South Platte ditches KCFD, goes for better coverage with cheaper AMR

The Southern Platte County Ambulance District will have a new service provider effective October 1, 2012. Americal Medical Response (ARM) will take over the coverage area currently be serviced by the Kansas City Fire Department at that time. AMR's contract was approved unanimously at Wednesday evening's meeting after being previously narrowed down as the final candidate at last week's board meeting where board President Bobby Kincaid was given approval to negotiate the contract. Wednesday was the first time AMR had been named publicly as the selected service provider.

Prior to the board going into closed session Wednesday night to review the contract with a representative of AMR, Kansas City Fire Chief Smokey Dyer addressed the board. In his statement he threatened to cut a mutual aid agreement with any selected contractor should the Southern Platte County Ambulance District decide to choose another provider. In the end, it did not deter the board and sets in motion the end to a relationship which has been on unsure ground since the district's previous provider, MAST, was merged with the Fire Department in 2010. Tensions have escalated over recent months as response times have continued to deteriate with KCFD response times with the recent report indicating ambulance calls only met contract standards 42% of the time. KCFD will be issued a 90-day cancellation as outlined under their current agreement.

Under the newly approved contract with AMR, SPCAD will pay an annual amount of $437,000 for ambulance services with a medical price index adjustment each year. The $437,000 contract price with AMR compares to the price of approximately $478,000 being paid currently to KCFD. Coverage under the new contract is also scheduled to increase as the district will have the 24 hour a day ambulance dedicated to the district it already has along with another ambulance which will be on-duty during the 12-hour period which has historically had the highest call volume.

"Having the ambulance dedicated to Platte County, and not other areas outside of Platte County, will mean they are just servicing the South Platte Ambulance District," AMR Operation and Communications Manager Cam Hendry said. "We didn't submit our proposal with only one ambulance, we felt it was important to have at least one and a half to meet the response time needs we were given."

Over the next 90 days, AMR will be responsible for making arrangements so the transition is smooth.

"I've asked for an operational plan to be added as an amendment to the contract, but it takes time for them to figure how many calls are placed in a year from a certain area to determine where to locate," Bobby Kincaid said. "As far as mutual aid agreements and other issues, this is AMR's contract so they will need to iron those issues out."

Hendry did not see a reason why Dyer and KCFD would not cooperate with the transition and hoped to work together in order to ensure everything is handled professionally as it has been in the past.

"We will need to work with both the KCFD and Platte County Sheriff's office to make sure the dispatch is transitioned well," Hendry said. "We expect to work with them as we have in the past to make sure the transition is smooth."

SPCAD to consider proposals

Board members of the Southern Platte County Ambulance District will meet Wednesday evening for their regularly scheduled June meeting. They plan to consider proposals submitted in response to the board’s request for proposals (RFP) for ambulance services to the district. According to the unofficial draft of May’s board meeting minutes, bids were requested from four local service providers. They included the Northland Regional Ambulance District (NRAD), the Weston Fire Department, American Medical Response (AMR) of Independence, and Heartland Medical Center of St. Joseph. The minutes, which are scheduled to be approved as drafted at Wednesday’s meeting, indicate Board President Bobby Kincaid’s belief that AMR and Heartland Medical were the two most interested in the opportunity to provide services in southern Platte County, but as detailed in last week’s Citizen, NRAD has also submitted a bid proposal while the Weston Fire Department has decided to turn down the opportunity to bid.

The proposals will be evaluated in addition to the Kansas City Fire Department’s proposal to revise the contract for services currently in the place between the district and KCFD. Since the district’s previous service provider, MAST, was merged into the KCFD in 2010, response times have failed to meet the standards outlined in the contract. Recently SPCAD board members began to explore alternatives which would lead to the nine minute standard response time to be met a higher percentage of the time. Whether a revised contract with KCFD or contracting with a new emergency medical service provider is the answer has yet to be determined.

NRAD wants to expand south

The Southern Platte County Ambulance District (SPCAD) appears to be moving forward with its exploration of possible alternatives to improving its current ambulance service.

This became evident last week as the Board of Directors of the Northland Regional Ambulance District (NRAD) approved a proposal for ambulance service to submit to SPCAD in response to a recent SPCAD request for proposals (RFP). NRAD, which is based in Platte City, services the Camden Point, Dearborn, Smithville and Central Platte Fire Districts, and provides emergency medical services to much of northern Platte County.

“Our neighbors to the south have asked for our help and we are excited about the opportunity,” NRAD executive director Scott Roy said. “We’ve worked with them (SPCAD) in the past and provided some services to their current provider. We think we can help them. We share the same passion for great ambulance care. We know how important it is.”

