Glendale Finds Paramedic Pact Less Expensive

After months of debate, Glendale officials have concluded that it would be more expensive for the city to operate its own paramedic ambulance service than to continue to hire a private contractor.

If the city began its own service, it would cost taxpayers at least $364,000 a year, a city analysis shows.

Last year, a contract for paramedic ambulance service cost the city $145,000. And now the company, headed by former Glendale Fire Chief Allan R. Stone, is offering to continue the service without that subsidy from the city.

Professional Ambulance Service Inc. of Glendale has provided emergency medical transportation for 10 years, with contracts that required the city to reimburse the firm for uncollected bills of patients and for false alarms.

Despite the firm’s offer to forgo the reimbursement, the Glendale City Council postponed until Feb. 4 any decision on awarding a new, five-year contract to Professional. The firm’s contract with the city expired Nov. 30 and has since been renewed on a month-to-month basis.

The company was the only one to bid for a city contract, which was to be routinely approved Tuesday. But Councilman John F. Day sought a delay, saying he wants more information about city-supported paramedic services.

Some council members and firefighters had said for months that the city might be able to provide its own paramedic services more economically and efficiently than a private service. The debate prompted the Fire Department to conduct a study, concluded last summer, which found that the city could improve emergency services while saving the cost of subsidies paid to a private firm.

The preliminary Fire Department report indicated that the department could cover the cost of paramedic services from the fees collected, said Capt. David Starr, a member of the research team who wrote the report.

But City Manager James Rez said the report assumed that firefighters could serve a dual role as paramedic ambulance attendants without the city hiring additional personnel.

After further analysis, Rez said, he and Fire Chief John Montenero have agreed that such a plan would not work because it would reduce the size of the firefighting force. As an example, Rez said, every available firefighter in the city was called to battle an early-morning blaze that destroyed the Glendale Elks Lodge on Sunday. He told council members that, if firefighters doubled as ambulance attendants, the city’s emergency response capacity would be severly restricted.

Alternatives in the Fire Department study also recommended that the city hire paramedic specialists. Rez said a subsequent cost analysis by the Finance Department of those alternatives indicated taxpayers would have to pay $364,000 to $470,000 annually for ambulance services.

He said the lower cost estimate is based on hiring employees not under civil service. The higher estimate is for using civil-service employees, who receive higher salaries and more retirement benefits. Rez said the estimates in the final report do not include the high capital costs of purchasing ambulances and other emergency equipment.

On the other hand, Professional Ambulance Service, the largest private paramedic firm in Southern California, said it can now offer emergency treatment and transportation without a city subsidy. Stone, its president, said the 20-year-old firm has grown large enough to operate efficiently without subsidies. “The reason we can operate for less money is that there is more business, more paramedic calls, while our fixed costs have not gone up that much,” Stone said.

He said the company, which operates a fleet of 32 ambulances and has contracts with several other cities and county areas, is responding to 29% more calls than six years ago, handling 45,000 ambulance cases a year.

Stone also said the company now receives higher Medicare payments for paramedic services. The company previously received a flat fee for all types of treatment and transportation.

An ambulance fee for an injury or illness that is not life-threatening is $101.75, and treatment requiring advanced life-support techniques is $210. The rates are set by Los Angeles County Health Services. Additional fees are charged for calls on holidays and for special services, such as administering oxygen.

Paramedics Available

Stone said about 40% of the 6,850 emergency calls in Glendale last year required paramedic skills to save lives. Although all three emergency ambulances stationed in Glendale by Professional are staffed by paramedics, patients are billed only for the level of treatment required, Stone said.

Emergency calls constitute only about 25% of the company’s business, Stone said, and the company competes with other ambulance companies for such services as transporting patients between hospitals.

Stone called the emergency contract with Glendale a “break-even operation.” He said the company is willing to absorb the cost of transporting indigent patients because “this is our hometown. We live here and work here. We have an awful lot of pride in what happens in this community and we want to render the best possible service we can.”