How fast is help coming? AMR paying big fines for late responses

13WHAM's Tanner Jubenville investigates emergency response times in the Rochester area and concerns that some EMS workers have about being able to do their jobs. (WHAM photo)

Rochester, N.Y. (13WHAM) - It's a situation no one wants to be in: Calling for an ambulance to help in an emergency.

When you do call, you want the ambulance to be there as quickly as possible.

Data obtained from the City of Rochester shows the city's ambulance provider, American Medical Response (AMR) has paid out more than $1.3 million in fines over the last two years over delayed response times.

Last year, AMR was fined $786,050 - up from $517,300 in 2016.

First responders say there's a variety of reasons for the big fines, including call volume and AMR's contract structure with the city.

"I do not think that either the city or Monroe County are operating at peak efficiency. I think there's always area for improvement," said Battalion Chief Joseph Luna, who oversees EMS operations for the Rochester Fire Department, which often assists AMR to calls.

Luna says AMR was called on 72,000 by patients in 2017, an increase of about 11,000 since 2012, the same year AMR's contract with the city was written.

Data does show AMR's response time is adequate on about 90 percent of calls.

"The reality is, the contract has to adjust to the way healthcare and emergency medical services have adjusted over the few years," said Luna.

According to data, AMR was late to 3,540 priority one and two calls in 2017. Those calls are considered more serious, like suspected heart attacks or strokes. Per the contract with the city, AMR is required to respond to these calls in 8:59 or less.

Each late call to priority one and two calls means a $100 fine for AMR.

"While the fine amounts can look large, I have to go back to the (amount of calls), if you look at the fact they very often meet their time expectations based on the priority of calls, it’s a very small subset," said Luna.

The delayed responses on these calls ranged from a few seconds to several minutes.

"That time can be affected by weather, by road construction, by a number of things. We still expect them to make that time, and that's not going to change," said Luna.

Monroe County Medical Director Dr. Jeremy Cushman agrees, but thinks there's more to the problem.

Dr. Cushman cites not only increased call volume, but also a decline in paramedic and EMT numbers, and falling revenues as other reasons why patients might have wait longer for help.

"You really have this perfect storm of increasing demand, a stagnant workforce, and decreasing revenue," said Dr. Cushman.

Another problem facing first responders around Monroe County is that New York State is a 'certificate of need' state. That means ambulance agencies are only allowed to operate in strict geographical areas, potentially hindering response times.

"That doesn't make a lot of sense when we're trying to be responsive to what our patients' needs are, throughout the county," said Dr. Cushman.

Dr. Cushman and other EMS officials in Monroe County say there's still plenty of crews to service the patients here. But they say ambulance agency heads and other EMS officials from around the area are meeting once a month, trying to figure out to work better with each other, and get to more patients in less time.

Problems facing AMR are also facing other agencies around the county. According to the Rochester Fire Department, AMR assisted other agencies around Monroe County 889 times last year. Mutual aid also went the other way, with other agencies covering for AMR 564 times in 2017.

AMR told 13WHAM in a statement, "AMR has a longstanding positive relationship with the City and commitment to the citizens and visitors of Rochester. Our duty to continuous improvement in quality of service, employment of City residents and investment in new equipment, vehicles and technology, makes Rochester a safer and healthier community. We work closely with the city and other regional partners to provide high-quality, responsive emergency medical services."

According to the mayor's office, fines paid by AMR go to the city's general fund, and helps offset some costs for EMS response provided by the Rochester Fire Department.

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