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Chief Tom Shannon, Scottsdale FD, and I had a very good conversation with the CEO, COO, Western US Director, and Regional Representative of Priority Ambulance on Wednesday this week. The intent of the meeting was to clarify a couple of items regarding our CON, their plans to ramp up services in our area, and the hiring challenges we all face.
All parties walked away with an understanding of how we move forward, as well as how we may be able to partner in the future regarding recruitment, retention, and training. The contract between CAFMA and Priority is in process with a projected timeframe for a finalized draft by the end of August/beginning of September-ish.
As a reminder, once the draft is finalized, it will be sent to the Bureau of EMS for a cursory review. While the draft is being reviewed at the State, we will bring our partners to the table to review the draft with them before we present a draft to the Board. Our partners include the Town of Chino Valley, Town of Dewey-Humboldt, Town of Prescott Valley, and representatives from the Board of Supervisors.
Talks between PRCC and Priority continue as they work to bring their AVLs on line and finalize purchase and installation of MDTs. I believe the actual agreement between the two is being reviewed by the City of Prescott legal department. Having a new transport partner in the area, and as a member of PRCC, will dramatically improve system efficiency and transparency.
I know things are still a bit clunky while we work Priority into the system, and they continue to increase the number of units available. To that end, I ask for your continued patience as there is light at the end of the tunnel and it’s not a train. My hope is that we will have Priority working within the system with more units in the next 60 days.
We are sending a letter to AMR advising that we are going to begin billing them $550 per transport for each time we have to provide the medic because their unit is BLS only. CAFMA will not charge when our medic rides in with an AMR medic because the patient’s condition requires the additional assistance.
The constitution of the State of Arizona clearly states that a governmental entity cannot subsidize a private company; it’s known as the gift clause. Based on the legal interpretation we have, when we provide a paramedic because the transport provider responds to a call requiring advanced care or advanced life support without a paramedic on their ambulance, we are subsidizing their private company.
You may ask, does the Bureau of EMS need to approve the fee we charge? In our opinion, the answer is no. This is not a fee for transport. Rather, we are required by the State Constitution to charge a fair market rate in situations like this. So, now you may ask, how do we determine a fair market rate for providing a medic? Good question. First, providing the medic actually means dedicating our engine and crew to the call until patient care is turned over to the hospital. Given we are providing a Type 1 engine and crew, we relied on our existing contract with the State for a Type 1 engine and crew, which equates to $275 per hour. After review of our paramedics riding in, we determined that each instance should be billed at a flat 2-hour rate which equals $550.
Do we need a contract with a provider to charge them the fee? Once again, in our opinion, no. The State Constitution requires us to charge them a fair market rate to avoid violating the gift clause, i.e. subsidizing a private company. Our fee structure is set and approved by the Board of Directors and filed with the County. We are not required to have an agreement with any contractors in order to charge them a fair market rate for services provided. Therefore, we see this as no different.
Prescott and CAFMA may have been the first to push this issue, but others across the state are starting to follow suit. It seems our legal analysis is not far off of other legal analyses that have been completed subsequent to ours. And this, my friends, is why you engage competent legal counsel 😊
My schedule the next seven weeks or so will be fairly hectic. Here’s a brief review regarding my upcoming travels and other fun stuff. I leave Sunday, August 21, for Fire Rescue International (FRI) in San Antonio. As some of you may remember, I serve as a member of the program Planning Committee for this event. The first two days of the week I will be in a Wildland Community Mitigation Best Practices class. Given my vast knowledge of wildland having moved here from St. Louis, I thought it might be good for me to seek some training. I present Wednesday morning, and then have a variety of classes to attend the rest of the week. Wednesday also happens to be my 31st wedding anniversary, and the 9th anniversary of leaving St. Louis for Arizona.
I will be back in the office the week of the 29th for a variety of meetings. I’ll head down to Mesa for Summer Fire School on September 6 to help set up and co-facilitate the New Chief’s Seminar which runs through Sunday the 11th. The evening of the 11th I will be the MC for the Healing Fields in Prescott Valley.
On September 13, I will be in the Valley for back surgery. Should be a simple rotorooter type thing, I think. Supposed to be pretty straightforward, but that depends on what they find when they open things up. It’s been my experience that they typically find more damage than what’s visible on the MRI. At least, that’s what happened each of the last 14 orthopedic surgeries I’ve endured. Down time after surgery is?? All I know is four weeks of walking and no heavy lifting. I hope to be back in the office in some capacity the following Monday, but we’ll have to see how things go. I’m certain that Tharp will carry my backpack for me…
A number of Staff, including me, will be in Peoria September 26-28 for accreditation training. Yes, you heard that correctly, we’re starting the process to be an accredited agency for the first time as CAFMA. Stay tuned for more on that.
On October 3 I will be headed to Flagstaff for the AFCA President’s Forum. The Forum runs through Wednesday the 5th. Finally, I’ll be in Mesa the week of October 10 facilitating the final week of the Chief Executive Officer Program (CEOP). Participants will graduate that Friday in a formal ceremony – as formal as we can get, anyway. I know Chiefs Rose, Parra, Feddema, and Tharp are looking forward to participating in next year’s cohort. I’ll have the dates for them shortly so they can get it on their calendars.
After October 15, things calm back down and hopefully my back will be better. I’ll be available by phone, text, and email while I’m traveling, and while I am convalescing. Senior staff will ensure that The Review, and the CAFMA Connect are written, recorded, and disseminated each week. Pretty sure they may not know that yet, but they will 😉 I’m sure I’ll cover a week or two writing The Review just to keep you updated regarding where I am and what I’m learning.
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