County enters negotiations with ambulance contractor
A recent move by Multnomah County officials means that an ambitious drive to cut waste in emergency services has officially fizzled.
County officials have quietly shut the door on a contentious two-year effort to remake the area's 911 emergency medical response system and moved to award ambulance company AMR a new five-year contract.
The decision means that the status quo in emergency services will continue, including an antiquated dispatch system that, studies and critics agree, all too often sends city fire trucks out on non-emergency medical calls.
But the county's proposed fix raised its own set of concerns. And dropping the efficiency push could save money in some areas and reduce legal friction, documents and interviews show.
City of Portland officials had blasted the system proposed by the county to improve things as itself potentially wasteful and duplicative, as shown in records obtained by the Portland Tribune last year.
The county's plan to partially privatize dispatch by layering a second "triage" dispatch system on top of the one currently operated by the city of Portland was considered certain to trigger a legal clash between the city and its employee unions — likely requiring a new round of costly bargaining.
AMR, which had remained neutral during the fracas between county and city officials, now says the county's decision to back off will save millions of dollars in ambulance billings.
Had the county not dropped its reform push, "our proposed pricing would have likely been 30 percent higher than ultimately proposed," AMR Regional Director Randy Lauer wrote in a March 7 letter to the county.
In 2015 alone, AMR reported $80 million in revenue from its countywide operations, coming from insurance companies, Medicare and the Medicaid-funded Oregon Health Plan.
So Lauer's letter suggests the county's plan could have increased ambulance billings by tens of millions of dollars.
Lengthy reform push
Two years ago, at the urging of their ambulance consultant, county officials launched an effort to remake emergency medical response using the county's legal authority to award an ambulance contract.
Last summer the City Council passed a resolution supporting the effort in concept, estimating that as much as a third of fire truck dispatches are unnecessary.
But fire departments around the state, as well as Portland city employee unions, reacted with alarm.
In part, it's because the county's bid meant that some response times would increase. Not only that, but the county called for a software system favored by the county's longtime ambulance consultant that is not universally supported in the industry.
Washington County, in contrast, uses a different system that is considered by some emergency professionals to give officials more control.
Portland Fire Chief Mike Myers had been expected to welcome the push for efficiencies based on reforms he's worked on in his previous job in Las Vegas. Instead, he became internally a vocal critic of the plan, records show.
Citing similar concerns from the city's 911 agency, the Bureau of Emergency Communications, he complained that some response times would go up under the plan. And he also feared that the winning ambulance company, by operating a second group of dispatchers that would join city dispatchers on calls, would intrude on the city's authority over call-handling and dispatch.
In January, the county dropped the controversial elements from its plan, but seemingly reserved the right to raise them again before the five-year contract is over.
Now, however, a county spokesperson says there are no such plans, saying any reforms will be driven by the city.
In the end, AMR was the only bidder. AMR's Lauer said his company will continue to work with the city and county to pursue efficiencies regardless.
"The good news for the community is there will be no disruption in emergency services, in the quality or anything," he said.