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Texas firm wins Alameda County contract to provide ambulance service here

Original post made on Apr 28, 2010

The Alameda County Board of Supervisors voted 4-0 Tuesday to replace the county's current ambulance service provider with a company from Texas.

Read the full story here Web Link posted Wednesday, April 28, 2010, 7:03 AM

Comments (40)

Posted by Carol
a resident of Livermore
on Apr 28, 2010 at 9:15 am

I sure hope Supervisor Haggerty has some recourse if Paramedics Plus DOESN'T hire the current AMR employees. We certainly DON'T need any more unemployed folks in Alameda County! I think the AMR folks are GREAT!

Posted by Pleasanton Parent
a resident of Pleasanton Meadows
on Apr 28, 2010 at 9:51 am

I'm not quite sure what the motivation behind the move was - cost or performance? The news reported that if the current provider was not meeting a 90% on time performance requirement the contract could go out for bid. I saw the fire chief was in support of the change - what his motivations are I do not know, but when the first responder is supporting the change it is a flag.

Competition is typically good - it drives efficiencies and product/service improvements.

My biggest concern (with any bidding process like this) are the hidden costs that were not detailed out - and that can potential cause a decline in service or an increase in expected cost.

Posted by Jessica
a resident of Birdland
on Apr 28, 2010 at 10:02 am

What about the EMT's that work for AMR?? They will be out of a job! Nice that the media didn't pick up on that. Paramedics Plus doesn't have EMT's so where will they go? If the cities really want to save money, there is no need for the fire department to go out on 70% of the calls they show up to.

Posted by dublinmike
a resident of Dublin
on Apr 28, 2010 at 10:11 am

dublinmike is a registered user.

AMR has a fine reputation. It must be cost cutting. Heaven only knows the quality we will get from the EMTs.

However, most likely many of the current EMTs will be hired and, if history repeats itself, at lower wages.

I will be writing Miley and Haggerty.

Posted by more_to_the_story
a resident of Another Pleasanton neighborhood
on Apr 28, 2010 at 3:39 pm

Jessica, Did we read the same article?


But Paramedics Plus chief executive Tony Myers said that he would hire locally and would retain all the paramedics who currently work for AMR, as long as they pass a drug test.

Supervisor Scott Haggerty said, "I don't want to see one of them (current AMR paramedics) unemployed."

Haggerty said he would "hold their feet to the fire" and would be "really p...ed off if I'm deceived."

Myers said, "We'll keep our promises and our commitments."

Posted by Jessica
a resident of Birdland
on Apr 28, 2010 at 4:36 pm

Yes we did. There is a difference between paramedics and EMT's: "...aid that he would hire locally and would retain all the paramedics who currently work for AMR..."

Posted by Cholo
a resident of Livermore
on Apr 28, 2010 at 5:13 pm

Ambulance Torres reporting for duty! tee hee hee, tee hee hee...

Posted by Good Luck
a resident of Livermore
on Apr 29, 2010 at 7:49 am

I am afraid that we may just see history repeat itself. Has anyone looked into the disaster that happened to the residents of Monterey? Another company won the bid process by undercutting the AMR competition. Looked good on paper, but just years later, the county had to ask AMR to come back and provide services again. The new provider ran out of money and resources to be able to continue service to it's community. In the mean time, employees were looking at losing jobs due to lay offs and not being "hired" by the new company. They were displaced as best as possible into other areas of AMR as to not be unemployed. And only because of AMR's size and national structure (money too) they were able to come back and meet the demand of the county that had just voted against them. Good luck to the employees of AMR. Good luck sleeping to the supervisors of the county if this goes bad and history repeats itself. I would hate to have that weight on my shoulders.

Posted by Joe
a resident of Downtown
on Apr 29, 2010 at 3:10 pm

Sometimes all you can do is just hang your head and pray that November gets here quickly. Ya, go ahead and write Haggerty...write em will only matter at election time.

Posted by Jeff
a resident of another community
on Apr 29, 2010 at 4:18 pm

I live in Castro Valley and I am extremely unhappy with this change. AMR has been great to our community. As the seat of the county's trauma center (Eden Hospital), we have a dozen ambulances in CV at any time. They are nice friendly people and it is always nice when you run into one at a fast food place, they stop and talk a little.

