City of Newburgh Ambulance Contract?

[Guest beentheredonethat]

So I heard through the grapevine an RFP went out for the City of Newburgh primary ambulance coverage....I know Mobile Life is their primary right now. Anyone hear of any other agencies gunning for the coverage??

[STAT213 332]

Anybody know the details of the RFP? A major city near me recently put out one that had payment TO the city by the ambulance service, to the tune of 300,000 bucks per year. They based this sum on the fact that the city was providing the dispatch services, MDTs and radios so the ambulance services would have to kick in money to cover those items. The year previous this was a zero dollar contract. AMR was awarded this years contract, having come closest to the dollar amount requested by the city proposal.

This is a very interesting turn of events in my mind. Anybody heard of this happening elsewhere?

[nfd2004 750]

A long that line, with the recent cutbacks to the Newburgh Fire Dept, do they respond on medical calls ? Did they respond prior to the cutbacks ?

[billy98988 107]

A long that line, with the recent cutbacks to the Newburgh Fire Dept, do they respond on medical calls ? Did they respond prior to the cutbacks ?

they respond if requested or if EMS has an extensive ETA.

i believe.

Edited February 3, 2011 by billy98988

[RNEMT26 40]

No city of newburgh FD would not respond to medical calls..PD would barely even show up unless it was ur typical psych, stabbings/shootings etc.

[Chief21 8]

Talking through the grape vine, I heard recently that the cutbacks have not ye taken place. Station 3 is still open and there have be no layoffs to date. The Guys throughout the Disrict have been working very hard to keep the guys in the houses and Station 3 Open. Chief Vatter had a great pitch for NFD to run their own EMS coverage. But was turned down after the Public meeting where MLSS (Mobile Life) pitched thier own defence. See the attached link for the most recent attempt by NFD to keep everyone working. http://www.local589.net/. Almost a $1,000,000.00. Thats right One MILLION Dollars in savings rejected by the city. What is wrong with these people.

[Guest beentheredonethat]

Talking through the grape vine, I heard recently that the cutbacks have not ye taken place. Station 3 is still open and there have be no layoffs to date. The Guys throughout the Disrict have been working very hard to keep the guys in the houses and Station 3 Open. Chief Vatter had a great pitch for NFD to run their own EMS coverage. But was turned down after the Public meeting where MLSS (Mobile Life) pitched thier own defence. See the attached link for the most recent attempt by NFD to keep everyone working. http://www.local589.net/. Almost a $1,000,000.00. Thats right One MILLION Dollars in savings rejected by the city. What is wrong with these people.

So NFD wanted to save jobs by taking over the EMS and MLSS made a pitch against it??

[helicopper 1,050]

So NFD wanted to save jobs by taking over the EMS and MLSS made a pitch against it??

I have no horse in this race so this is not personal.

How would the FD takeover of EMS save money for the city? They would have to staff ambulances in addition to the minimal fire coverage they currently provide and probably require more personnel with attendant salaries, benefits and pensions.

How many of their members are paramedics? How many of them are EMT's? How much EMS experience do they have? If they've never been doing EMS and suddenly jump into it there is a legitimate concern about the quality of care that would be received.

Given that the FD is pathetically under-staffed for fire suppression, they should be lobbying to do that better and not expand into another discipline for which they have no experience, no resources, and no money.

I hope you're not surprised that MLSS made a pitch against it. The FD proposal would cost EMS professionals their jobs and arguably, based upon provider experience, reduce the quality of care.

Does the City pay MLSS under the current EMS contract? Does anyone know how much $$ and for what number of resources? That information would help make this a more informed discussion too.

[PEMO3 523]

I have to agree with Chris on this one.

The patient base in Newburgh is either under-insured or uninsured. This leaves question to income based on call volume as an uninsured, unemployed patient is someone you are not going to recover from quickly. Add to that the additional costs of full tour equivelants and the fact that you need to have personnel to cover sick leave, comp, vacation time and RDOs, you are working with more personnel than you need to run the buses. This does not take into account that you just don't go to Avis and rent an ambulance, this is equipment and supplies that require purchasing to the tune of approximately $100K per rig not counting having any spares and preventive maintenance cost. If you take just 3 people per tour ( 1 off 2 on) and 3 tours and multiply that by apx $100k per person (salary, benefits, vacation days, sick leave and pension) you are at $1 million per unit for the first year. Any we have not even touched on insurance, gas, supervision, etc. While I would love to see NFD expand its operation I am missing how they can claim the savings unless it is a long term goal because to me the first year would be a deficit.

[Bnechis 3,961]

No city of newburgh FD would not respond to medical calls..PD would barely even show up unless it was ur typical psych, stabbings/shootings etc.

