Clark County Reorganizes Ambulance Routes in Response to Short Response Times

RENO, Nev. (775 Times, NV Globe) – Every 911 medical emergency in Clark County is handled by the Clark County Fire Department.

A private ambulance is also called to the location if it appears that someone may need to be hospitalized.

Ambulance crews have 12 minutes to arrive or they would be declared late. According to county officials, it is then that the fire department takes up their responsibilities, stretching already-scarce public resources.

Ambulance providers are out of compliance if they are late to more than 10% of calls each month, according to contractual requirements with Clark County that continue through 2026.

During a recent 17-month period, the two largest ambulance companies in Southern Nevada, AMR and MedicWest, both owned by Colorado-based Global Medical Response, only met the 90 percent on-time benchmark one and zero times, respectively, according to fire department Deputy Chief Jen Wyatt in a Nov. 15 presentation to county commissioners.

According to Wyatt, AMR averaged 85.2 and 85.6 percent in its two zones, whereas MedicWest reported rates of 76 and 83.3 percent in their respective territories.

According to numbers acquired, this has amounted to over $2 million in fines since November 2021.

“This is an emergency,” Commissioner Michael Naft said during the meeting. “There is no contract we have more significant than this one.”

Naft was part of a unanimous vote that supported a fire department plan to reorganize ambulance zones managed by the three businesses with county contracts.

Community Ambulance, a third firm, has not been out of compliance since February, when it received greater territory from the other companies under a November 2021 redistricting, Wyatt said.

AMR and MedicWest have contracts with the city of Las Vegas, and the latter is the exclusive operator in North Las Vegas. Community Ambulance provides non-emergency services to the city of Henderson. The municipalities did not furnish the needed performance statistics before the publishing deadline.

Redistricting: The new Clark County map, which goes into effect on Jan. 3, expands the local company’s influence on the Strip by adding a new zone with approximately 31,000 yearly calls.

Community Ambulance will handle 52 percent of total calls in Clark County, up from 17 percent prior to the 2021 redistricting.

AMR and MedicWest, which handled about 83 percent of all calls until February, argue redistricting isn’t the only solution to the ambulance industry’s overall staffing need.

Community Ambulance, on the other hand, is prepared for the extra workload, according to Glen Simpson, the company’s senior director.

“Every time we’ve taken on a large lift, a large project, we’ve heard it, that we can’t do it, mostly from our competitor,” Simpson said. “I go back to our track record; it speaks for itself.”

Restructuring of the industry

Michael Johnson later informed that a forthcoming Clark County Fire Department academy of 110 trainees, half of whom would come from ambulance businesses, will simply exacerbate an already terrible situation.

Thirty of the candidates are AMR and MedicWest paramedics. He noted that there aren’t enough paramedic training programs in Southern Nevada.

He said that the county sent AMR and MedicWest a map barely a week before the November public meeting, and that the majority of the firms’ suggestions were ignored. Johnson went on to say that the final map was only shown to him a few hours before the vote.

“It seems like the process is a little flawed,” Johnson said.

He said that officials did not evaluate other considerations before redistricting, such as how the change will influence existing travel routes, distances, development, infrastructure, flow, and other performance elements that are carefully reviewed using analytics. Revenue sources from “payer mixes,” or claims submitted with Medicare and insurance companies, are also shrinking.

“All of those things should be factored into redistricting,” he said. “They are not the experts in my business; we are the experts.”

Wyatt stated that the future fire department academy “is not news to them,” that the agency has given the names of the candidates, and that the career change is a natural move in the past. She went on to say that they were aware that future redistricting was always an option.

During the public comment phase of the November hearing, Johnson had roughly three minutes to convince lawmakers to postpone the decision.

“I think that there’s an opportunity here, if we’re going to change the system, let’s change it to the system that’s going to work for all the stakeholders, including the community,” he told commissioners.

Despite their skepticism, commissioners stated that the debate is not over. They requested frequent updates.

If no progress is made, Commission Chairman Jim Gibson stated, “then we need to take a close look at something more extreme.”

Commissioner Marilyn Kirkpatrick expressed her dissatisfaction with the final map, noting that it differed from the one shown to her.

The strategy, according to Kirkpatrick, does not address underperforming ambulance responses in east Las Vegas.

“I don’t care how you slice or dice this, but if I don’t see any improvement, I’m bringing it back myself to have a different kind of conversation,” Kirkpatrick said. “Because someone has to service those people, and that’s your job.”

‘Fantastic, exciting career’

During a recent early recruitment event at one of AMR and MedicWest’s valley offices, a half-dozen employees sat in the darkly lit dispatch center assessing numerous displays displaying real-time maps and analytics. Future and existing paramedics were in the classrooms studying the trade.

The EMS system has been failing for more than a decade, according to the American Ambulance Association and the National Association of Emergency Medical Technicians.

The epidemic, the present financial crisis, overwork, and job-related trauma can all aggravate the situation. Paramedics from Community Ambulance were stationed at the Route 91 Harvest festival, for example, when a shooter opened fire during the bloodiest mass shooting in American history.

According to Simpson, the business’s senior executive, the corporation has prioritized mental health to decrease turnover. “What can we do to make sure that our employees’ well-being and mental health are prioritized?” he asked.

Surveys in which employees discuss “the good, the terrible, and the ugly” motivate changes, he adds.

Changes made once the county reopened following the initial pandemic-related closures included reduced labor hours and improved salary, benefits, and signing bonuses.

Paramedics used to alternate between three and four-day weeks, but they are now on three-day weeks with 36 full-time hours, according to Simpson.

Furthermore, earnings climbed by 15%, and the corporation added extra paid time off.

To accommodate the 30,000 or so additional calls each year, the business is recruiting more paramedics and purchasing more equipment.

He claims that their staff are their best recruiters.

According to Johnson, AMR and MedicWest have become inventive in attracting people who had never considered employment in the business previously. They have created a “earn while you learn” program in which employees may train to become paramedics while still working.

According to Johnson, over 100 staff graduated from basic medical courses in the previous year. “It makes room for the next level of advanced EMT.”

According to him, the corporation invests more than $15,000 and takes 16 months to make each paramedic.

He stated that AMR and MedicWest are not opposed to its paramedics joining the fire service, but urged self-regulation.

“How many people can you take at one given time,” he said. Maybe the fire department can host smaller classes to give the private ambulances time to recover, he added.

“When you take 20 (paramedics) from me, that’s close to a year’s worth of work,” Johnson said.

According to Johnson, proper paramedic staffing would reduce response times.

“If I had (enough) bodies, I would be able to put them on the street,” he said. “Even Steven.”

Credits: Review Journal