The City's contract with American Medical Response (AMR) is expiring in 2025. In anticipation of the contract ending, the Colorado Springs Fire Department and City Administration are exploring a different service model for providing emergency ambulance service in Colorado Springs by standing up a CSFD-based Emergency Medical Services (EMS) Enterprise that would operate emergency ambulance transport.
The Fire Department and City leadership presented the proposal to City Council at the Council Work Session on May 13, 2024. A first vote of the City Council to establish an EMS Enterprise is anticipated to take place on June 11.
view the May 13 presentation Watch the May 13 City Council Work Session
About
About the proposal
Per City Code, the Colorado Springs Fire Department (CSFD) is responsible for emergency medical service and emergency ambulance transport in Colorado Springs. Currently, CSFD contracts with a private operator, American Medical Response (AMR), to provide this service.
The City’s contract with AMR is set to expire on April 1, 2025. In anticipation of the current contract ending, CSFD and City Administration are doing their due diligence to explore the best service model for providing emergency ambulance services in Colorado Springs. CSFD is proposing to stand up a fire department-based Emergency Medical Services (EMS) enterprise that would operate emergency ambulance transport.
City administrators and CSFD leaders have been meeting with City Councilmembers, local philanthropic groups, and community leaders to discuss this option and the impact it would have on the Colorado Springs community.
Through this exploratory process, City Administration and CSFD have found significant positive benefits in the CSFD-based model.
“The CSFD has established respect and trust in our community and beyond. Among its many accomplishments and accolades, Chief Randy Royal is the Fire Chief of the Year for the State of Colorado and CSFD received the Congressional Fire Services Institute 2023 Excellence in Fire Service-Based EMS Award for its innovations in the delivery of emergency medical services. The time is right to place the responsibility of EMS transport in the hands of those who are most capable to manage risk and who are tasked to do so by City Code - our Fire Department.”
- Mayor Yemi Mobolade
History
History of Ambulance Transport Services in the City
In 1979, the first Advance Life Support (ALS) provider came to El Paso County; they were known as A-1 Paramedics. A-1 Paramedics served the city alongside Mountain Valley Ambulance, also known as Professional Paramedics, a Basic Life Support (BLS) provider. About 10 years later, A-1 Paramedics bought Professional Paramedics. Around the same time, St. Francis Hospital began its own ambulance service. A-1 Paramedics went on to buy St. Francis Hospital’s ambulance service, which once again made A-1 Paramedics the sole provider for the city.
In 1993 A-1 Paramedics was bought out by American Medical Response (AMR) leaving AMR to be the main provider for the city. At the time, the City was part of the Emergency Service Agency (ESA), which was created by City of Colorado Springs and El Paso County leaders with an oversight board for ambulance services. During this time, the City and County were under the same contract with AMR.
In 2013, the City broke ties with the ESA and released a Request for Proposal (RFP) for ambulance services. At the time, AMR was the only one to bid, and the City signed a 5-year contract with them. In December 2017, the City released another RFP for ambulance transport services as its 5-year contract with AMR was set to end in 2018. Three providers responded to the RFP: AMR, Priority Ambulance, and Apex Paramedics. Priority Ambulance’s bid was chosen, but negotiations with the company were unsuccessful. At that time, the City extended its contract with AMR and had 1 year to solicit new bids for ambulance services.
In 2019, the City once again released an RFP. This was the first time CSFD decided to go through the RFP process for a fire-based ambulance transport model. The technical committee reviewing the RFPs ultimately chose CSFD’s proposal; however, Issue 300 (which requires Enterprises to be fully separated financially from the General Fund) was not taken into consideration in the department’s proposal at that time, making it ineligible. The city then chose Falck Rocky Mountain as the top proposal. During negotiations, the City and Falck mutually decided to refrain from moving forward. The City was left to go with their second choice, AMR, and eventually renewed the contract for another 5 years which is set to end in April of 2025.
Why is this important?
Many citizens in Colorado Springs will only call 911 once in their lifetime, so their first impression will be their lasting opinion of their fire department.
Why is this important?
The reliability of ambulance transport and fire response under one umbrella of control will provide the best possible service delivery to our community in their greatest time of need.
With a patient-focused public safety approach the CSFD recognizes that poor teamwork can result in poor patient outcomes. But strong local control over a single system of providers, all operating under clearly defined expectations and with one mission, vision, and code of conduct will enhance consistency and improve patient care.
The Fire Department is proposing to provide emergency medical services enterprise to:
Improve emergency medical service delivery in Colorado Springs.
- Improved response times.
- Increased resources dedicated strictly to 911 response.
- Transparent information and dashboarding to the community.
- Improved retention by providing better wages, benefits, and improved working conditions for EMS staff.
Reduce costs to the community when ambulance transport is needed.
- Utilizing a conservative and sustainable business model and financial projections.
- Central oversight & management of the entire emergency response to a 911 call creates efficiencies in the overall system. · Dynamic deployment and civilian staffing create cost and system efficiency.
