Days after print publication, Bill Knight’s syndicated newspaper column, which moves twice a week, will appear here. The most recent will appear at the top. (Columns before Sep. 11, 2017, are archived at http://billknightcolumn.blogspot.com/).

Tuesday, February 13, 2024

Behind the scene and beyond the public eye, talks start on Peoria medical transport pact

You can’t call talks about an early renewal of the City of Peoria’s contract with Advanced Medical Transport a “back room deal.” First, there’s no deal. Next, City staff is involved.

Discussions, if not negotiations, between the City of Peoria and AMT are underway, involving City Manager Patrick Urich, Emergency Communications Center Director Brandon Blayney, and AMT executive Andrew Rand, plus Fire Chief Shawn Sollberger. Peoria Firefighters Union Local 50 isn’t directly participating yet.

“Local 50 will surely weigh in from a union perspective,” comments Peoria Mayor Rita Ali.

“It is good to begin discussions early,” she continues. “It is too early, in my opinion, to execute a new contract.”

Councilman Charles Grayeb of the 2nd District seems somewhat surprised.

“I do not believe the Council has authorized or directed staff to do so,” he says. “It would be inappropriate if there are ongoing clandestine discussions without direction from our elected officials.”

Urich and Rand have worked together before. Before becoming Peoria’s City Manager in 2011, he was Peoria County Administrator from 2001-2011. Rand was a Peoria County Board Member from District 4 from 2008-2022.

Ali did not disagree with Grayeb’s emphasis on involving elected as well as appointed officials.

“Ultimately, the City Council will have to approve or deny the contract,” she adds. “We are quite a ways from that and there’s no sense of urgency from my viewpoint.”

Initially established in 1975 by Peoria hospitals merging their ambulance services, the private non-profit venture in 1978 was named Peoria Hospitals Mobile Medical Services (PHMMS), and in 1991 started doing business as Advanced Medical Transport of Central Illinois (which also has other operations, including Advanced Medical Transport East, Inc., Advanced Medical Transport of Springfield, Inc., and Advanced Medical Transport of Iowa).

Although AMT rates aren’t posted, sources estimated the corporation charges about $1,000 for Basic Level Service, $1,500 for Advanced Life Support (paramedic-level service) plus fuel costs.

In general, people being treated by paramedics are responsible for paying any fees for transport, or treatment, even if they didn’t request an ambulance. Some health insurance policies cover the expense, but Medicare does not.

According to the most recent tax return for “Peoria Hospitals Mobile Medical Services d/b/a Adv Medical Trans of Central IL” (Internal Revenue Service Form 990, from 2021), the corporation reported program service revenue of $32,028,441 that year – a 17% increase from the 2020.

The City’s current agreement, which expires in December 2026, says the arrangement is “non-exclusive,” but AMT is the city of Peoria’s only transport provider.

“AMT has a monopoly,” says Captain/ Paramedic Josh Martin, president of Local 50. “They can set their rates at whatever they want, which is terrible for residents. In Springfield, where AMT also operates, there are three private ambulance services and none of them have a contract with the City of Springfield. So why would Peoria?” 

The City continues to provide dispatch services, and AMT pays the City more than $85,000 annually. Peoria’s Emergency Communications Center, which dispatches 911 calls for emergency medical services, fire and police throughout the City of Peoria and Peoria County, has dozens of workers, each of whom earns around $48,000 a year.

The Peoria Fire Department currently is a non-transport Advanced Life Support first-responder. Nevertheless, “the Peoria Fire Department could transport,” Martin says. “However, it would have to be after the AMT/City of Peoria transport agreement expires on Dec. 31, 2026.”

Grayeb says, “Firefighters have always been and continue to be fire/ rescue personnel and arrive on the scene, more often than not, ahead of AMT.”

Martin agrees, noting that “response duplication is typical. The majority of the time (70-75%), the Fire Department arrives on scene first and initiates patient care. Furthermore, oftentimes a firefighter/ paramedic will ride in the ambulance to the hospital to further assist with patient care.

“In 2023, Peoria firefighter/paramedics rode into the hospital with AMT 587 times,” he adds.

An eight-page PowerPoint-style package presented to the City titled “City of Peoria and AMT Partnership” is vague on suggested changes, but it does propose a 10-year agreement, perhaps anticipating City preferences.

Ali says any renewal should include key elements such as high-quality services, timely and efficient services, affordability, fairness, high standards of service delivery, and a shorter contract term.

“I would not be in favor of another 20-year-long contract,” she tells the Community Word. “If renewed, five or ten years is more reasonable.

“Quality and timely ambulatory and paramedic services, under the current arrangement, have improved in the past several years and relationships between city fire personnel (including leadership) and AMT personnel (including leadership) are better than they were five or six years ago,” she adds. But “I am not a big fan of subcontracting government services if they can be performed from within with high quality, proficiency and affordability.”

Grayeb stresses the efficiency and accountability of local-government oversight.

“I feel fire/ rescue is best left to the PFD,” he says. “Our taxpayers should not subsidize a private operation when public safety is at stake. In the mid-’90s we missed – by one vote – the municipalization of our ambulance function.

“Taxpayers are funding this private and expensive operation!” Grayeb continues. “This has been true for a long time. It is time to return this function to the municipality. Public safety in the fire/ rescue area should not be outsourced. Would we do that for police?”

With more than 300 employees, AMT is led by Rand, whose annual compensation was more than $630,000 in 2021, according to that year’s IRS tax form 990.

Meanwhile, two PFD rescue units in 2019 were disbanded in a cost-cutting move, but the Peoria City Council in November approved in its 2024-2025 budget spending $1.2 million to restore one unit.

That’s not enough, Grayeb says.

“Rescue One was inadequately staffed with a so-called ‘jump crew,’ and it remains inadequately staffed. We enhanced its staffing only nominally.

“We need two fully staffed rescue trucks as we previously did,” he says. “Shorting public safety will catch up with us with eventual dire results.”

There may be an opportunity next month to return Rescue One to full staffing, Martin says.

“To restore the rescue squad permanently with three personnel it would cost around $1.3 million per year,” he says. “The city has an opportunity to apply for a grant in March that would staff the rescue squad, and in return free up the funds allocated for overtime staffing.”

No timetable for possibly renewing an agreement with AMT for ambulance service has been announced.

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