Category Archives: Emergency.Services

The Problem of Private Ambulance Services

Source: David Anderson, Current Affairs, August 13, 2018

Nationwide, there is one massive monopoly, American Medical Response, which is kind of like the McDonald’s of EMS, since they have branches all over that are fairly decentralized but still linked to the same capital distribution system. … The private ownership model for ambulances is fundamentally at odds with its own purpose. In the beginning they were useful insofar as they were an ad-hoc option in a society that gave no thought to whether or not speed was important in treating an illness or injury. However, this jumble of organizations across the nation creates big problems beyond figuring out billing logs. A key problem is the cost of doing business. A single ambulance can cost somewhere in the $500,000 to $1 million range, so any ambulance company’s first priority is to reduce overhead as much as possible. … They want to get the cheapest gear, the cheapest ambulances, and the cheapest workers. You will see EMS personnel make fast-food level wages, for what is ostensibly an extremely important job.

… For all the cost-cutting and neglect, you might at least expect ambulance services to be affordable. Yet as anyone who has taken one knows, consumers pay fat stacks of cash to keep this system running. … The usual justifications for free markets fail completely when it comes to ambulances, since there’s no practical way for “consumer choice” to improve services. When you’re bleeding to death, it’s hard to comparison shop—not that you’re even offered a choice. … Given the poor employment conditions, EMT culture should be fertile territory for left organizing. Unfortunately, the poor pay of EMTs has often been used as an argument against the improvement of other workers’ lives. … Capitalism struggles to fit emergency services into its overall structure. .. Good emergency medical services are going to be expensive and unprofitable. …

DeKalb ambulance provider will pay for poor service, county says

Source: Joshua Sharpe, The Atlanta Journal-Constitution, August 7, 2018

DeKalb commissioners on Tuesday voted unanimously to approve a settlement with the county’s ambulance provider after a long history of complaints. Under the agreement, American Medical Response will resolve $1.9 million in contract penalties for allegedly providing poor service — though only $600,000 will be paid in cash. The company, which has been subject to complaints of slow response time such as one in Dunwoody that took 58 minutes, previously declined to settle the fees but agreed to increase performance. Tuesday’s agreement gives $1.3 million credit to AMR for boosting staffing and adding ambulances at two DeKalb fire stations, one in Dunwoody, the other in Stonecrest. …

‘First of many’: Lawsuit filed against state contractor blamed for Eastpoint wildfire

Source: Jeffrey Schweers, Tallahassee Democrat, July 12, 2018

This week marked the first claim filed in Leon County against the Tallahassee contractor responsible for setting the prescribed burn that’s been identified as the cause of the 820-acre Limerock wildfire that destroyed 36 homes in Eastpoint. … The Vinson/Cooper/Hattaway complaint alleges that Wildlands was engaged in an “ultra-hazardous activity while engaging in a controlled burn” and is strictly liable for all damages caused by the wildfire. The company knew of the foreseeable risk, the complaint said, and “could have reasonably taken precautions to eliminate the risks of the controlled burn.” …

… Wildlands was contracted by the Florida Fish and Wildlife Conservation Commission to burn a 480-acre area within the Apalachicola River Wildlife and Environmental Area to clear it of hazardous underbrush that can become fuel in a fire. The burn was ignited June 18 and extinguished six hours later. The next day, the burn boss said the burn went well and submitted an invoice for $26,400 to the FWC. The fire reignited June 24 and crossed over 600 acres of private land, razing several dozen properties a quarter-mile away on Buck Road, Ridge Road and Wilderness Road, leaving about 125 people homeless. A preliminary report by investigators with the law enforcement branch of the Department of Agriculture and Consumer Services said the prescribed burn caused the wildfire, ruling out arson and lightning. …

Ambulance cuts pave way for new ride providers in skilled nursing

Source: Kimberly Marselas, McKnight’s Long-Term Care News, April 19, 2018

With mounting financial pressure driving some private ambulance companies out of business, more ride-hailing operators are stepping into the vacuum and providing non-emergency transportation to and from nursing homes. A convergence of private and alternative services has arisen as ambulance operators brace for a 13% cut to one of their bread-and-butter services: non-emergency dialysis transport. Some services have already stopped providing those type of rides to beneficiaries in advance of an Oct. 1 Medicare rate cut. …

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Ford launches on-demand medical transportation service
Source: Megan Rose Dickey, TechCrunch, April 18, 2018