So you are saying all calls.........lol

[50-65 205]

I believe that the MLSS agreement with the city is informal and they do not get paid by the city. It is, in general, a money losing agreement. As someone already pointed out, most are under/uninsured.

My own opinion is that the previous attempt by NFD to run an EMS division was a way for them to justify jobs. They assumed in their numbers to city counsel that they would actually get paid for some of the EMS calls.

Their recent agreement with the city saved the 12 positions that were to be cut through layoffs by taking paycuts for a defined period of time. I believe 5% for 2 years.

[xfirefighter484x 234]

I find it laughable that politicians always readily look to cut other institutions, yet how many offer themselves, to give concessions such as demotions, salary cuts, or layoffs "for the better good"?

As an example, can't (and doesn't) Congress routinely vote on their own raises? Must be nice...

[helicopper 1,050]

I believe that the MLSS agreement with the city is informal and they do not get paid by the city. It is, in general, a money losing agreement. As someone already pointed out, most are under/uninsured.

My own opinion is that the previous attempt by NFD to run an EMS division was a way for them to justify jobs. They assumed in their numbers to city counsel that they would actually get paid for some of the EMS calls.

Their recent agreement with the city saved the 12 positions that were to be cut through layoffs by taking paycuts for a defined period of time. I believe 5% for 2 years.

I don't know how "informal" it is but the agreement is one of zero cost to the City (thanks to the members who clarified that for me). That makes it nearly impossible for me to believe that the city could save any money by going from a zero cost commercial service to a fire-based municipal system.

The City of Newburgh would also have to apply for a Certificate of Need (CON) through the Department of Health and that would be certainly opposed by all the services who can operate in Orange County, most notably the current service provider.

[dashield 61]

I believe that the MLSS agreement with the city is informal and they do not get paid by the city. It is, in general, a money losing agreement. As someone already pointed out, most are under/uninsured.

I personally find it hard to believe that MLSS does not make any money in Newburgh. Lets be honest, MLSS is a privately owned BUSINESS. What business would stay in a market in which they don't make anything to cover their cost to operate. I am sure they cover there operational costs through medicare/medicaid.

Edited February 4, 2011 by dashield

[INIT915 1,119]

I personally find it hard to believe that MLSS does not make any money in Newburgh. Lets be honest, MLSS is a privately owned BUSINESS. What business would stay in a market in which they don't make anything to cover their cost to operate. I am sure they cover there operational costs through medicare/medicaid.

Not that unusual actually. There are some tangible benefits that are positive cash flow by participating in agreements like this.

[helicopper 1,050]

I personally find it hard to believe that MLSS does not make any money in Newburgh. Lets be honest, MLSS is a privately owned BUSINESS. What business would stay in a market in which they don't make anything to cover their cost to operate. I am sure they cover there operational costs through medicare/medicaid.

Nobody said that MLSS doesn't make money in Newburgh but their revenue is exclusively from billing patients for services rendered and hoping to collect from insurance companies/Medicaid/Medicare etc.

The City does not fund the program with funds from the tax levy.

This means that MLSS eats stand-by calls, unfounded responses, etc. where no patient is transported.

[Bnechis 3,961]

The City of Newburgh would also have to apply for a Certificate of Need (CON) through the Department of Health and that would be certainly opposed by all the services who can operate in Orange County, most notably the current service provider.

As a municipality the law allows them to apply for a Municipal CON for 1 year (I think its 1) which DOH must issue. This is done without comment from any other providers. After one year they have to apply for a permenent CON. To do that they must prove to the REMSCO that there is a need for an additional service. If they handled calls all year, then there is a need and its generally a done deal.

[WAS967 97]

Barry beat me to it. So what he said.

Also classically, ambulance providers don't hold 911 contracts to make money off the 911 side, they make money off the transports out of the facilities in the 911 catchment area (nursing facilities, hospitals, etc). Any money made off the emergencies is usually a bonus.

Link to RFP: http://www.cityofnewburgh-ny.gov/hom/docs/RFPforEmergencyGroundAmbulanceServices.pdf

Edited February 5, 2011 by WAS967

[helicopper 1,050]

As a municipality the law allows them to apply for a Municipal CON for 1 year (I think its 1) which DOH must issue. This is done without comment from any other providers. After one year they have to apply for a permenent CON. To do that they must prove to the REMSCO that there is a need for an additional service. If they handled calls all year, then there is a need and its generally a done deal.

I respectfully disagree. After the one year (or two year) CON that is automatically issued to a municipality, if the CON is contested by other certificate holders during the CON hearing, they will have to demonstrate that there is a need that is currently unfilled. I believe that MLSS would have a pretty persuasive argument in this regard.

This just happened in Utica and the FD was denied their CON by the regional council and they lost their appeal to the State Council. It went on for a couple of years and cost thousands of dollars to appeal.

