Editor's note: This is the first of a two-part series on ambulance service in the Quad Cities. To read the second part, click here.
Tensions are building within the Quad Cities community over ongoing concerns regarding Life Line Ambulance’s management and response times.
Owned by Colorado-based American Medical Response (AMR), Life Line is the only ambulance company serving the Quad Cities.
In August 2017, Central Arizona Fire and Medical Authority (CAFMA) began filing complaints with the Arizona Department of Health Services, the regulatory body for all ambulance services in the state, whenever Life Line had an “extended response time,” which CAFMA defines as more than 30 minutes after fire crews have been dispatched to an emergency medical call.
“We just filed a formal complaint for a 53-minute response time,” said CAFMA Fire Chief Scott Freitag. “Some of that has curved, but if we were to bump that to 20 minutes, we would be filing a lot more complaints.”
In such instances, if there is a patient on scene that either requires or requests transportation to a hospital, CAFMA personnel have to wait with the patient until an ambulance arrives.
“We can’t legally leave the scene,” said Doug Niemynsky, CAFMA’s emergency medical services captain. “We have to turn it over to at least an equal level of care, or higher.”
Not only does this translate to a waste of fire personnel’s time, but it also can impact a patient’s outcome.
Prescott Fire Department (PFD) saw this recently when a patient’s condition significantly worsened because an ambulance didn’t arrive in a reasonable amount of time to transport the patient to a hospital.
“We experienced an untoward event in the last month because of an extended response time,” said PFD Fire Chief Dennis Light.
Light didn’t wish to share the current condition of the patient, but the fire chief has filed a complaint against Life Line because of the incident. He added that PFD looked at some metrics recently and found that about 85 percent of the time in the past year, fire units showed up well in advance of the ambulance service.
Glenn Kasprzyk, Chief Operating Officer for AMR’s northern Arizona region, said he understands the concerns, but Life Line has maintained compliance with its state-mandated response time requirements for the 30-plus years it has provided ambulance services to the quad-city area.
“We all want to be to the scene of a critical call as fast as we can, but, unfortunately, from time to time, you get a car accident, a number of resources get deployed to one incident; the system has stress factors,” Kasprzyk said.
He also noted that Life Line prioritizes its calls a little differently than the fire departments do.
“Non-emergency calls obviously are handled secondary to emergency calls where a life may be at risk,” Kasprzyk said. “Because those are calls where time is an important factor, but the issue is not life threatening, that can add to response times.”
Light recognizes this difference in operation, and feels it sometimes is at the expense of the patients and the other first responders who have to respond to every call in a timely manner.
“I respect that [Life Line] is a business, but the business philosophy and being for-profit is counterintuitive to some of the public safety needs to care for patients,” Light said. “What I mean by that is [Life Line] can very often make unilateral decisions without any consultation with the other first responders that really support their operation by providing the necessary hands to conduct emergency medical services.”
AN EMPLOYEE SPEAKS OUT
Local fire departments are not the only ones taking issue with how Life Line is being managed.
An employee with Life Line recently reached out to The Daily Courier to share concerns with how the company’s operations are trending.
“We’re always short on ambulances,” the anonymous employee said. “Ever since AMR came in about six years ago, they’ve been downsizing our operation, which is the opposite of what we need in the Prescott area. It’s upsetting to a lot of people here within the operation, especially the field personnel.”
AMR stated there has been no reduction in the number of unit hours or ambulances in the Quad Cities area.
Kasprzyk did acknowledge, however, that employee retention is a challenge for ambulance services industry wide, and that Life Line is no exception.
“We do have a fair amount of turn over, but we do have a pool of people coming in,” Kasprzyk said.
He said the revolving door is primarily a symptom of the occupation. Paramedics and emergency medical technicians (EMTs) are usually looking to work for an ambulance company to gain the initial medical experience and then move on to higher-paying positions within the medical field, such as nurses, he said.
The other challenge for the industry is the changing wage structure as minimum wage increases in Arizona and many other states.
“There’s a lot more competition at the minimum wage-plus level, so, generally, the industry and public safety is seeing a decline in overall interest,” Kasprzyk said. “The same challenges exist in private ambulance as they do in public ambulance. If you look around the state, most every ambulance company is always hiring EMTs and paramedics just because people are constantly working toward a higher level of education.”