Ford is launching an on-demand transportation service for non-emergency medical needs. The idea is to better help patients get to their doctor appointments. Ford is initially launching this in partnership with Beaumont Health in Michigan to serve more than 200 facilities. Called GoRide, the fleet has 15 transit vans to accommodate people with varying needs. By the end of the year, Ford plans to have 60 vans, all driven by trained professionals, as part of GoRide’s services. The GoRide fleet can accommodate people with wheelchairs, thanks to flexible seats that can flip up and a wheelchair lift. …

… In March, Lyft committed to cut the problem of healthcare transportation in half by 2020. Lyft provides API access to partners like Allscripts, Blue Cross Blue Shield and Ascension to integrate the ride-hailing service into its health platforms and electronic health records services. Meanwhile, people seem to be moving toward on-demand platforms for trips to the emergency room, as well. Last December, a study reported ambulance use has gone down about 7 percent nationwide since the rise of Uber. Though, neither Uber or Lyft are particularly accessible to people with mobility disabilities. In March, Disability Rights Advocates, on behalf of the Independent Living Resource Center and two people who use wheelchairs, filed a class-action lawsuit today against Lyft. The plaintiffs allege the ride-hailing company discriminates against people who use wheelchairs by not making available wheelchair-accessible cars in the San Francisco Bay Area. Uber also faces a number of lawsuits pertaining to the lack of services it offers to people with mobility disabilities. …

FTC ‘Misconduct’ Charges Loom as Uber Health Service Launches
Source: Fred Donovan, Health IT Security, April 16, 2018

Uber is being hit with additional federal penalties for “misconduct” in not reporting a major 2016 data breach at a time when it is launching its Uber Health service, which the ride-sharing company pledges will be HIPAA compliant. The Federal Trade Commission (FTC) announced April 12 that Uber had agreed to expand a proposed settlement it reached last year over charges that it deceived consumers about its privacy and data security practices. The FTC said it was expanding the settlement scope because it learned after the initial settlement that Uber had not disclosed a significant data breach that occurred in 2016 while the agency was investigating the company about the consumer deception charges. … Still, healthcare partners of Uber Health might be concerned about the FTC’s allegations that the parent company deceived consumers about its privacy and data security practices and failed to disclose a major data breach at a time when it was under federal investigation.

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Paramedics Plus, Oklahoma agency settle federal kickback lawsuit

Source: Erin Mansfield, Tyler Morning Telegraph, April 3, 2018

A company with ties to the former East Texas Medical Center has settled a federal kickback lawsuit. Paramedics Plus was a subsidiary of the East Texas Medical Center health system that provided emergency medical services to an Oklahoma agency called Emergency Medical Services Authority. In January 2017, the Department of Justice filed suit against Paramedics Plus and the other defendants in the case alleging that Paramedics Plus paid more than $20 million in kickbacks to the Oklahoma agency.

… In March 2017, the East Texas Medical Center health system announced it would merge Paramedics Plus with a similar subsidiary and spin off the two emergency medical services entities into a new company. A month ago, the East Texas Medical Center health system completed a deal to sell its assets to Ardent Health Services, based in Tennessee, and the University of Texas system. The new entity is now called UT Health East Texas. Three weeks later, UT Health East Texas announced it would lay off about 400 employees, or 5 percent of its workforce, as part of a plan to bring the new health care system toward financial stability. …

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Justice Department moves forward in its case against ETMC, Paramedics Plus
Source: Roy Maynard, Tyler Morning Telegraph, May 12, 2017

The U.S. Department of Justice continues to build its case against East Texas Medical Center and its ambulance division, Paramedics Plus, in what they say is a $20 million kickback scheme to ensure Paramedics Plus retained lucrative contracts. Most recently, Justice Department attorneys filed a list of people they expect to depose in coming months. In all, more than 100 people could be deposed as this case moves forward. The government also filed a proposed schedule, which outlines when fact discovery will take place, when expert discovery will occur, deadlines for motions and trial preparation and finally, an expected timeframe for the start of the trial – summer of 2018. … In January, the Justice Department announced it would intervene in a lawsuit against ETMC and Paramedics Plus brought by a whistleblower – former employee Stephen Dean, who was Paramedics Plus chief operating officer. According to the suit, ETMC and Paramedics Plus paid more than $20 million in kickbacks and bribes, including cash payments to Oklahoma officials. …

