Ted Siefer's City Hall: AMR ambulance service makes mind-boggling recovery
Just call American Medical Response the comeback kid.
Less than a year ago, the city launched an audit of AMR, its designated emergency ambulance provider, following a deluge of complaints over large bills and aggressive collection practices. On Monday, the fire chief and members of the aldermen's Committee on Administration recommended that AMR be given a new 5½-year contract.
The decision was all the more puzzling because, as Ward 4 Alderman Jim Roy noted during the meeting, the other department heads on the committee that reviewed the proposals all lined up behind the other finalist, American Ambulance of New England.
Later in the week, Roy, who was also on the review committee, provided a draft version of the minutes from a meeting a couple of weeks ago when the final proposals were presented. They show that, in contrast to what Fire Chief James Burkush told the aldermen - that there was no clear consensus for one company or the other - American was favored, 6-3, by those who voted at the meeting. In addition, in a table that ranked the companies in a range of categories from customer service to legal performance, American outscored AMR, 52-43.
"It boggles the mind," as Roy told me.
Perhaps what was most mind-boggling was the change of heart by Alderman At-Large Dan O'Neil, who had been strident in his criticism of AMR, citing his wife's experience wrestling with a large bill from the company.
Just a few months ago, O'Neil said at a committee meeting that AMR "caused a lot of heartache for a lot of people, and we'll never know unless we get the attorney general involved how much money was actually overbilled and paid by our consumers."
A cynical reaction would be that it's a union thing. AMR is unionized and American Ambulance Service is not. And O'Neil has a reputation for being friendly to unions.
The suggestion by some that the firefighters union had thrown its weight behind AMR was not contradicted by the appearance, at the review committee meeting of a letter from the president of the International Association of Fire Fighters. It accused American Ambulance Service of trying to "manipulate" the bid process by suggesting in a letter filed with its proposal that American had IAFF support "where none exists."
In fact, no such letter was included in the bid, and the American letter cited by the firefighters union was meant to counter claims that American's parent company, Falck, based in Denmark, wanted to go into the business of private firefighting. The letter, according to American's Brendan McNiff, was sent to verify that the company "had never entered the realm of fire suppression."
It bears mentioning there were actually three finalists for the ambulance contract. Burkush said the third, the New Hampshire-based CarePlus, didn't have the financial resources to take on emergency services for a city the size of Manchester. (An executive with the company was gracious about the decision.)
In the side-by-side scoring of the companies, AMR took its biggest hit in the legal performance category, receiving a zero for not disclosing "administrative or judicial proceedings being filed against the proposer."
As has been reported in these pages, there have been legal moves taken against AMR. The biggest case came in 2011, when AMR settled with the U.S. Office of the Inspector General, paying a $2.7 million fine and signing a "Corporate Integrity Agreement."
Mayor Ted Gatsas appears to have come around to AMR's side after it agreed to enter a provider agreement with Anthem, the city's largest insurer, and it set up a local billing office.
Gatsas noted it's been months since "he's heard any complaints."
In the end, Burkush made it clear that it was up to him which company he would recommend, as is the case with any contract the department is considering.
"The ultimate recommendation is the fire chief, and the ultimate decision comes from the Board of Mayor and Aldermen," he said.
We'll see how they vote when the contract comes up at the July 2 meeting.
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You know things aren't going so well in contract negotiations when the opposing parties spend more time talking to the media than to each other.
Ward 10 school board member John Avard, the chairman of the board's negotiations committee, sent an email last week to several media types providing a fairly detailed analysis of the proposal that the teachers union had rejected.
If the teachers had switched to the proposed Health Savings Account plan proposed by the negotiators, they would face additional health care costs of $582,614 in the first year, which would be offset by proposed raises that total $1,470,214.
The union's "refusal to sign a contract," Avard wrote, "is costing the bargaining unit" more than $950,000.Ben Dick, president of the Manchester Education Association, responded with numbers of his own. He noted that the HSA, which has a lower premium but higher deductible than the other HMO and Point of Service plans available to the teachers, has proved unattractive to members. It's been offered for several years, and only around 11 of the district's 1,100 teachers have signed on, Dick said.
For most teachers, the proposed contract would mean their premium rates would jump 20 percent, a cost that would eclipse the proposed raise and result in a net loss of $2,000 a year, according to Dick.
Along with the salary increase, the school board committee has proposed hiking the premium rates for the HSA from 7 to 15 percent, and for both the HMO, which now has a 7 percent rate, and the POS, which has a 14.5 percent rate, to 20 percent.
The teachers union proposed the HSA rate go to 9 percent, the H.M.O. to 11 percent, and the POS to 18.5 percent, according to Dick.
Dick said the difference between what the union and the district proposed was separated by only $1.2 million. And he noted that this was nearly the amount the aldermen sent to the district as part of its final budget.
Of course, the aldermen expected this money would go toward hiring more teachers, not to make the health plans of the current teachers more palatable.
"It's not the employees' job to pay for more employees," Dick said. "I don't think a guy at the convenience store says to his boss, 'Let me give you a couple bucks so you can hire another guy,'" he said.
Ted Siefer may be reached at email@example.com. Follow him on Twitter @tbsreporter.