Colorado Springs Fire proposes plan to take over ambulance service with no cost to taxpayers

COLORADO SPRINGS, Colo. (KRDO) - The Colorado Springs Fire Department proposed a plan to take over emergency medical services, promising better response times and lower costs for residents, as the current provider has struggled to meet contractual requirements.

The proposal is for an emergency medical services (EMS) enterprise run by the Colorado Springs Fire Department (CSFD) but will be completely separate from the city’s general fund. Right now, Colorado Springs is only one of four of the 40 most populated cities in the country that doesn’t have a public-run EMS, according to the Colorado Springs Fire Department.

This plan comes after years of the current EMS provider, American Medical Response, struggling to arrive at emergency calls on time. KRDO13 Investigates has extensively reported on this issue, finding AMR had to pay more than $3.4 million in damages in 2022, for arriving late to Code 3, or life threatening, calls throughout the year. In the last three years, AMR has been late to 33,000 calls and paid the City $5.5 million in fines.

"They are in it to maximize profit for shareholders," said Colorado Springs Mayor Yemi Mobolade. "I'm in it to maximize services for our taxpayers."

In 2022, AMR responded on average to all medical calls in 15:21, while CSFD responded in about half the time at 8:50. Response times in 2023 were similar with AMR responding in 13:26 and CSFD in 8:29. CSFD claimed these differences in times could save more than $500,000.

"I've talked about the other services we provide that are taking the workload off which frees up both ambulances and fire resources to be more responsive," said Colorado Springs Fire Department Chief Randy Royal about why CSFD will excel where AMR struggled.

The Colorado Springs Fire Department said this entire EMS would be funded by users. The startup costs would be about $11.1 million, which would be funded by lease purchases of equipment and facilities, as well as $3.8 million in loans from at least four local foundations, including El Pomar, Pikes Peak Community, and Katalytic. CSFD said these loans with a low-interest rate will need to be paid off in five years.

Click here to read more about the city's proposal and view the May 13 presentation.

The city’s current contract with AMR ends in April 2025. If this EMS enterprise plan is approved, the projected revenue would come from transportation costs and government funds. Transportation costs with CSFD would range from $1,975 to $2,275 depending on the treatment. This is 26-30% lower than what AMR costs.

This enterprise plan is projected to make $42 million over a nine-year period without the support of government funds. The city claimed they missed out on about $7 million in federal funds a year because only public EMS can receive these funds. With government funds, the enterprise plan could make $107 million over a nine-year period. CSFD said these government funds will also help lower transportation costs.

At the workshop, however, AMR officials disputed some of the data and conclusions presented to the council. AMR consultant Daniel Cole said the city's plan doesn't include nearly enough ambulances.

"What determines ambulance response times is the number of ambulances on the street," he said, "And if you compare the number of ambulances that CSFD is projecting to field to the number of ambulances that AMR actually fields during peak times, you'll see that CSFD is projecting to field 18, and AMR fields 22."

Cole also pointed out that the city's revenue figures were based on its ability to collect roughly 80% of the amount billed to patients, when it reality AMR's collection figure is closer to 50%.

"AMR and our predecessor company have historically provided the highest level of emergency medical services available to the City of Colorado Springs for 40 years. Our dedicated first responders continue to selflessly serve their community, and our main priority remains the safety and wellbeing of the residents and visitors of Colorado Springs, as well as our AMR Colorado Springs team members.

We trust city officials will keep the best interests of the citizens of Colorado Springs in mind while reviewing ambulance transport service options."

- AMR

The Colorado Springs Fire Department said it would hire private sector industry professionals with billing and collections services. Still, many council members were concerned about how much money the public EMS service would collect from insurance companies and patients. The city said it was conservative in its projections of how much it would be able to collect from billing.

"I'm just very concerned the financial model isn't built in a way that is typical in any industry," said City Councilman Brian Risley. Instead of looking at what the actual received revenue is and then building a budget to not exceed that, the fire department by their own definition and admission has done it in the reverse. They developed what they believed to be the cost and then built a revenue stream that they believe supports that and substantiates that."

According to its projections, the EMS enterprise plan is expected to make $25.4 million in revenue in the first year with a net revenue of $755 per transport. The expenses for this EMS service is expected to be about $23 million in the first year with 155 full-time employees.

The city said there are some start-up risks, including acquiring vehicles and facilities, as well as finding the staff to run this new EMS service. The proposed plan is for CSFD to have 25 ambulances, including 18 during peak call volume hours. Each of those ambulances will be staffed by one paramedic and one EMT. There will also be four EMS field supervisors.

However, the city said there is a higher risk by doing nothing and staying with a private ambulance service.

An enterprise service, like this proposed EMS, doesn’t need a vote by residents but just approval from the Colorado Springs City Council. The council will vote on the proposed plan on June 25.

“Why do we hear so many complaints? Because we are there doing work," Royal said. "We are administering IVs, we're providing medication, we’re doing respiratory assist, but we are still waiting for an ambulance to show up.”