Counties are always looking to cut costs, but certainly there are better ways than this. Even if the Texas company hires all of the current AMR employees, what happens to the support companies? A friend of mine owns the business that does all of the uniform and clothing embroidery for AMR in the county. What'll happen to her business with a change of providers?

Not to speak ill of others, but firefighters always phrase every issue in the "improving service for the community" light, even when it is about protecting themselves. Firefighter salaries are usually very high with excellent pensions and maybe they are afraid that if we don't cut from somewhere else, they'll be asked to take a reduction.

In short, if it ain't broke, don't fix it.


Posted by Pleasanton Parent
a resident of Pleasanton Meadows
on Apr 30, 2010 at 9:28 am

I disagree. I think contracts should be up for review every year or two - just to keep the competition alive. One of the reasons firefighter salaries/benefits are so high is because of situations like this where there is no competition to drive efficiency and cost savings. I think, on the surface, this is a valuable activity.

Posted by Paramedic Mom
a resident of Livermore
on Apr 30, 2010 at 12:06 pm

My son just finished his 2 year AA degree in Paramedic science and would have earned $15-18/hr working for AMR. If he had wanted to become a Firefighter/Paramedic he would make upwards of $100K/year. So word among the workers is this Texas company will rehire some of the AMR crew at cheaper pay. This is what the community will get, a whole lot of unhappy workers who were already underpaid for what they do. He doesn't want to be a firefighter because he sees them as having very little to do most of the time and he wants the activity of responding and helping more people, it is a shame.

Posted by CoCoCounty
a resident of another community
on Apr 30, 2010 at 11:17 pm

Paramedics Plus has been endorsed by the union NEMSA and has agreed to keep all EMTs and Paramedics at their current salary.. AMR has not been holding up their end of the Union contract. I.E.: They are expecting employees to go entire 12 hour shifts without meal breaks.. I welcome PP with open arms and hope they make it in Alameda County..
Also! You cannot compare them with WestMed as WM was a very VERY small company with VERY limited resources.. PP has the 911 contract in many counties throughout the country and has proven they can maintain it.. Do some research before you knock PP or any other company..
Thank you County Supervisors for a much needed change!

Posted by Alcomedic
a resident of another community
on May 1, 2010 at 2:00 pm

This change can not happen fast enough. P+ and the union have agreed to not only keep the salaries the same but to also keep the current pay steps that are in place. Amr is trying to save money by barganing away these steps & Amr currently tries to save money by having the above mentioned fire departments come run those calls that they can not handle instead of staffing enough ambulances.
I am willing to bet that in the near future that we will see P+ in other neighboring counties like Santa Clara, San Mateo and maybe Contra Costa when their contract runs out. My family lives here and I truly believe that we will receive even better care by being served by a non profit company compared to that of a profit driven company.
If Amr had treated their employees a little better I bet that this would have never occurred.

Posted by SMH
a resident of another community
on May 1, 2010 at 3:28 pm

So the question never got answered. Will P+ keep AMR's EMTs rather than just the paramedics?

Posted by MyersFoe
a resident of another community
on May 1, 2010 at 3:41 pm

*Alcomedic, ETMC is a not-for-profit HOSPITAL system... P+ is a FOR- PROFIT ambulance company.
*CoCoCounty, are you really going to open the NEMSA debate?! The dues paying members DO NOT support NEMSA's endorsement.
*PleasantonParent, the Fire Departments back this change because they are being promised new toys by P+.Bribery & greed is the bottom line.

