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Ambulance provider to close in Akron: Who will respond?

AKRON, Ohio (WJW) — The 150 paramedics working for the Akron Fire Department will soon see their workload increase exponentially, while another 50 medics working for a private medical transport company that has been helping them for decades will be out of a job.

For decades, Akron fire medics have been transporting the most critically ill or injured patients while Colorado-based AMR Medical Transport has been handling the non life-threatening cases to help free up Akron Fire Department ambulances for other serious calls.

The city currently has 13 ambulances, one at each of their stations, handing about 9,100 medical calls a year.

AMR Medical Transport handled another 22,000 calls a year without asking the city for any money to assist.

The company’s revenue came exclusively from billing of patients.

But in recent months, the company demanded millions of dollars from the city to continue the longstanding relationship.

“AMR came to us and they wanted a stipend,” said Akron Fire Chief Joseph Natko, addressing city council members during a budget planning session this past March.

Natko told council members that during their first meeting he felt as though AMR was holding the city hostage.

“Initially, they wanted $3 million a year in order to do business with us. We said that that’s not possible,” said Natko.

A request was sent to other providers to see if there was any other transport company willing to take the calls AMR Transport was handing, but Natko said there was nothing feasible.

“AMR did come back to us with a five-year proposal that said they would only charge us $2.1 million the first year, and then it would increase year-by-year after that, just totaling over $11 million in the private contract. We said that’s not feasible,” said Natko, explaining to council members that the fire department would simply absorb the calls.

AMR Medical Transport said it will close its Akron office after July 31, leaving its 50 medics out of work.

Between fire and EMS calls, the Akron Fire Department responds to about 150 calls per day, according to firefighters union president Kevin Gostkowski.

Fire department medics typically responded to all of the calls from which AMR would transport patients before handing off the patient to AMR Medical Transport.

Gostkowski believes the city can handle the increase in calls after AMR.

“It would have been nice to have a little more breathing room to put a plan together. A couple of months is not a good timeframe to put a plan together. It’s going to be a stress on our medics, our firefighters, our equipment. We will be out responding to more calls, trying to get med units to people,” said Goskowski.

“There’s no doubt it will be an adjustment for everyone involved. Like I said, AMR has been around for several decades. We have relied on them for patient transports in collaboration with AMR in general, so it will be an adjustment for everyone,” Akron Fire Department Capt. Sierjie Lash told FOX 8 News on Thursday.

“Our chiefs, our EMS bureau, have been in preparation for what is to come. They have been in conversation with AMR so — planning for what’s going to happen, preparing our paramedics. All of us involved in EMS are getting prepared for whatever happens in the next few months,” said Lash.

Chief Natko on Thursday released a statement saying:

The City of Akron and the Akron Fire Department are disappointed in the decision of American Medical Response (AMR) to permanently close its facility on 485 S. Broadway. This closure will result in 50 employees being laid off, including EMTs, paramedics, supervisors and a mechanic, and will place additional strain on Akron Fire’s EMS crews.

The relationship between the Akron Fire Department and AMR has always been amicable with a ‘no cost’ contract in place that utilized AMR as a subcontractor for the City for non-emergency calls for transport. AMR was able to profit through this contract. Unfortunately, AMR came to the City several months ago and explained that they would not renew their contract with the City unless we were able to pay a significant subsidy to AMR. This payment of a subsidy was untenable for the City of Akron and its taxpayers. The decision was made to support Akron Fire with increased staffing and resources to compensate for the additional non-emergency patient transports that will be conducted by Akron Fire starting August 1, 2023.

The men and women of Akron Fire are incredibly resilient and have been preparing to handle this additional patient transport load. Mayor Horrigan and Akron City Council have been responsive and supportive of the needs of Akron Fire when this difficult situation was presented to them. Because of our employees, and due to the support of the City, Akron Fire will continue to adapt to the ever changing environment of Emergency Medical Services and provide excellent care to Akron’s patients.

Akron Fire Chief Joseph Natko

Gostkowski later told FOX 8 News:

“Absolutely, I think it’s feasible for us to handle it. Our problem is really going to be the turnaround times at the hospitals for the people we do transport. If our med units are waiting on the walls of the hospital and can’t get back into service, that’s where our delays are going to be caused. It’s not going to be from us not being able to respond to calls.”

In the meantime, the 50 medics working for AMR are all competing for the same job openings in the public sector, in many cases finding only part-time work with less money and benefits.

Steve Caraboolad has been working for AMR for 30 years, spending most of the last 20 years as the president of their employee union, the National Association of EMTs & Paramedics Local 43.

On Thursday, he told FOX 8 News that he had some advance notice from the city that this could be happening, but confirmation was not made to employees until after the city’s disclosure in March.

“It’s somewhat of a blessing in disguise that we know this is coming. We’ve known for two months that the shutdown is going to happen of the corporate in Akron, so we have had time to prepare,” said Caboolad.

“You’ve got 50 employees leaving one company and trying to find jobs somewhere else — after the same jobs — but hopefully there will be enough opportunities out there for all of these soon to be out-of-work employees,” he added.

The city is hoping to use grant money to add as many as three new ambulances at a cost of at least $250,000 each to its fleet of 13 and hire more medics to compensate.

The chief told council that the city collected about $2.1 million last year for medical transports by billing insurance companies and settling for what insurance would pay.

Natko told council that AMR reported collections of more than $3 million last year from its private billing of patients as well as their insurance.

With the increased transports, the city will be able to see an increase in its collections, although Natko told council they would not be as aggressive as AMR in going after patients for what insurance would not pay.

“We are going to absorb this service and we are going to do it ourselves. It will make for a healthier fire department, a happier citizen and a better service if we can do that,” Natko told council members in March.

“We think we can absorb it. This is going to be a trial-and-error type of thing, but we feel we can do it,” he added.