Dispute over ambulances migrates north

The battle over ambulance service has moved to North Las Vegas, where the City Council on Wednesday will consider a franchise application from Southwest Ambulance, which is challenging the monopoly of American Medical Response in the Las Vegas Valley.

AMR's franchise agreement is nonexclusive, so any entity can entertain an application from competing companies before AMR's contract expires in 2003.

Southwest has received permission to apply for a franchise from Clark County, but the Las Vegas City Council has said the company may apply for a franchise only for nonemergency transports. With two of three local government bodies split on the issue, the decision made in North Las Vegas will be closely watched.

"The issue is, is there a real need," said Ray Burke, who is working with the North Las Vegas franchise agreement. "Right now, the county has said 'Yes there is,' and the city (of Las Vegas) says 'No there's not.' We're in the middle of this."

Because of an interlocal agreement, the company must have the permission of the county, Las Vegas and North Las Vegas to be successful.

Southwest representatives say they hope to convince North Las Vegas officials of the benefit of bringing the company in for emergency transports -- adding one-third more ambulances on the street.

A decision like that would fall in line with the Clark County Commission's approval in December to negotiate a similar contract.

The challenge from Southwest has sparked a public mud-slinging campaign, with representatives of both companies pointing out resignations of executives at both the local and parent company levels, falling stock prices and corporate debt.

But North Las Vegas officials say the companies' finger-pointing is skirting the real issue: will North Las Vegas residents be better served with another ambulance company?

Mayor Michael Montandon said last week that the most important factor to consider is providing the best, safest coverage.

"It doesn't matter to me the politics of it, who makes what profit," he said. "I hear information about collection rates, emergency transport vs. nonemergency, and what I want is I don't want to get a call from someone saying 'I waited 20 minutes for an ambulance.' "

John Wilson, executive partner for Southwest, said the situation in North Las Vegas is unusual: that because of its soaring population and number of seniors moving into the area, there is a need for another ambulance provider.

The senior population uses ambulance services 10 to 13 times more often than the general population, he said.

Wilson said part of his argument will center on AMR's performance.

"In North Las Vegas we will be hammering on the need much more specifically than we did in Las Vegas," Wilson said. "Our strategy (in Las Vegas) was not to attack AMR directly. My strategy is that we will not follow the same tactic."

Southwest has criticized AMR for the increasing number of exceptions it has made for failing to meet required response times. Exceptions are allowed if the ambulance is hindered by conditions beyond the staff's control, such as weather or traffic.

AMR's acting executive Trace Skeen said the strategy in North Las Vegas will be similar to the arguments with Clark County and Las Vegas.

He maintains that the franchise agreement identifies specific performance criteria that must be met, and AMR has met and exceeded those criteria. He says there is no need for an additional ambulance provider.

"The arguments we'll make is that they have one of the best (emergency) systems in the country with AMR and the fire department that play a very important role," he said. "We think it's a delicate balance. Making major changes runs the risk of decreasing the level of service."

Skeen said bringing in another service provider would only complicate things, as the fire department already goes out on all emergency calls.

But Wilson disagrees. If Southwest were to take part in emergency service or nonemergency service, patients would never know the difference.

"For emergency service, it will be absolutely transparent to the person in need," he said. "You dial 911 and the call goes to the fire alarm office and based on the jurisdiction you're in, the closest ambulance will always be sent."

As argued before the Las Vegas City Council, Skeen said perhaps the best course would be to give the franchise agreement an expiration date. That way, the entities could prepare another document, taking into consideration the fire department's expanded role, and put it out to competitive bid so Southwest, AMR and any other provider can enter the market.

"We are a staunch supporter of competition, but it should be for the whole market rather than day-to-day ambulance wars," Skeen said.

Both Skeen and Wilson said they have met with each North Las Vegas council member, but are not sure how they will vote.

It's not clear whether the council members themselves know. "If I had to push the bottom today, I could sleep at night on either direction," Montandon said. "This fight has been something that's been an attempt to tear apart that regional franchise jurisdiction."

Burke agrees.

" It seems like someone is trying to split us all up. We saw through Cox negotiations that as long as we stuck together, we would get the best for all entities," he said, referring to a cable television system franchise given in 1998 to Cox Communications of Las Vegas Inc.

Meanwhile, recently hired City Attorney Sean McGowan said he has a conflict of interest and must hire an outside law firm to represent the city on this issue.

Prior to McGowan's hiring as city attorney in January, he was a partner in the law firm of Schreck & Morris, which represents Southwest.

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