The Birmingham Fire Department, under Chief Ray Brooks, has received the blessing from the City Council to begin transporting all 911 patients this spring.  Chief Brooks tells me the move will result in a more efficient use of fire paramedics, who now make the initial call and usually stay on the scene until an AMR ambulance arrives.    Plans calls for increasing the ambulance fleet to 16 from the existing 10.   In 1997, AMR transported 15,657 cases, or about 45% of its business load for the area. 

Two months and counting.  Have you made plans to attend Fire-Rescue Med? The conference is the major fund-raiser for the EMS Section.   The funds are then used for expenses when the EMS Section represents the IAFC at numerous EMS-related and necessary events or meetings.  A good example is the current development of a national ambulance reimbursement fee schedule through the "Negotiated Rule Making" process with the Health Care Finance Administration (HCFA).  This process and what ambulance services will be reimbursed by Medicare in the future deeply impacts many  fire agencies.   The EMS Section is representing the IAFC at the negotiation table.   Along with that representation comes expenses of travel, research, etc.

Fire-Rescue Med will be held April 26 - 29, 1999 at the Orleans Hotel in Las Vegas.    Even though last year was an unqualified success, this year's program looks even more tremendous.   Call the IAFC at 703-273-0911 to register or get a brochure.

Speaking of Negotiated Rule Making - The negotiations will start February 22 - 24, 1999 in Washington D.C.

Who may be the next major city to merge EMS and fire?   Pittsburgh! Discussions are currently under way but don't expect anything in the near future.

OUCH!   American Medical Response took a major hit in the Hartford Courant in Connecticut.   The several-day series of articles headlined such stories as, "Firm Puts Squeeze on 911 Service," "Ambulance Industry Chases Profits," "Where are all the Ambulances? Not in Hartford," Lack of EMS Oversight Called Very Frightening," "Slamming Against an Ambulance Floor and Suffering Devastating Side Effects," "Gasping For Breath and Waiting For an Ambulance," "Dying of A Heart Attack as an Ambulance Driver Gets Lost," "Waiting For an Eternity for Help After Toddler Falls from a Window," and "Bleeding to Death and Kicked Out of An Ambulance." 

The articles, written by four different staff writers, detailed problems with AMR, not only in Hartfortd but throughout the state and the country. Interestingly, the reporters found documentation of what this column has been reporting for some time.  According to the 1996 financial filing with securities regulators, AMR outlined how they plan to deal with rising cost pressures of 911 contracts.   In the document filed by AMR, the fine print said, "most of the company's 911 contracts provide for a renegotiation" of terms.  With that in mind, AMR said they could pressure communities to pay more to handle emergency calls.  Further, the document said,   "The company could also attempt to change the staffing of its ambulance crews and negotiate for longer response times."    This strategy would obviously net higher profit returns for Laidlaw.   According to the Courant who spoke to a former high- ranking AMR executive - who declined to speak publicly out of fear of legal retaliation - said saving money by cutting back on 911 business is a persistent theme in AMR's corporate office.    Once a staunch supporter of consolidation, the executive was further quoted as saying, "The conglomeration of the ambulance industry is the worst thing that could have happened.  There is an inherent conflict between trying to answer the profit-driven concerns of shareholders and doing a good job out on the street."

When it rains it pours!  Laidlaw has released their first quarter reports. Revenue from the ambulance division declined 11.4% to 265.2 million from $299.4 million in the first quarter last year.  The operating margin was 10.2% compared with 12.6% last year.

Nominations are being accepted for the position of Treasurer and Chairman for the EMS Section.  The current Treasurer Dave Becker has already thrown his hat into the ring and the current Vice-Chairman Ken Riddle plans on running for the Chair position.   Nominations should be faxed to me at 314/645-9182 before March 5, 1999.