You Paid For It: Pinellas Commissioners discuss ambulance kickback settlement Tuesday
Source: Mark Douglas, March 21, 2017

Former U.S Attorney Brian Albritton told Pinellas County Commissioners Tuesday that a federal lawsuit alleging ambulance fee kickbacks could have cost taxpayers as much as $1 billion if they lost in court. Commissioners agreed to settle the case involving Paramedics Plus Sunstar ambulance service for $92,700 and to forgo an estimated $500,000 in uncollected ambulance fees from patients. They will also have to pay legal fees to Albritton who the county secretly hired last year to resolve the case. Pinellas commissioners discussed the case publicly Tuesday for the first time since Eight On Your Side first broke the story of alleged kickbacks and a federal investigation of Pinellas County’s ambulance contract last month. That settlement, signed March 7 by Vice-Chair Kenneth Welch, requires the county to pay $92,700 to federal prosecutors, the Florida Attorney General and attorneys for the whistleblower–a former executive with Paramedics Plus. It also requires Pinellas County to turn over all documents and evidence gathered in the course of the county’s own internal investigation, and to cooperate with an ongoing federal investigation and whistleblower action filed against Paramedics Plus in Texas.

… Since 2004, Paramedics Plus has operated as Pinellas County’s exclusive ambulance provider under the county-owned brand name Sunstar. The current county contract with Paramedics Plus amounts to about $50 million a year. In 2014, a former high-ranking executive of Paramedics Plus filed a whistleblower action in Texas that alleged an ongoing ambulance fee kickback scheme that stretched from Pinellas County to Oklahoma and California for over a decade. The scheme alleged by the whistleblower and federal prosecutors in a related legal action included so-called “profit cap” rebates that essentially funneled overcharges from Medicaid and Medicare to Pinellas County and other local governments that oversee public ambulance contracts. County leaders in Pinellas insist the “rebates” or “kickbacks’ in Pinellas totaled only $35,000 or so and ended up in county bank accounts, not someone’s pockets. In Oklahoma, the whistleblower suit alleges those kickbacks amounted to as much as $20 million. Federal prosecutors in Texas have cited specific acts of corruption in Oklahoma that include kickbacks, political payoffs and self-enrichment involving Paramedics Plus executives and government overseers in Oklahoma. … Pinellas County Administrator Mark Woodard says the settlement has no impact on the county’s ongoing $50 million a year contract with Paramedics Plus because the company has not been charged criminally or been found guilty of anything.

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Settlement Concluded Between OSHA and Altamont Ambulance

Source: Greg Sapp, 979 XFM, January 19, 2018

A settlement has been finalized between the US Occupational Safety and Health Administration and Altamont Ambulance Service. OSHA opened investigations in January 2016, after receiving a complaint alleging violations of OSHA’s bloodborne pathogens exposure and various other health and safety standards. … Six different activities were alleged in January 2016. Two of those alleged violations by Altamont Ambulance, two by Effingham City/County Ambulance and two by Vandalia Ambulance. The current penalties total $149,000. The initial penalties totaled $379,000. Altamont Ambulance has ceased operations in Effingham County and Fayette County.

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Emergency medical service provider fails to protect employees from risks of bloodborne pathogens: OSHA proposes fines of more than $290K to Altamont Ambulance Service
Source: OSHA Regional News Release, July 7, 2016

Federal safety and health investigators found Altamont Ambulance Service Inc. failed to follow specific guidelines to protect emergency healthcare workers from exposure to bloodborne pathogens and other hazards while providing patient care. On July 6, the Department of Labor’s Occupational Safety and Health Administration issued five willful, 16 serious and three other-than-serious safety and health violations to the emergency medical service provider with proposed penalties of $290,100. The agency opened inspections in January 2016, after receiving a complaint alleging violations of OSHA’s bloodborne pathogen exposure and various other health and safety standards. …

… The agency’s Fairview Heights area office found the employer failed to:

  • Establish an exposure control plan for bloodborne pathogens and other potentially infectious material.
  • Make Hepatitis B vaccination series available to employees.
  • Train workers about chemical and bloodborne pathogen hazards and precautions.
  • Develop an emergency response plan.
  • Dispose of, clean or launder contaminated personal protection equipment.
  • Train workers in operations level emergency response.
  • Communicate decisions on the use of personal protective equipment to employees.
  • Develop a respiratory protection program to protect again infectious diseases.
  • Train workers about the use of hazardous chemicals in their work area.
  • Conduct an exposure determination for blood borne pathogens.
  • Provide injury and illness logs to inspectors within four hours.
  • Mark, keep clear and properly light emergency exits.
  • Follow electrical safe work places. Investigators found opened breaker panel boxes, extension cords used as fixed wiring, exposed light sockets.
  • Train workers in the use of fire extinguishers.