Enhance innovative programs and services.
- Ability to provide additional tiered response services to the community, which allows for the proper level of care to those experiencing minor injuries, mental health issues, and homelessness through programs such as:
- Community Medical Unit (CMED)
- Homeless Outreach Program (HOP)
- Community Response Teams (CRT)
- Alternative Response Teams (ART)
- Transitional Assistance Program (TAP)
- Super Utilizer Program
- Nurse Navigation
- The CMED program has shown its ability to reduce risk to the community by allowing for a non-emergent response to calls that are less likely to progress to a more serious condition. This helps ensure 911 emergency resources are available to respond to calls in order to protect loss of life and property.
FAQs
Why now?
The City’s contract with AMR expires in April 2025. This is the ideal time for the City and CSFD to move forward in starting an enterprise for a fire department-based EMS transport system. This model continues to grow across the country with 36 of the largest 40 cities in America operating ambulance transport out of its fire department or government, rather than a private third-party. Additionally, grant funding for some key mental health services expires mid next year. If brought under the transport enterprise, these programs will have reliable, renewable funding to meet the needs of our community.
Are we growing government?
Growing government typically refers to increasing the tax burden to residents for programs or services that fall outside of core municipal functions. The Enterprise will provide full separation from the general fund and will be funded entirely by users.
Is it common to have a fire-based ambulance transport system?
36 of the 40 largest cities in the US have a fire-based or government run ambulance transport system. In the Pikes Peak region, every community except for Colorado Springs has moved away from a third-party ambulance transport system. This includes Monument, Security, Fountain, Manitou Springs, Fort Carson, Falcon, Black Forest, Calhan, and Cimarron Hills.
How will billing be handled?
Since billing and collection services are not the core functions of the CSFD EMS Enterprise, these services will continue to be provided by the private sector industry professionals.
How much would an ambulance ride cost under CSFD?
CSFD is proposing the Transport Fee be a flat fee without any hidden or additional charges. For the first year we will aim to have an Advanced Life Support (ALS) ride cost $2,275 per transport. A Basic Life Support (BLS) ride would cost $1,975 per transport. That is a greater than 26% decrease than what a resident might pay for a ride with AMR. **These numbers are base numbers and are subject to change.
Does CSFD currently have ambulances?
The CSFD currently has 3 squads (ambulances) that are used when the city has a high volume of medical calls and all AMR ambulances are in use. The squads are staffed to handle the overflow of calls and are able to transport patients when needed.
Will we go through the RFP process?
It is not required for the City to go through the RFP process. The RFP process can be lengthy and is all confidential. We believe going through the Enterprise process creates the ability for us to provide full transparency into our plan and calculations. We also believe this will allow stakeholders, skeptics, and supporters to take a deep dive into the financials, risks, and benefits.
Will this be funded through taxpayers?
Creating an Enterprise will be completely separate from the General Fund and will be funded entirely by users and will not use tax dollars.
What are CSFD’s current response times?
In 2023, CSFD averaged a 5 minute and 41 second response time for all emergent calls. Every 911 call is different and determines how CSFD responds and who responds. For example, that could be a Community Medicine (CMED) unit in a sport-utility vehicle that
responds to less emergent calls, or it could be a Community Response Team (CRT) for a behavioral or mental health crisis.
When would an EMS Enterprise begin transport services?
A significant amount of work has already been done to establish the enterprise. This includes briefing all City Councilmembers, engaging stakeholders, and fundraising. CSFD and City leadership brought the proposal forward to councilmembers in a public Work Session on May 13, 2024. From there, a first vote to establish an EMS Enterprise is expected to take place in June with a final vote likely at the end of June.
Soon after the proposal is approved, CSFD will lease a facility, vehicles and equipment. Operational standup and new employee orientation will take place in December 2024. The EMS Enterprise is estimated to be fully operational in April 2025.
Will residents vote on establishing CSFD-based emergency transport services?
Voters are not required to approve the establishment of an enterprise. The EMS Enterprise will be fee-based, will not increase taxes, and will only be charged to people utilizing emergency medical services provided by the enterprise.
Why not renew with AMR?
In the City’s last contract discussion with AMR, they gave the City three options:
- The City renegotiated contract terms and reverted to a previous contract scope of work that loosens contract requirements, including allowing longer response times so they don’t incur fines and don’t have to put more ambulances on the streets to meet the needs of the community.
- The City gave them a subsidy of $3.8 million from the General Fund
- If the City allowed them to exit the contract early
The City Administration and CSFD do not deem these conditions to be acceptable.
Has Colorado Springs ever had a government run ambulance transport system
Colorado Springs has not had a government or fire department-run ambulance transport system. In 2019, the City submitted an RFP for an in-house transport system. . The RFP was chosen by the technical review committee as the best proposal, however the Fire Department at that time did not consider Issue 300, which requires Enterprises to be fully separated financially from the General Fund. That issue has since been addressed through philanthropic commitments and loans that will allow CSFD to launch the Enterprise without violating Issue 300.