Paradise Valley ambulatory contract, needs and frequency under review

The Town of Paradise Valley has one ambulance stationed in town, it resides at 6517 E. Lincoln Drive to assist residents in emergency situations. (Independent Newsmedia/Josh Martinez)

In a relatively small community, the Town of Paradise Valley has hundreds of emergency calls for service each year, resulting in more than 300 ambulance transports annually.

Paradise Valley is evaluating its ambulance services, as the contract with PMT Ambulance is set to expire on Sept. 30.

On March 14, Paradise Valley Town Council took their first steps to evaluating and discussing services rendered when a resident is having an emergency.

On average, the Town of Paradise Valley has two ambulance calls per day, with half of the calls resulting in a transport to a hospital, Deputy Town Manager Dawn Marie Buckland said during her presentation to council.

Data presented in the council’s study session meeting shows:

  • 2015: 612 calls for service; 382 transports
  • 2016: 692 calls for service; 405 transports
  • 2017: 561 calls for service; 332 transports
  • 2018: 731 calls for service; 379 transports.

“There aren’t a lot of unnecessary calls for service coming out of Paradise Valley,” Ms. Buckland said. “When someone is calling for help, they really need that help.”

There is one transport unit stationed in town staffed by a paramedic. PMT has leased a town-owned house at 6517 E. Lincoln Drive, since 2010, providing living quarters for staff and ambulance staging facility. The terms of the $3,000 per month lease are concurrent with the terms of the ambulance contract, town officials say.

The level of support in Paradise Valley is known as advanced life support service — or ALS — while the second tier of service available is basic life support, or BLS.

ALS service includes an ambulance equipped with more sophisticated equipment and additional pharmaceuticals and staffed with at least one paramedic. BLS service includes limited equipment and pharmaceuticals, with an ambulance staffed with emergency medical technicians, also referred to as EMTs.

When a paramedic is required with BLS service, a local fire fighter must accompany the ambulance on its transport.

Prior to 2007, the town was part of Rural/Metro. Since 2007, the town has an intergovernmental agreement with Phoenix for fire protection services, and emergency ambulance services provided by PMT.

Dawn Marie Buckland, deputy town manager. (Independent Newsmedia/Arianna Grainey)

In the wake of a sunsetting ambulance contract, there are some changes to be considered when evaluating the current ambulance situation, according to Ms. Buckland.

The City of Scottsdale previously contracted with PMT as well, and had ALS back-up ambulances available from various Scottsdale locations, if the need for an additional ambulance was needed in Paradise Valley.

“One issue we wanted to bring to council’s attention is that of a back-up ambulance,” Ms. Buckland explained. “We have and have had since year 2000, one ambulance stationed here in Paradise Valley with one crew. Occasionally multiple ambulances are required, where there are multiple patients at one incident. Or, a call arises while an ambulance in service is on another call.”

As of February 2018, Scottsdale contracts with Maricopa Ambulance for BLS service only. PMT ambulances are no longer located at Scottsdale fire stations, and Maricopa Ambulance does not provide ALS service in the area.

PMT reports in a 12-month period, there have been 22 incidents requiring more than one ambulance.

The best service provided

The Department of Health Services regulates ambulance companies, and issues a certificate of necessity, which authorizes the provision of ambulance services in a geographic area.

The three certificate of necessity holders for Paradise Valley are PMT, Maricopa Ambulance and ABC. However, ABC primarily provides specialty transport services and does not provide emergency ground ambulance service in Maricopa County, officials say.

(Independent Newsmedia/Josh Martinez)

The issue at-hand appears to be, where can additional ambulance services come from in the rare occasion that more than one ambulance is needed at the same time? Ms. Buckland says Phoenix Fire Department has been there to help in a pinch, even though they don’t have provisions to operate in the town without a certificate of necessity, issued by DHS.

Town Council members voiced a desire for additional information before moving forward with this topic, while the staff had a handful of recommendations for the local ambulances, including to maintain ALS service, continue with the current provider and explore different providers and service-level options.