OSHA investigating Altamont Ambulance complaint
Source: Bill Grimes, Effingham Daily News, March 1, 2016

The U.S. Occupational Safety and Health Administration has opened an inspection of already-embattled Altamont Ambulance Services, Inc. The administration opened the inspection Jan. 6, according to the OSHA website. Area Director Aaron Priddy of the administration’s Fairview Heights office would not go into specifics about the probe, but he confirmed there has been a complaint filed against the service. Altamont Ambulance has been the sole emergency ambulance provider in Effingham County since 2004. In November 2014 the county sought to open the ambulance market to other providers, but that move is tied up in court. …

Family wants answers after relative dies during AMR transport

Source: Matt McFarland and Kaitlyn Naples, WFSB, January 11, 2018

A local family is demanding answers from an ambulance company. William Scanlon’s family said they have a number of questions after he died on his doorstep when he was transported home from the hospital. They say he needed oxygen to breath, but that for some reason, when an American Medical Response ambulance transported him back home Saturday morning, with temperatures hovering near zero, not only was he not hooked up to oxygen, they say the ambulance crew also made him walk. … AMR said it expects to finish up its internal investigation soon. The family said they’ve already met with a lawyer and are filing a lawsuit against the company.

Hurricane Harvey, Irma, and Maria Contract Spending Revisited

Source: Project on Government Oversight, January 8, 2018

Back in October, the Project On Government Oversight did a top-level analysis of federal government spending on Hurricane Harvey, Irma, and Maria recovery contracts, as reported by the Federal Procurement Data System (FPDS). The FPDS spreadsheets contain a wealth of data that allow the public to track billions of dollars in federal contract expenditures in precise detail: the agency awarding the money, the amount, the purpose, and the recipient. At that time, the government had spent a total of $1.65 billion on contracts. However, FPDS imposes a 90-day delay on the release of Department of Defense (DoD) data, so we were missing a big piece of the spending puzzle. Now, DoD numbers are starting to trickle in and we are getting a more complete picture of federal contracting outlays for the recovery efforts in Texas, Louisiana, Florida, Puerto Rico, and the Virgin Islands. The federal contract award total now stands at $3.3 billion: $1.2 billion for Harvey$726 million for Irma, and $1.4 billion for Maria. … Federal expenditures on Hurricane Harvey, Irma, and Maria contracts have now surpassed the $3 billion spent for Hurricane Sandy and are steadily approaching the $20 billion total for Hurricane Katrina. As the total grows, so too will the misuse of those funds. To that end, POGO plans to release a database that will track all federal spending relating to Hurricane Harvey. …

Central chooses contractor to run next five years of privatized government

Source: Andrea Gallo, The Advocate, January 9, 2018

People in Central should expect another five years of their government services coming from private contractor IBTS after the company won praise Tuesday evening from both Mayor Jr. Shelton and the Central City Council. IBTS, the Institute for Building Technology and Safety, has spent the past seven years running government services in Central, where the number of city government employees can be counted on one hand. The not-for-profit, Virginia-based company was one of two that bid for the contract to run services that other City Halls hire government employees to accomplish. IBTS offered its services starting at $3.9 million annually and working up to $4.4 million in the final year of a five-year contract. … One big change Shelton said Central wants from IBTS is to beef up emergency services. The August 2016 floods exposed a weak spot in Central’s privatized system of government — the lack of personnel and resources available on a round-the-clock basis to respond to disasters, he said. … CH2M Hill provided city services before IBTS took over.

NIFA report suggests eliminating crossing guards, closing Marine Bureau

Source: News 12 Long Island, August 31, 2017
 
A new report by the Nassau Interim Finance Authority (NIFA) suggests the county should eliminate crossing guards, privatize ambulance services and close its Marine Bureau in an effort to close a $54 million deficit.   CSEA President Jerry Larrichuita says he’s outraged by language in the report that suggests many of the proposed cuts would not have an impact on county services.  “I think they should stick to banking, which is their job, and stay out of government operations,” says Larrichuita. …