it is something that is done to secure busy intersections," Shobert said.

AMR has paid around $1,000 a month since the lease began more than 10 years ago.

Sorrick also said that AMR's average response time in Murrieta--with its ambulances parked at fire stations--is six minutes and 50 seconds.

The Murrieta Fire Department has a six minute, 30 second average response time for its trucks, which all have paramedics aboard.

"We arrive on scene before or at the same time as the fire department at least 25 percent of the time," Sorrick said. "...so if they arrive before us, the patient is still being treated before we arrive and a hand-off occurs."

While AMR is contracted by Riverside County Emergency Medical Services Agency to provide ambulance services to western Riverside County and unincorporated areas, Sorrick clarified that they are not paid by the county. Rather, the payments come from insurance, MediCal and Medicare, or sometimes not at all if patients are uninsured.

"We operate solely on what we charge and receive zero taxpayer subsidies," Sorrick said, denying that the contract is what the Murrieta fire chief figured to be a $95-million-a-year contract.

The Riverside County Board of Supervisors is due to hold an Oct. 17 workshop about the possible extension of AMR's contract for two five-year periods. The current contract ends in June 2012.

The city of Murrieta approved a resolution Tuesday, asking the Board of Supervisors to let the contract go out to bid amongst other possible ambulance providers.

"The fact is, only 26 percent of patients transported in the county have insurance that covers the full cost of a transport, while more than half--52 percent--are covered by Medicare, where the average allowable charge is $500, and MediCal, where the allowable charge average is $140," Sorrick wrote.

"In addition, about 20 percent of the patients transported are uninsured and almost all of those--92 percent--end up paying nothing. Furthermore, the chief does not account for AMR’s actual hard cost of providing the transport, which can average between $500 to over $1,000 depending on the circumstances of the patient."

The economics involved in providing ambulance transports is a factor that needs to be considered, according to Sorrick--especially when the chief has expressed his desire for the fire department to operate its own ambulance services, he said.

Editor's Note: Additional quotes from Murrieta Fire Chief Matt Shobert stating that AMR ambulances do park inside Murrieta fire stations, as well as about AMR ambulances not being required to follow Murrieta fire trucks except preferably at busy intersections, have been added since this article first published.