Committees Vote Against Hiring Outside EMS Firm

During a Sept. 9 joint meeting of the Door County Administrative and Public Safety committees, an overwhelming majority of supervisors who serve on those two committees expressed their belief that the county has the experience and knowledge to efficiently direct its emergency medical service into the future.

The meeting was called to consider a proposal from Colorado-based American Medical Response (AMR) – the “nation’s leading medical transportation company,” according to its website. 

In March, the county decided to put out a request for proposals with the idea of reducing costs for the expensive, wholly county-run service, possibly to the point of privatizing it. Two companies responded: AMR and Curtis Ambulance Service of Milwaukee. Both said they would not consider taking over the county’s unique emergency service but would be happy to be hired as consultants to help the county find efficiencies in it.

The county asked both companies to elaborate on what they could provide, and Thomas Maxian, AMR’s president of the northeast region, responded in a letter dated August 2019 that AMR could help in six areas, including “Billing Review: A detailed examiniation [sic] of billing processes aiming to streamline processes and increase revenue.”

At the meeting, Emergency Services Director Aaron LeClair pointed out that the county is currently collecting an astounding 98.06 percent in its billing, while the national average is 75 percent.

Maxian went on to say that for a flat fee of $7,500, AMR would perform a Door County needs assessment.

A cursory reading of AMR’s multi-page letter found that, in addition to misspelling “examination,” the company chose for the word “vendor” the uncommonly used spelling of “vender.” Does it matter whether the “nation’s leading medical transportation company” has a spelling problem? 

It should matter, but the supervisors were more invested in all the brain power already in the county that has made Door County’s EMS into what many referred to at the meeting as a “Cadillac” service.

“Being a Cadillac service could be a positive or a negative,” said County Administrator Ken Pabich, who had been taking a lot of hits since proposing seeking outside assistance for running the service. He justified it by saying it’s difficult to be self-critical. 

“Sometimes it helps to have some of that outside input and at least get some benchmarks,” Pabich said.

He mentioned that AMR also proposed studying salary ranges, but Door County EMS had just ratified a three-year contract the previous Friday. They would look at the long-term impact, he said.

Supervisor Dave Lienau was the only member of the two boards to vote for hiring AMR, saying that in other areas of county business, they have hired outside consultants to make things better and take the service to the next level. He justified his no vote by saying that every time the county has looked outside for advice about EMS, it has gotten better.

“I don’t think it takes $7,500 for another company to help us decide,” said Supervisor Jon Koch in a message that was repeated by others on both committees. “I think we’re fully capable of doing that and making those decisions through discussions with our EMS director. I don’t think it’s going to take a study to do those kinds of things. We have good information from the past and the present.”