Posted by Alcomedic
a resident of another community
on May 2, 2010 at 9:12 am

The fire departments have wanted Amr out for some time. The transporting departments have wondered why the fire departments as a whole will not go after the entire county and transport themselves. If you want to look at politics then there would be a lot of leverage if that occurred. To have 2/3 (ems, fire & police) of the 911 pie would go a long way.
If P+ is unable to staff their ambulances like that of Amr then they will push back and make their voices heard. The transporting departments have been forced to come up with policies that state that their last ambulance will not be forced to run Amr calls . Why? Amr can not handle their current contract. Berkeley, Albany, Piedmont and Alameda have their own areas that they are responsible to cover and provide service. One can not expect that Albany and Piedmont can keep sending their only paramedic ambulance out of their city to run Amrs calls.
If you look at Contra Costa County you will notice that San Ramon and MOFD DO NOT send their ambulances to cover Amrs calls. Why? Who would then run their calls?
Helping each other out is one thing but to do a job for a company that has a contract but fails to full fill it on a daily basis can not and will not continue.

Posted by Alcomedic
a resident of another community
on May 2, 2010 at 9:31 am

Amr might be losing the 911 contract to P+ but Amr will still in Alameda county providing Basic life support service (emt). Not all of Amr's emts work on a paramedic ambulance.
With that being said P+ will not be offering basic life support service to start. Their emts will be working on the paramedic ambulance with a paramedic. The only way P+ would not hire one of us would be if we failed their new employee drug test. Would you want a user not only driving lights and siren but also providing emergency care to your loved ones?
One other option is that fellow Amr employees can check and see if another county that Amr provides service is in need of an emt or a paramedic. One example would be Contra Costa County, different counties but same union contract. If Contra Costa has an opening then we can put in for a transfer.

Posted by Skippy
a resident of San Ramon
on May 2, 2010 at 10:29 am

AMR did not exist 40 years ago - it was "formed" in the early 90s as a national "ambulance company consolidator." What a phony ploy to generate some sensationalism.

Posted by SMH
a resident of another community
on May 2, 2010 at 6:02 pm

Thanks alcomedic, was wondering where that would place our basics. Makes a lot more sense now.

Posted by CA-EMSwatcher
a resident of Another Pleasanton neighborhood
on May 2, 2010 at 7:57 pm

The sensationalism surrounding this on all sides is obscuring the facts surrounding this contract. It shows the multi-million dollar nature of this ambulance contract and the lengths that AMR will go to keep it, Paramedics Plus will go to get it, and Alameda County will go to get better service after years of AMR reducing the level of ambulance service in the county.

Fact # 1: The contract was for 911 services in Alameda County. AMR is the company that said they would pull BLS services out of Alameda County if they lost the contract. Since the county contract was not for BLS, the blame lies with AMR as to why BLS people will allegedly lose their jobs. It is AMR's choice to continue their BLS operation in Alameda County, or to close the operation and shift resources elsewhere.

Fact # 2: Paramedics Plus has a proven business model and a record of success at managing large EMS systems in Pinnellas(sp?) County FL, Ft Wayne Indiana, and Oklahoma City. This is their first successful move into California however they are unproven in California to date.

Fact # 3: AMR has a record of behavior in the county of behavior that is contrary to the apparent goals and desires of the Alameda County Board of Supervisors. Short filling of shifts to intentionally limit ambulances on the road create a huge cost savings for AMR. Fire departments have expressed a desire for some time to see the county take a harder line against AMR using poorly conceived coverage plans with an irresponsible number of units available. The writing was on the wall in Alameda and AMR was vulnerable to the competitive process after years of having a monopoly.

Fact # 4: This contract for both providers comes down to profit. The question becomes this... how much money is AMR sending to it's corporate masters at EMSC in Colorado on a monthly basis. Paramedics Plus bid a specific financial package that keeps excessive profit in Alameda County, returned to the citizens in the form of better service. AMR claims that after the approximate 20% of revenue the send directly to Colorado, they are barely profitable in Alameda County. Paramedics Plus bid that they will be a local Alameda Based company that returns profits above 7% to the county, and that corporate overhead is low. It's a huge difference and a huge selling point in the RFP.

Fact # 5: Paramedics Plus won this RFP by 211 points. That is no small margin and shows that AMR overbid the RFP and underperformed in their previous business affairs with the county. This wasn't a one category thing, but a comprehensive rejection of AMR.

Fact # 6: The union endorsement had nothing to do with the RFP. The Board of Supervisors said so themselves. Any internal union strife between members and NEMSA has nothing to do with the facts, and the facts speak for themselves.

AMR got beat, plain and simple...

