EMS & Ambulance Gap Analysis

The Jersey Journal reported on Friday, December 13, 2013 that Mayor Fulop and his administration want to  change Jersey City’s EMS provider.  I wrote a separate blog post here that goes into more background about both providers.   The Jersey City Medical Center (JCMC) is the current EMS provider, and their current contract expires on December 31, 2013.  The Mayor’s preferred provider for the new contract is Bayonne-based McCabe Ambulance.

In the five days since the mayor’s announcement about preferring McCabe Ambulance instead of JCMC, their has been robust public debate in the Jersey Journal and on online message boards, and City Council members have been inundated with calls from residents.  The City Council was supposed to vote on the EMS contract at tonight’s meeting (the last City Council meeting of the calendar year).  But today, only hours before the planned vote, the city decided to remove the EMS contract vote from the agenda because it is “expecting an outside legal opinion that will answer council members’ questions.”

I am glad the City Council is still asking questions, because many questions remain unanswered.  Here are some questions I still have, based largely off of a simple gap analysis.

Gap Analysis for Jersey City EMS Contract Transition (if McCabe Ambulance is chosen as the new vendor via City Council vote)
All numbers provided below are sourced to local press reports.  Ideally, primary data – provided by the city and put into a usable/readable format for the public – would be optimal, but lacking that, I had to cobble together numbers from news reports.

McCABE AMBULANCE JCMC
(Represents current demand for EMT services in Jersey City)
GAP
IN SERVICE AS OF TODAY
# Of Current Calls (represents demand met with current resources) 10,000 calls within Bayonne / 22,000 calls in greater Hudson County area Approx. 91,000 within Jersey City 69,000 responses/calls
(using 22,000 as base/as-is)
# Of Employees (EMT, paramedics, dispatchers, drivers, support staff) 125 250 125 employees
# Of Ambulances 18 42 24 ambulances
Net financial gain to city $0.0 –
$2.6 million*
$0.0  $0.0 –
$2.6 million
Net financial loss to city $0.0 $0.0  $0.0
Cost of transition to city Unknown $0.0 Unknown

* Please see #1 under “Financial Questions” below.

  • General Questions:
  1. Is the chart above a fair representation of as-is and future state if McCabe Ambulance is chosen as the EMS provider as of Jan 1, 2014?  If not, why not?  Can the city provide transition details to the public?
  2. The City Council was, as early as 9am today, readying to vote on the EMS service provider for the city. Is the city’s decision to postpone the vote solely because of “an outside legal opinion” or are other concerns apparent to the City Council?
  3. If the answer to #1 above is “yes – the only reason is outside legal opinion,” then:  McCabe Ambulance would only have 13 calendar days and 8 business days between tomorrow and January 1, 2014 to make the transition (if it was voted as the new EMS provider).   Is the City Council confident that there was sufficient time for McCabe to transition into its new role, given Financial, EMT/Ambulance, and Transition Timeline related questions below?  If yes, what is your basis of your confidence (i.e. a transition report)?

Financial Questions:

  1. I don’t fully understand the payment of $2.6 million from McCabe Ambulance to Jersey City.  Is this a net gain to the city, i.e. is the city currently paying the JCFD $2.6 million above and beyond the contracted amount to JCMC?  Can cost / benefit analysis used to justify this payment as “beneficial to the city” be made available to the public?
  2. Will the city incur any costs related to changing EMS providers?  If so, have those costs been quantified and factored into the rationale to change vendors?  I have not read anything about transition costs in the press, but assume they exist in the normal course of business.

