EMSA, contractor dispute reason for service delays

Ambulance response times for the most serious emergencies are below minimum standards and getting worse in Oklahoma City.

That is the assessment of Jim Winham, president of the Emergency Medical Services Authority, in a scathing letter to executives of American Medical Response ( AMR), the contractor responsible for day- to- day ambulance operations in the city.

Winham wrote on Sept. 22 that "AMR hit a surprising low" in August, arriving in a timely way at Priority 1 calls only 76% of the time, despite promises to meet response time requirements and maintain staffing.

The letter says AMR shredded field reports needed for billing purposes and allowed at least one unlicensed person to staff EMSA ambulances. AMR provides the system's emergency medical technicians and paramedics.

"Having personnel providing services within the EMSA system who do not meet state licensing or certification requirements is a clear violation of federal law," Winham's letter says.

In all, EMSA cites six instances in which it says AMR is in default of its contract.

EMSA and AMR are in federal court in Tulsa over $ 16 million in excess profits EMSA claims AMR owes under terms of a 10% profit cap.

AMR questions the legality of the profit cap; EMSA has withheld $16 million in payments to AMR.

The lawsuit and default declaration have moved the two sides closer to a split.

AMR threatened last month to terminate the contract, originally signed in 2013 and renewed for five years in 2018, by Jan. 31.

EMSA's board chairman acknowledged Thursday that planning has begun to take over day- to- day operations.

A public trust, EMSA says it serves about 1.1 million residents in the Oklahoma City and Tulsa areas.

Tom Wagner, an AMR group president, said in a written statement Thursday that AMR's staffing "was stressed to the limit by the COVID-19 pandemic as well as National Guard call-ups of emergency personnel."

Response times did fall below the normal performance levels set in the contract "in some cases," he said, "and for serious COVID-related extenuating circumstances."

"The contract exempts performance during disasters such as the COVID- 19 disaster," Wagner said. "Prior to the impact of the national health crisis, AMR met the emergency response time requirements in Oklahoma City and Tulsa more than 97% of the time."

In his letter, Winham says AMR "has demonstrated a declining pattern of nonperformance with regard to response time compliance" in the Oklahoma City area since the contract extension was agreed upon in 2018.

EMSA Board Chairman Wiley Williams said in an email Wednesday, after the board met for an hour in private to discuss the lawsuit, that patient safety "is the predominant reason for sending the letter of default."

"Rather than remedy the areas of concern, AMR has instead offered excuses and has provided notice that it desires to terminate its association with EMSA," he said.

EMSA has said the profit cap is intended to return excess profits to the ambulance system.

"It is not as if AMR is losing money on this contract," Williams said in a second email Thursday. "AMR just wants more."