So their handling of the work is not an automatic "pass" in the CON process.

[gpeifer 89]

I personally find it hard to believe that MLSS does not make any money in Newburgh. Lets be honest, MLSS is a privately owned BUSINESS. What business would stay in a market in which they don't make anything to cover their cost to operate. I am sure they cover there operational costs through medicare/medicaid.

I am sure it is NOT the 911 business that is making them money, but the private inter-facility work keeping them in business. Private ambulance services are struggling just to stay afloat. Medicare has changed the reimbursement rates, have set limits on payments, will not pay the ambulance service if they feel it was not medically necessary, but the ambulance had to answer the 911 call. Third party insurance companies are now looking to streamline and match Medicares low rates. Individuals paying the balance or any part of the bill??? LOL Salaries and cost of doing business have been steadily increasing. The days of an ambulance service being a cash cow are over.

Good luck to those still in business. Communities should develop a contingency plan for the day when their ambulance provider shutters their door without warning.

[WAS967 97]

Good luck to those still in business. Communities should develop a contingency plan for the day when their ambulance provider shutters their door without warning.

Reminds me of CMTi.

[orangEMT246 6]

Salaries and cost of doing business have been steadily increasing.

Which companies have salaries increasing? My two jobs, one in NJ, and the other in the Hudson Valley area have not had a pay increase in the past three years. The cost of my benefits went up though. At least they aren't laying off. That is something to be thankful for.

[orangEMT246 6]

I just read the RFP. Is it me, or is there a lot of penalties included in it? ie.. A response time over 3:59, a fee, ALS ambulance on every call or a fee, 0 level staffing over 8 minutes, a fee, etc... Is this a typical RFP, or is the city looking to make a little money out of this? MLSS has been covering the city for a long time now and must have been doing something right. Is the city changing the terms, or is this how it always have been?

[Medicone 14]

City of Utica v. DOH is going to make some great case law; however, the ability of a municipality to secure a permanent operating authority still largely depends on the REMSCO. Unfortunately, the REMSCOs and SEMSCO are still dominated by employees, managers and stockholders of commercial ambulances entities. In the event that conflicts of interest are not disclosed and a municipal CON is denied; it is appealed to the SEMSCO which comprises many members of UNYAN (United New York Ambulance Network, lobby group funded by the majority of commercial ambulance services including MLSS) making an impartial appeal very difficult.

Either way, arguments could be made for both sides. It is debatable how fair/practical it is to have a municipality essentially instantaneously declare Public Need and operate, pushing out a commercial provider who depends on those calls to sustain a larger operation. However, it certainly is not fair to have your competitors sitting on the REMSCOs and SEMSCO determine whether or not your municipality or organization should be granted a license.

With that being said there are many Fire Departments in upstate New York who have successfully obtained municipal CONs and have secured permanent operating authority (as well as seen a significant amount of profit to help offset department budgets).

With respect to the profitability of a specific municipal contract, while the specific call volume within the municipality may not yield a profit if the municipality is to run a standalone service; if a large commercial provider provides the service and adds it to their system status, the call volume may actually yield a profit for them by increasing their calls/unit.

However, many smaller municipalities are forming consolidated EMS districts/programs that are extremely successful. The call volume and resources are shared rather than duplicated and there is a level of accountability that is not commonly found when contracting with commercial EMS entities.

Just some thoughts,

M1

[v85 212]

Just heard Newburgh FD dispatch an engine to a BLS medical call. Is this something new?

[billy98988 107]

Just heard Newburgh FD dispatch an engine to a BLS medical call. Is this something new?

no.

they run medical if requested by Mobile Life.

usually when MLSS is responding from a distance.

[x1243 141]

I know this RFP went out awhile ago but why is the City posting it again? Is the City putting a new FP out?

http://www.midhudsonnews.com/News/2011/March/21/Nbrg_amb-21Mar11.html

Edited March 21, 2011 by x1243

[201/65 94]

I heard the city had to change some of the RFP due to it possibly being illegal to ask of certain things. They edited the original RFP atleast 3 times already.

www.cityofnewburgh-ny.gov/hom/docs/AddendumNo.1dated1.27.11.pdf

www.cityofnewburgh-ny.gov/hom/docs/AddendumNo.2datedFebruary72011.pdf

www.cityofnewburgh-ny.gov/hom/docs/AddendumNo.3datedFebruary102011.pdf

[ndpemt519 10]

On Monday night the Newburgh City Council unanimously (by a 5-0 vote) approved a multiple-year deal continuing Mobile Life as the designated EMS provider.

[x1243 141]

I wonder if Mobile Life and the City went with the original RFP?

That was a pretty tough and costly RFP to meet. Does anyone know the stipulations of the contract?

Edited March 29, 2011 by x1243