Growing cities may outsource ambulance care

Apple Valley, Lakeville and Farmington are considering replacing their current ambulance service because of growth in the communities, leaving local paramedics worried that they may lose their jobs.

With the number of medical emergencies steadily rising, leaders of the cities' cooperative ambulance service say it may be time to hire a contractor. ALF (for Apple Valley, Lakeville and Farmington) Ambulance has invited outside providers to submit proposals by Aug. 5 to take over the job starting in January, though the plan aims to retain current workers.

The ambulance service, a quasi-municipal group formed by the three cities in 1985, serves about 124,000 people in an area covering 160 square miles. Paramedics respond in three ambulances operating out of two 24-hour stations in Lakeville and Apple Valley, and a third in Farmington that's staffed 10 hours a day.

A contractor might be able to serve patients with a larger pool of paramedics and ambulances, as well as support staff with more expertise in tasks such as medical billing and administration, said Brian Landhuis, ALF interim administrator.

But many of the service's 27 workers fear they'll be replaced by paramedics who don't know the terrain or the people as well as they do, resulting in worse patient care, said Brian Sturz, unit leader of the union that represents many of the paramedics.

"We have very close-knit relationships with our police departments, with our fire departments," he said. "We know each other by name, we have excellent response times, we do public education, and on top of that, we have a combined 230 years of experience at ALF. It's people that have been there, on the average, about 11.5 years, so it's not paramedics that have come and gone every two to three years."

ALF's request for proposals calls for contractors to make a good-faith effort to keep local employees, and one prospective contractor has already said it's "anxious" to do so, said Farmington City Administrator Peter Herlofsky, who serves on the tri-city group that oversees the ambulance service. "The purpose of this was not to get rid of a whole bunch of people," he said.

Paramedics have seen an annual call increase of 9 to 11 percent in recent years, and this year, they're on pace to respond to more than 5,000 incidents for the first time, Landhuis said.

The move to consider contracting out for service got going this spring when ALF's administrator retired and ALF leaders thought it would be a good time to think about restructuring.

As the service has gotten busier, city staff members who handle support tasks for ALF in addition to their other duties have had to spend more time working on more complicated finance and administrative issues related to running an ambulance service, Herlofsky said. And local paramedics currently work 24-hour shifts, sleeping between calls. But more emergencies mean less rest, which could someday erode the quality of care that paramedics are able to give patients, he said.

All things considered, it might make sense to turn to an outside ambulance service, Herlofsky and Landhuis said.

ALF is overseen by a board, composed of City Council members, that presides over a managing committee of staff members from each city. The staff committee is expected to make a recommendation this fall on whether to hire a contractor, and the board gets the final say, Landhuis said.

But the issue is largely about being proactive to prevent a drop in care quality, Landhuis said.

"We don't want to be forced into making a decision based on a tragic event happening that tells us it's time," he said.