A Look At One West Valley City's Ambulance Partnership In Arizona's Changing EMS Landscape

By Casey Kuhn
Published: Friday, February 26, 2016 - 9:17am
Updated: Friday, February 26, 2016 - 9:20am
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(Photo by Casey Kuhn - KJZZ)
A Peoria firefighter works in a fire station.
(Photo by Casey Kuhn - KJZZ)
An ambulance operated by private ambulance company Rural/Metro.
(Photo by Casey Kuhn - KJZZ)
The call-center at Rural/Metro in Glendale.

Operators at the Glendale headquarters of private ambulance company Rural/Metro take 911 calls and direct the dispatchers to hospitals.

Those calls span from Yarnell to Black Canyon City.

Rural/Metro holds a certificate of necessity, or CON, which means Arizona allows the company to operate ambulances across all of Maricopa County. That resulted in a stronghold over the Valley's EMS operations, with Rural/Metro reportedly trying to block cities from running their own ambulance service.

For example, when Tempe put in their application for a CON last year, Rural/Metro intervened, saying it would overlap an area they already covered.

Ultimately, Rural/Metro declared bankruptcy in 2013 and was bought by Colorado-based American Medical Response.

AMR regional operational manager Glenn Kaspryzk says his company’s goal is to rebuild trust. "We’re about building relationships, and maybe mending what happened under Rural/Metro," he said.

Calls chime in the fire trucks and rescue vans howl at one of Peoria’s busiest fire station, and could soon be joined by the clamor of ambulances. The city was just awarded their CON last month without AMR intervening.

Peoria EMS Chief Jim Bratcher says working with AMR is the key to dependable service for the residents.

"Emergency transport is a critical component of public safety, and we want to be sure we can maintain that and are not subject to any fluctuations in the private sector," Bratcher said. Especially as Peoria's population keeps growing.

"We do anticipate growth," Bratcher said. "There are a few logistical challenges in the size of the city and being able to respond to all parts of the city and meet parameters."

It took Peoria about two years to get their CON application approved, and they’ve set aside a million dollars per ambulance for operating and staffing.

Deputy Chief of Emergency Medical Services Ithan Yanofsky at the state health department says the lengthy process is a necessary one.

"It's a complex process probably modeled after the Arizona Corporation Commission utility model," Yanofsky said. "If you talk to people there’s a lot of pluses and minuses."

Terence Valenzuela, an EMS professor at the University of Arizona, says this exemplifies how the field of paramedicine is changing. And he thinks the regulations in Arizona could be given a second look in the legislature.

"I think it does bear looking at now because the role of EMS is changing," Valenzuela said. "It’s not just how fast can one get there, it’s now 'Where are we going to fit in the whole spectrum of care post the Affordable Care Act?'"

He says cities like Peoria can focus on getting care to patients who desperately need it, like stroke or trauma patients. Meanwhile, private ambulances can be used for less dire 911 calls, freeing up the city rescue.

AMR’s Kaspyrzk says his company is trying to provide more of those public-private partnerships, giving West Valley cities an opportunity to bring in new revenue through the insurance paid for ambulance care.

"Historically, pre-economic crash, patients had insurance and low deductibles and insurance kind of covered everything," Kaspyrzk said. "Now they have high deductibles to manage their healthcare , and it's about forming those partnerships to delivery medicine instead of an ambulance commodity."

Before Peoria was approved, Surprise was the only West Valley city allowed to operate their own ambulances. Kaspyrsk says American Medical Response is also looking to partner with Avondale and Glendale.

AMR will still answer 911 calls in the West Valley. But in the future, cities can use their own resources to get transport critical patients to urgently needed care faster.

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