Increased service levels could include an additional staged ambulance in the town, a requirement of ALS backup available within a certain amount of minutes, or requiring shorter response times than those mandated by DHS regulations.

“One option I think being presented is we can have another ambulance from the same provider stationed in town. The other solution would seem to be an agreement, even if it’s not with the same company, to have a backup service available on a certain time frame,” Mayor Jerry Bien-Willner said.

“From a policy perspective, my approach, and I think probably a lot of our feelings would be, we always want an ambulance to be available when needed and promptly. The question is, how do we get there? We have one stationed here that seems like it’s doing a great job, great experience there. We’ve had occasions where we need two — is a solution to have another ambulance from another company on call that may not be doing anything? Is it a contract with another provider or IGA, or something else? These are areas I think I’d like to try to understand better before we give more direction.”

For the 22 times a second ambulance was needed in the past 12 months, Councilwoman Julie Pace asked how long it took for the service to be provided.

“I’m trying to understand is there a problem to solve here, or is it working?” she asked.

Ms. Buckland says between the three ambulance providers have been able to meet the need. However, Phoenix Fire Department does not have a certificate of necessity to operate within the Town of Paradise Valley, but their services have been used when needed.

“Those are the questions that we’ve been asking as well. Basically what we’ve heard is ‘it is working,’” she said.

“The overlay there is that certificate of necessity. Right now we have certificates of necessity for PMT, Maricopa and ABC — Phoenix Fire does not. Now, we understand that during a time of an emergency they’re going to bring whoever they need to — that’s what’s important and what matters. We’re just trying to be mindful as we look forward to say do we have all of that covered, are we doing it the right way as well?”

Ms. Buckland says Scottsdale’s contract with Maricopa, who only provides BLS service, created a bit of complication because Paradise Valley wants the top-tier of service, which requires a Phoenix Fire Department paramedic to be on-site if Maricopa is responding to the emergency; whereas when PMT was operating in both Scottsdale and Paradise Valley, the ALS service was available at all times.

“PMT provides service throughout the state of Arizona and elsewhere as well; where we found ourselves is in a little bit of an island because now we’ve got the City of Phoenix that has their own ambulance provider, we’ve got the City of Scottsdale that’s using Maricopa — and not only using Maricopa, however only using a BLS service, because their paramedics and fire fighters are riding with them,” Ms. Buckland explained.

“That’s a bit of a challenge we’ve been trying to work through.”

Ms. Buckland said regardless of the emergency transport intricacies, the Phoenix Fire Department has been there when needed.

Councilman Paul Dembow asked Ms. Buckland if Paradise Valley has the best choice for ambulance service and what efforts have been done in the way of a request for proposals from other services.

“What I’ve seen today is not enough to understand ‘A.’ If we have the right company, other than it sounds like ‘so far so good’; and ‘B.’ If there’s a better company or better provider in our town; whether we can have two providers; or if it’s even required to have two providers?” Mr. Dembow asked.

“I don’t know what information I’m going to need for that but it’s different than what this is.”

Councilman Mark Stanton added that he thinks the request for information will bring information forward that could shine a light on

“I think this is obviously a top priority for this council and for our town — I look at what you’re coming forward with as a request for information, which I think will be the gap where we find some things that will make us stronger, define good policy decisions moving forward, whether that be with the very capable teams we have in place now or if there seems to be based on smarter practices or new information that we can better judge if there should be a change in what we do,” Mr. Stanton said.

“I think the idea of a request for information is very helpful. I think it will bring us some affirmation or it could bring us some new policy decisions.”

Mr. Bien-Willner says from his perspective, the town needs to ask themselves and the industry what a state-of-the-art best practice response time is, followed by the service level questions.

“I think that’s a policy decision we need to make,” he said. “There may be trade-offs. Maybe if you go with Maricopa, for example, which has ambulances around this area — maybe they can offer a better, faster response time but you get less service level. I think the question we’re all sort of dancing around is the outliers. In terms of objectives, my objective is to have the best ambulance service, period.”

News Editor Melissa Rosequist can be reached by e-mail at mrosequist@newszap.com or follow her on Twitter at www.twitter.com/Mrosequist_

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