AMR begins service in Valencia County


By now Valencia County residents have probably noticed the new ambulances on the streets.

Julia M. Dendinger-News-Bulletin photo: Stephen Siebert, left, an EMT for two years, and Bruce Bowlin, right, a paramedic for 15 years, man one of the American Medical Response ambulances now stationed in Valencia County. Last Wednesday, the Public Regulations Commission granted AMR a 90-day temporary authority to operate in the county.

As of late last week, American Medical Response, the largest emergency transport company in the country, had three units in the county, ready to transport patients north to Albuquerque hospitals.

Valencia County Fire Chief Steven Gonzales said the Public Regulations Commission granted the company a 90-day temporary authority last Wednesday to operate within in the county. Gonzales, as well as staff from AMR and Living Cross, the current ambulance transport company operating here, testified before the PRC.

The new company will have a unit staged in Los Lunas, one in Belen and a third in what Gonzales called a “roaming status.” The chief said when one unit is in Albuquerque dropping off a patient, AMR would send a replacement ambulance south from its location there.

The two ambulance companies will be dispatched on a rotation basis through the Valencia Regional Emergency Communication Center, Gonzales said.

“Who is called out will also depend on where the units are in the county, who is closer to the call,” Gonzales said. “So far, the rotation system is working. They are sticking to their rotations and areas of response and communicating well with dispatch.”

He added that he had received positive feedback on the rotation call out protocol from county emergency services volunteers.

Nicholas Moya, the division chief for county EMS, said having the additional transport agency in the county would be a “tremendous help. The bottom line is, as time goes on, our population increases and so do the calls.”

Moya said the department was running into the problem of having county rescue units initiate transports north, when Living Cross units were up in Albuquerque.

“That’s not what we’re supposed to do. We are first responders, get to the scene, stabilize the patient, gather information, and then when the transport unit gets there, give them the information and send the patient with them,” Moya said. “We saw our on-scene time increasing because we had to wait. And we saw our units initiating transports on a regular basis.”

Last year, between the county and all the local municipalities, there were 9,781 medical calls for service in Valencia County. Moya said the department started tracking instances where a county rescue unit initiated north-bound travel in April 2011.

In those 10 months, he there were 18 instances of a county rescue unit heading north, either going all the way to Albuquerque or meeting Living Cross for a transfer.

“We saw a drastic increase last year — it jumped up to 59,” Moya said. “The bottom line is patient care; making sure patients get a timely response from an ambulance.”

AMR isn’t under contract for services with the county or any municipality, Gonzales said.

“The state gave them temporary authority for Valencia County. Generally, within the 90 days, the PRC will schedule a hearing to determine whether a permanent authority will be granted,” the chief said.

“And the biggest thing I want to emphasis to the public is we are not trying to put Living Cross out of business or push them out. We had the need.

“The additional service ensures patients will reach definitive care in a timely manner. That is the only reason we wanted a second service in Valencia County.”

John Valentine, the AMR general manager for the company’s New Mexico and Arizona operations, said the decision to request transport authority in Valencia County was partially based on stories he heard from AMR Albuquerque employees — employees who also work with Living Cross.

“We heard some interesting stories on how things were going down here, so we reached out to the Valencia County fire chief,” Valentine said. “AMR, as well as the PRC, feel there was a need down here.”

In order to be granted the temporary authority, Valentine said the company had to prove there was an “emergent and imminent” need for services in the county.

“In the next 90 days prove that there is a continued emergent need for additional service,” he said.

The case will go back to a hearing officer who will make a recommendation to the PRC. Valentine said the company will continue to gather information and data similar to what was originally presented to the PRC for the temporary authority — number of trips, services provided, scene times and unit availability.

“Given all that, we think there is a huge need for additional services,” he said. “The county is having to transport patients and rendezvous with the Living Cross on the highway.”

Valentine said AMR has submitted a draft standard operating guidelines to Living Cross and the dispatch center. He said the ambulance company has indicated it is in favor of the SOG and is awaiting word from VRECC.

He also said the rotation call system was working well between the two companies.

With 33 years experience as a paramedic, Valentine said he has a sense of the challenges are facing Valencia County emergency medical services.

“We are going to face a lot of the same challenges that Living Cross has been looking at for years — no local hospital, a lengthy transport, frequent long drop off times,” he said “One thing we have available to us that they may not is our Albuquerque operation.

“We can use them to back fill the market down here. I don’t think that is something that is currently available to the current provider.”

Valentine said AMR also has openings for certified emergency medical personnel of all levels on both a full-time and part-time basis.

“I would encourage all the folks down there to come over and apply,” he said. “Over the last 10, 15 years, we have seen a decline in volunteer and paid staff. The training requirements have come up and it’s hard to get people to do that for next to nothing and with a lot of committed time.

“This is a big county. We are in the midst of contracting with dispatch to do our dispatching. All our trucks are GPS equipped, so it will be very easy to give the center information to track them in live time. That way, when they are dispatching, it’s very easy to look and see what the closest unit is on a CAD screen.”

Joe Earnest, the attorney who represents Living Cross and argued the company’s case in front of the PRC last week, said it was the company’s position that AMR coming into the county doesn’t fix anything in regards to ambulance service, which is problematic because of the lack of a county hospital.

“We have over two hour round trips that take ambulances out of county,” Earnest said. “Living Cross has been losing money, so it is hard to economically justify more ambulances. It is a problem when all ambulances are out of the county.”

Earnest said he was not aware of what operating procedures had been implemented for the two companies as far as dispatch was concerned.

The attorney said he did present the issue to the PRC, that as a matter of economy, Living Cross would have to reduce its number of ambulances if someone else came into the county.

Earnest said as of the hearing Wednesday, the company had three 24-hour units and one 12-hour unit.

“We are already with losing money. The ambulances going to Los Lunas are the most profitable. Our certificate is for the entire county and the PRC requires us to position our ambulances where we can serve the entire county, which is not profitable,” Earnest said. “They (the PRC) let them (AMR) put theirs in Los Lunas.”

As a matter of legal opinion, Earnest said Living Cross opposed AMR’s application for transport authority because, “If they bring in more ambulances, it simply forces us, in the long run, to reduce the number of ambulances. The long-term fix here in the county is to either build a hospital or subsidize the ambulance service so we won’t lose money on it.

“Everyone recognizes it’s not the best situation when all the ambulances are out of the county and we have long response times. Just letting in another company doesn’t necessarily fix that.”

AMR, founded in 1992, is based in Greenwood Village, Colo. According to its website, the company employees 16,458 people in 40 states and the District of Columbia, and serves 2,100 communities.

Valencia County won’t be AMR’s first presence in the state. It operates the AMR Dona Ana County service, providing emergency and non-emergency medical transport for Dona Ana County and the city of Las Cruces.

The Dona Ana operation was founded in 2007, and employs about 100 paramedics and EMTs and handles an average of 23,000 calls annually, according to the company’s website.

AMR Otero County provides transport services to the city of Alamogordo, Holloman Air Force Base, the Sacramento Mountains and Otero County. The service was founded in 1993, employs about 28 paramedics and EMTs and handles 6,000 calls per year on average, the site says.

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