Posted by SJ AMR Paramedic
a resident of another community
on May 2, 2010 at 11:13 pm

Paramedics plus please come look at San Joaquin County, we want Paramedics plus here.

Posted by SJ AMR Paramedic
a resident of another community
on May 2, 2010 at 11:20 pm

Below is the loaded crock that AMR wants everyone to believe. We all know as AMR's employees that this is a loaded crock. The bottom line that AMR CEO, Directors, Managers and supervisors care about is the pocket book that they get paid from and their bonuses come from. The proof can be seen with anyone who relies on AMR for service, recieves a bill from AMR, and AMR's employees who hate coming to work because AMR's management team does not support the employee but rather looks to belittle the employee and make them powerless.

Fact: AMR San Joaquin County ran Thursday night, April 29th, 2010 from 2200 hrs to 0500 hrs with 4 ambulances for a population of 280,000 + residences not including the out lying areas of the county they have stated to care for in the contract for 911 services.

The same thing happens here as reported in Alameda County Fire Department reports. Other ALS 911 system providers are being forced to run AMR ALS 911 calls or move up and cover AMR's response zones on a daily regular basis, leaving thier own areas vulnerable to no ALS coverage. Manteca District Ambulance moves over to cover Tracy City AMR or respond Code 3 with lights and sirens to Stockton AMR because AMR Stockton does not staff enough units or has Tracy AMR and Lodi AMR units moving into Stockton to cover due to shortage, staff reductions, ambulance brown outs or overloaded call volumes that is predictable by countless hours of data gathering by dispatch centers. But AMR's management team continues to fail the employees that want to do more or provide better safer operations and instead reduce the unit hours to a minimal number of 911 ALS paramedic ambulances on a given street corner.

AMR's unprofessional and ignorant dispatching services are rated as a "F" compared to the professional "A+" services you will recieve from a 911 Fire Dispatch center.

AMR paramedics and EMTs in San Joaquin County dream that Paramedics Plus will come look at us when it is our time for a new county contract. The current AMR Paramedics and Emergency Medical Technicians that work for AMR are excellent care givers that you would trust your life with but when you interject the AMR management team you have a failed system on your hands. The blame lies in the AMR management teams from the field supervisors on up to Lou Myers sitting in his Stockton Office to the President/CEO sitting in his office in Colorado.

You ever wonder why there is very little employee turn over at the fire departments? Because the employee is empowered to care and is patted on the back by management. There is a commarodary that is built into the fire service to empoyer the employees to succeed. AMR management does not want empoyerment, because it takes away from thier power. They see the employee as a threat to thier own jobs so they must continue to empower back stabbing and belittling to depower the employee.

When you have Directors of county operations running the Dispatch centers also, you have a double monopoly that is a failed system. When you have AMR dispatchers sending ALS Paramedic 911 units Code 2 without lights and sirens to a possible cardiac arrest because they know they can not make the time response under code 3 lights and siren operations is a failed system. When you have paramedics that are being investigated by management teams when they disregard a dispatchers request to respond code 2 for a possible cardiac arrest CPR call but instead respond code 3 with lights and siren because the paramedics and emts know that life and death is only seconds away but are still being treated like they did something wrong because they went code 3 with lights and sirens and not code 2 without lights and sirens per the dispatchers orders is a failed system.

AMR's Vision statement outlines the values that guide the company and its employees. Our company Vision is comprised of three elements: our mission, our values and our vision of the future.

Our mission is to make a difference by not caring for our employees and your need.

Patient Focused … Customer Centered … Caregiver Financed

By following our mission and values, AMR envisions a future that includes the following:

•AMR will be one of America's most hated companies because of the pride it takes in making its employees powerless, its loyal customers, its clinical leadership, and its financial success. (Hmm says it all right there, financial success)

•AMR employees are not trusted, not empowered to serve people with compassionate care and innovative solutions by our management teams.
•AMR is not a strong, dependable community partner. Our customers can not count on and appreciate our reliability, the quality of medical care we provide, our dedication to relationships that benefit all and the efficiency with which we operate.
Patients, customers and communities experience peace of mind knowing AMR professionals are not ready to serve when needed.

