Medical crisis averted

SPOKANE COUNTY – Local fire chiefs and officials with American Medical Response have reached an 11th-hour agreement keeping ambulance service in place for all jurisdictions except the city of Spokane.

If an agreement had not been reached, AMR’s five-year contract would have terminated at midnight Nov. 13, meaning the ambulance service provider would have been operating “ungoverned” in the county, Cheney Fire Chief Tom Jenkins told the City Council at its Nov. 10 meeting. At the time, negotiations had ceased between the company and the county Ambulance Service Board — which represents all jurisdictions except Spokane — with the two sides at an impasse, making the termination likely.

But in a Nov. 16 email, Jenkins said AMR had acquiesced to the board’s proposals and had agreed that effectively immediately, the base transport rate would be allowed to increase by 2.5 % to $878.83. The parties had also agreed to an increase in the per mileage fee of 8.2 %, and a new fee for oxygen use of $52.49 for patients who need oxygen.

“For clarity, this is a one-year ‘extension’ and not a new contract,” Jenkins said. “Therefore, we will need to continue to negotiate what our next county contract is going to look like as this extension is up in July of 2021.”

The county has been involved with AMR in contract negotiations since February, offering to extend the agreement for one more year under current conditions while talks continued. Jenkins, who chairs the county ambulance board, said the contract sunset in July, and after several meetings failed to produce terms agreeable to it, AMR notified them it would be exercising the contract’s termination clause effective Nov. 13.

In a Nov. 12 letter to the board, while continuing to disagree with the board’s “determination on rates and financial sustainability of the emergency medical services system” AMR regional director Paul Priest wrote they were suspending pursuing rate relief and accepting the board’s proposal effective Nov. 13 at 12:01 a.m. Priest said their decision was based on the ongoing Covid-19 pandemic and “other circumstances.”

“We believe that we have a higher calling to serve our patients and community during these challenging times despite negative impacts to our organization,” Priest wrote. “Because we continue to value our long standing relationship, we request that good faith negotiations begin now for a new agreement beyond June 30, 2021.”

The two sides were originally at odds over an AMR-proposed 58 % increase in the base transport rate. In a July 2 Cheney Free Press story, Jenkins said this would equate to a trip from Cheney to a Spokane medical facility costing about $1,600 — a price that would be entirely incurred by the patient.

Jenkins said in the July 2 story that AMR has cited increased employee costs as one of the reasons for the steep increase. Adding to the difficulties may be concessions Spokane — which accounts for 54 % of ambulatory transport in the county — made as part of the one-year renewal of its contract.

According to a May 10 Spokesman-Review story, Spokane’s fire department urged the City Council to agree to the one-year deal that increased rates 20 % rather than a five-year agreement that included just a 2 % increase. The agreement allows AMR to compensate for fewer available paramedics with less-skilled emergency medical technicians (EMT) and waive penalties charged to the company for longer response time if vehicles are out of service.

It also now requires AMR to respond to non-urgent medical calls that Spokane Fire Department used to handle. Jenkins said AMR doesn’t respond to these types of calls in the rest of the county.

With a one-year extension in place, the two sides now have about seven months to come to agreement on these issues and a new, long-term contract. In the event one cannot be reached, AMR has indicated its letter of Nov. 12 agreeing to the one-year term will serve as its “notice of non-renewal of our current Agreement.”

Jenkins said the board does have other options it can consider should the agreement expire.

John McCallum can be reached at [email protected].