While the Kansas City Fire Department is the current contract provider of ambulance services for SPCAD, poor response times have led to debate on what options are available to provide improved service. Currently, KCFD is under a five-year contract — that began on May 1, 2011 — to provide ambulance service to SPCAD. The cost is $453,165 per year. But the contract includes a cancellation clause which can terminate the contract with notice of 30 days, 90 days or 120 days.

SPCAD April meeting minutes obtained by The Citizen detail that KCFD will no longer provide the board with a monthly record of response times and has no plans on moving forward with the current contract as a performance based service despite violating language in the contract which makes it a requirement. SPCAD documents also show discussion was held concerning whether KCFD had the legal right to discontinue services leaving the district without a provider, which had previously been implied by Chief Smokey Dyer. SPCAD Board President Bob Kincaid mentioned he would explore other options and RFPs would be sent to other ambulance service providers.

When contacted by The Citizen, Kincaid declined to comment on the details of the situation or offer what other area ambulance service providers had been solicited, citing possible legal concerns. SPCAD’s next regularly-scheduled monthly meeting is June 20.

In addition to NRAD, other ambulance service providers which may have been solicited include the West Platte Fire District and Heartland Health Clinic, which operates an ambulance service in St. Joseph and is constructing a new clinic in Parkville. West Platte officials said it has not submitted a proposal. Calls to Heartland by The Citizen were not returned as of The Citizen’s Tuesday evening deadline.

Roy, who took over for retired former executive director Tom Taylor June 1, was not able to disclose the specific price included in the approved NRAD proposal, but did indicate it was higher than the one currently in place between SPCAD and KCFD. Roy said the increase was needed to meet the same standards and goals NRAD provides its current coverage area.

“The RFP proposes that we provide them with the same level of service and dedication that we provide our current district,” Roy said. “In the price, we offered to match the same response time standards and reliability that we currently provide, which would be at a higher price than they currently have.”

Roy emphasized that any contract with SPCAD would not affect service NRAD currently gives to its coverage area.

“We are a tax appointed entity, so we have to be responsible to our home base and the citizens we’re already committed to,“ Roy said. “We take that very seriously, so we couldn’t jeopardize that level of service. The proposal takes all those factors into mind, the amount reflects that. There are a lot of things we have to weigh as an organization. We have to make sure we’re not giving a service somewhere else that’s going to neglect what we’re already committed to.”
When asked why MAST, the district’s service provider prior to 2010, was able to provide a high quality service at a lower price, Roy believed it could stem from several different reasons.

“I think there was a small benefit with the economies of scale they had with resources in close proximity back then. They could maybe move ambulances in easier,” Roy said. “Changes in economic times and changes in the reimbursements from private insurance, Medicare and Medicaid can go a long ways in describing the situation.”

While the SPCAD is a smaller, more densely populated area, it shares a border with the current NRAD service area and the call volume is similar which leads them to believe they can help meet their goals in several areas.

“We would dedicate an ambulance to their popular center and make it a priority when that ambulance goes out to use our collaborative resources to fill in its place. That is what we took into account when we put together our cost estimate,” Roy said. “They run about 1,000 calls a year, we run about 1,000 calls a year, so we looked at what we already do to meet that nine minute response times. Not every call will be met in nine minutes, but we’d like for the average to be nine minutes.”

Roy also says one of NRAD’s biggest advantages comes from their dispatch being shared with the primary service answering point at the Platte County Sheriff’s department. This means the same person who dispatches the ambulance is the one who answers the 911 call and there is little time between the call be placed and an ambulance being dispatched.

“The amount of time between when the call is answered and the ambulance dispatched is a very short period of time because there is no delay, which is the case with the KCFD,” Roy said. “We’ll see a little bit of savings in time in that regard. As we know thirty seconds to a minute is a big savings. It’s more of a simple system.”
Although competing for a possible contract award, Roy says all the ambulance districts work together from time to time and the goal is the same for all of them.

“If as elected representatives, they decide to go a different way, we’ll still be their biggest supporters and still provide any assistance we can. We’ve worked with them in the past and provided some services to their current provider,” Roy said. “We have nothing but good things to say about all these providers, even the current one, SPCAD is just looking for alternatives right now. Either way, we share the same passion for great hospital care. We know how important it is.”

Heartland Medical out of St. Joe and the West Platte Fire and Ambulance District are rumored to also have submitted proposals in response to the RFP, which are likely to be considered at the next SPCAD board meeting.