Posted by Eric
a resident of Civic Square
on May 3, 2010 at 8:07 am

I can tell you that i have first hand knowledge that many of the paramedics and emts will not go to work for paramedics plus by choice,they will transfer to other countys that AMR operates in.This will cause a severe staffing shortage and ambulances getting to your home late. I encourage anyone with a late response to their home to file suit against the county and EMS office(Alex Briscoe).The reason the fire chiefs support paramedics plus is because they were promised equipment fron them,the fire chiefs primary concern is not the publics welfare.

Posted by alcomedic
a resident of another community
on May 3, 2010 at 11:47 am

So, many of our coworkers are just going to leave? Which county has all the openings?
In these economic times you want us all to believe that these caring coworkers are going to leave?
More scare tactics.

As far as fire goes, some departments have passed on this "new equipment" to keep their existing equipment. That have wanted AMR out for years. If they had their way fire would transport and then a majority of us would be out of a job.

Posted by OKC Medic
a resident of another community
on May 3, 2010 at 8:04 pm

As a paramedic who has worked in both the Bay Area with AMR and in OKC/Tulsa with paramedics plus, I can say with no doubt that PPI can handle the county with no problem. Here in OKC/Tulsa, PPI has never missed target times, has never been short staffed, and is always on the cutting edge of the medical tech that is out there. In all of the counties that PPI has, they have the full support of the fire depts and are very progressive in keeping the county happy by giving whatever the county wants. PPI I know for a fact will do great and I feel will bring a higher level of care to the county residents that AMR refused to do.

Posted by mjr
a resident of another community
on May 3, 2010 at 10:17 pm

as a medic for ALCO, I desire not to change companies. Supervisor Haggarty says it is a simple switching patches. Many disagree. We and our former incarnations have served for 40 yrs. Many of us not only I may see problems with AMR but the county and hospitals also share blame. We are literally held just short hostage. Hospitals believe that if they keep the units there no more will come and bring patients to an already crowded inpatient system. PP will expierence the same thing and do it with less units.

you will see

Posted by weary
a resident of another community
on May 4, 2010 at 10:20 am

The shortsited comments made by ALCO medic and SJ AMR medic reveal both his/ her bias and ignorance. I have no doubt that the writer is one of the minority ' discontented' that have miserable lives and need someone to blame. The meal break issue is a red herring, the issue with the Fire departments running AMR calls is nonsense. The MOA allows for mutual response, and AMR runs all the 5150's in those cities because the FD's dont want their crews tied up at JGP for hours. It works both ways. IF the FD's did not want the Mutual Aid they would not continue to agree to sign the MOA's.
SJ AMR, maybe your operation sucks, but ours does not. We have heard that SJ is a mess, but that is your problem, not ours. Worry about your own county and stop trashing our county ops because you dont like yours. and the reason why FD's have low turnover is because they have enviable wage structures and retirement plans, all at the taxpayers expense...
ALCO BLS may not be profitible without the ALS structure to support it. AMR will crunch the numbers and decide if it works to keep a BLS system in ALCO. If not, the BLS EMT't are SOL and our union could care less.
Dont't think for a moment that NEMSA's support of PP is anything but feathering their own nest and pushing the NEMSA agenda, regardless of the impact to the ALCO employees.
And yes, Alco medic, you reveal your ignorance. Lots of people will leave ALCO, it happens every time. Those of us who have been through this before know this. The day the Board made their decision the migration to other AMR operations began. And now ALCO is getting apps from the miserable workers in San Joaquin county who want to leave we can look forward to an increase in the miserable and discontented who want to blame others for their lousy lives and life outlook. That'll be fun to have them on our rigs.

Posted by Alcomedic
a resident of another community
on May 4, 2010 at 11:55 am

Some of those departments do run their own 5150s (piedmont) and they only have one ambulance. If that ambulance was already on a call then We or another agency might run it.
As far as leaving the county, who has all of these openings? Some counties have a long list of emts waiting to move up to paramedic. It is sad that employees stated that they cared so much about the citizens but then state that they will just leave. I guess that they really did not care about the citizens that much.
If you don't like nemsa then make sure to get a hold of the petition going around to recall Torren.

