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If a plan put forth by Mayor Muriel Bowser gains traction, the District could soon enlist third-party ambulance companies to help alleviate the stresses on its overstretched fleet of 39 vehicles.
But as remarks at a two-hour hearing Thursday afternoon revealed, Bowser will have to convince some members of the D.C. Council that her proposal won’t render the District too dependent on private entities to perform a basic government function—and that the deals involved won’t be too costly.
Testifying before the Council’s Committee on the Judiciary, Fire and EMS Chief Gregory Dean explained that emergency legislation authorizing his department to contract with medical-vehicle providers is needed to accommodate growing demand on D.C.’s medical-response services. EMS calls and patient transports jumped by 28 and 41 percent, respectively, between fiscal years 2008 and 2015, Dean said; additionally, FEMS responded to more than 160,000 calls and moved more than 115,000 patients during the latter fiscal year, or 10 and 6 percent more than during the 2014 fiscal year. As written, the emergency legislation would give D.C. first responders the discretion to call private ambulances if they’ve determined that a patient doesn’t require serious treatment; this would purportedly free FEMS vehicles and staff to handle patients in need of lifesaving care.
“It became immediately clear to me that we didn’t have sufficient resources to do our jobs, especially in answering EMS calls,” Dean said, mentioning a six-month review process of FEMS he initiated earlier this year. “Both our people and equipment are overwhelmed on a daily basis.”
Dean added that FEMS recently responded to what it considered 234 “low priority” EMS calls on a day when it received 503 total calls; these included “patients complaining of stomach pain, throat pain, and leg cramps, or patients with a foot injury, or pain from a previous injury.” Had private ambulances responded to the day’s low-priority calls, Dean claimed, FEMS could have saved 154 hours, or 32 percent, in the amount of time its units actually spent processing calls.
Despite the benefits such partnerships could bring, four councilmembers at the hearing grilled Dean on the specifics of the District’s potential contracts with third-party ambulance providers. Through questions and comments, they displayed some skepticism toward how the privatization plan would play out in practice, and introduced concerns regarding its scope, duration, and costs.
At-Large Councilmember Elissa Silverman said the emergency legislation was “bare-bones,” wondering aloud whether it would effectively privatize “a core government function.” She noted that when D.C. has attempted to privatize other public services during the past year, such as food vendors for schools and the H Street–Benning Road streetcar, it hasn’t saved money, raising “red flags.” Silverman also pressed Dean on the permanency of the initiative and budgeting for costs.
“So we have not figured out the fee-structure, though, for these ambulances that we’re going to be putting on the street in 30 days [after FEMS contracts with the private providers]?” she asked.
“The fee-schedule, correct, the budget for it is something that we are going to be working on during that period [of approved dealings with the ambulance companies] also,” Dean explained.
“So we have no budget right now,” Silverman countered. “We’re going to be approving authority for which we don’t know how much it’s gonna cost?” “Correct,” Dean replied, later adding that the city could draw from a pool of four to five national ambulance companies based in the area.
“That’s problematic,” Silverman declared before moving on to other questions regarding FEMS training. Under the plan, D.C. paramedics would evaluate whether to call private ambulances to transport patients in non-serious situations; Dean said they would begin getting monthly training.
Ward 6 Councilmember Charles Allen wanted to know more about ensuring accountability for the private providers in the partnership: “How are we able to use the contract as the vehicle for a required set of response time?” Dean answered that ambulance companies would look at District data to determine in how much time they could feasibly respond to EMS calls, perhaps in ten to 12 minutes across the city. Penalties would apply to companies that couldn’t meet the standards.
But it was Ward 8 freshman LaRuby May who may have had the most personal remarks during the hearing. Discussing the culture of FEMS, she recalled an incident during which she was “literally dying” and was picked up by a D.C. ambulance. May said it was “100 percent negative.”
“They mistreated me. They dogged me out. They said inappropriate language, inappropriate comments the entire time I was in the ambulance,” May remembered. “Once they got me stable, I refused to continue to be transported by that ambulance.” She added that she’s somewhat concerned about how third-party ambulance company staff would treat the residents of her ward.
“What you’re commenting on is unacceptable,” Dean said. “People call the District usually once in their life and ask for assistance. That is the one time they will touch this department. And they will share the same story you just shared over and over again, so it’s important for our people to be courteous, be respectful, so when you talk about your experience with [FEMS, it’s positive].”
At-Large Councilmember Anita Bonds chaired the committee, standing in for usual judiciary chair Kenyan McDuffie, of Ward 5, who had to leave at the hearing’s start for family reasons. The Council must approve the mayor’s emergency FEMS legislation by next Tuesday, Oct. 6.
Photo by Darrow Montgomery. Screenshots via DCFEMS.