Posted by Da Truth
a resident of Livermore
on May 6, 2010 at 5:43 pm

Supervisor Haggerty is an idiot who is just going to miss his contributions from AMR. What a crook.

Posted by Morton
a resident of another community
on May 11, 2010 at 10:28 pm

AMR has a well-deserved reputation. They are not a labor friendly company. Here's but one example from this year:

" May 6--A complaint against American Medical Response has been filed by the National Labor Relations Board. It alleges unfair labor practices in connection with staffing changes the ambulance provider made to its Monterey County operation.."

Posted by alcomedic
a resident of another community
on May 13, 2010 at 5:48 am

Paramedics plus by their own admission at the Board of Sups meeting is a non-profit company.They said they are not in alameda county to make money.They said that anyone who prefers not to pay for ambulance transport does'nt have to and that they would dismiss the bill.That's very nice of them,sounds like something we should all take them up on.Free is always the best price.

Posted by Cocomedic
a resident of San Ramon
on May 15, 2010 at 8:56 pm

Amr might be caring in Alameda County but in Contra Costa we are planning to lose 22 full time paramedic slots come July 1. We wish Paramedics Plus would come to our county, Maybe then jobs might not be lost.

Posted by Cocomedic
a resident of San Ramon
on May 15, 2010 at 8:57 pm

For those who think that I might be lying it was on the Channel 2 news at six. It might be on again at 10.

Posted by Hmm
a resident of another community
on May 23, 2010 at 1:21 pm

P+ is a FOR PROFIT company. They said that at the county meetings too. They never said they were non-profit.

Posted by A_Former_AMR_Medic
a resident of another community
on Jul 1, 2010 at 7:54 am

Directly from EAST TEXAS MEDICAL CENTER website, the parent company for Paramedics +
Gifts from individuals and organizations to our not-for-profit health system have been a cornerstone for our East Texas hospitals, and that support is needed today more than ever."

Posted by Johhny Q Public
a resident of another community
on Jul 7, 2010 at 5:59 am

I've seen it before. Paramedics Plus "out bid" AMR in Pinellas County in 2004. That system has all the billing go to the County who then paid the provider. Paramedics plus bid $21.3 million and AMR bid $25.4 million. Clearly PP won the bid on cost and the promise to put all new ambulances in the County. Almost immediately PP fell into financial ruin and went to the County for more money. In 2008. PP was getting $32.7 million/yr (34% more than AMR originally bid) and they are still going for more this year. Pinellas County is a relatively low call volume area and nowhere near the same complexity as AlCo so I have no faith at all that this will work.
PP is also offering every Fire Department in the County shinny and expensive new equipment to buy their loyalty and support. (The extortion by the FD’s is a whole new topic I won’t get into because it sickens me so). Even these expensive gift will soon be old and lackluster like the new ambulances PP put in Pinellas, many of which are still in service today.

Posted by anthrmedic
a resident of another community
on Jul 10, 2010 at 10:55 pm

Pinellas? fairly low call volume? Paramedics plus runs 240,000 responses a year and over 185,000 transports. Im very confident they can handle ALCO

Posted by Greg
a resident of another community
on Sep 25, 2011 at 2:31 pm


If you think Castro Valley has "a dozen ambulances"
in the area at any given time, you're sorely mistaken. AMR runs
their crews at bare minimum staffing on a daily basis.
Santa Clara county recently (July) got rid of AMR in favor of another provider
for piss-poor response times. Some calls the average response times
were hitting the 30min mark!

Posted by mmedic50
a resident of another community
on Oct 30, 2011 at 6:32 pm

This story is nothing new in health care specifically, and buisiness in general. Change is inevitable, and the dollar is the bottom line, even in morally complicated matters such as EMS. EMS has been privatley run for the majority, and has not enjoyed the lucurative financial structure of the tax based emergency systems of police and fire. We have also not been impacted when municipalities start cutting costs and laying off police and fire because of lacking tax revenues. As healthcare struggles to function under the upcoming changes in the Healthcare Reform Act, things will only get more difficult.

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