EMT / Ambulance Resource Questions

  1. Mr. McCabe (owner of McCabe Ambulance) stated his intention to purchase 15 new ambulances if he is awarded the contract.  Will those 15 ambulances be ready on January 1, 2014?
  2. As of November 2013, McCabe Ambulance is on record in the Jersey Journal as having 18 ambulances.  If he purchases 15 ambulances, that will bring his fleet up to 33 vehicles, which is 9 fewer than the 42 ambulances currently owned by JCMC.  Is this 9-ambulance gap a concern?  If not, why not?
  3. How long does it take to procure a fully equipped BLS ambulance?  A fully equipped ALS ambulance?  Is the EMS provider required to own a certain number of each type of ambulance if so, how many of each? How many of each – BLS and ALS ambulance – does McCabe Ambulance currently own?
  4. Mr. McCabe is currently recruiting employees on Facebook in anticipation of being awarded the contract. As of November 2013, McCabe Ambulance is on record in the Jersey Journal as having 125 employees.  JCMC’s EMS team currently has 250 employees.  Do you believe McCabe will have to staff up to the 250 EMTs, paramedics, dispatchers, drivers, and support staff currently employed by JCMC’s EMS?

Transition Timeline Questions:

  1. If, at 12:00am on January 1, 2014, McCabe Ambulance is contractually bound to provide EMS service but cannot meet the demands currently met by JCMC, who will provide EMS service to Jersey City?
  2. Did the Mayor or City Council have any thoughts as to the feasibility of conducting this EMS provider transition during peak holiday season, with Christmas Day and New Year’s Day being federal holidays, with employees potentially being out of town, on vacation, etc?
  3. Would city employees have been required to work overtime to allow this transition to move forward and if so, was any associated overtime cost factored into the decision to switch vendors?

Questions Related to a Delay of Vote:
Per the Jersey Journal, the mayor stated his administration will request that “JCMC continue providing ambulance service on a month-by-month basis, at no cost, until a new provider is approved.”

  1. Has the JCMC agreed to this go-forward plan?
  2. Is a month-to-month contract legal?
  3. Are there any costs to the city associated with extending the JCMC contract (e.g. procurement services within City Hall) on a month-to-month basis?
  4. Will the administration or the City Council be releasing a transition report aimed at the public (i.e. average layperson, not healthcare or non-profit professional) that will provide the public with assurances that McCabe Ambulance can meet the demand currently met by JCMC?

These are my initial questions.  Some of these may be quickly answered, as I am not a healthcare professional and may lack basic knowledge that would allay some of these concerns.

3 Comments

  1. These questions can be asked, but I also think that the 5 member committee that looked at them came up with their answer. The whole idea of a difficult transition strikes me as overblown. I’ve seen similar arguments and counterarguments made in the context of school bus contracts. A long time provider is replaced by a newcomer and you immediately here the argument of “what’s a few dollars, this is the safety of our children at stake?!?!” Usually the new contractor hires the old drivers and can easily purchase or lease the vehicles.

    Obviously an incumbent contractor can always claim an advantage to being on the ground with the resources now. Most businesses do not have a habit of maintaining so much excess in terms of inventory and personnel when they are not providing a service. That doesn’t mean it can’t be done.

    I don’t want to completely discount the question of whether a new contractor can put adequate personnel and ambulances on the street in the next few weeks, but it doesn’t strike me as the main issue. Many of the EMT’s will be the same and likely just go from JCMC to McCabe. As I see it, the real thing the city has to look at is the technology and ability to dispatch. I have toured the Medical Center and was extremely impressed with their command center.

    But again, we had five professionals evaluate the capabilities of the bids. It was a close 3-2 vote, which indicates to me that this was not a fait accompli. All of the bids were very close, and the one voter (Stacey Flanagan) who had the largest margin in favor of JCMC has since said she now feels comfortable with McCabe’s capabilities. I have liked all of my experiences with JCMC, and otherwise have no dog in the hunt. But it seems that much of the arguments to stop this contract have a large element of alarmism to them. As well as the fact that some of the loudest voices against this contract (other than JCMC itself) are the same voices that always attack what any administration does for any reason.

    • Your entire comment invites thoughtful analysis / persuasive reasoning that I plan on incorporating into some upcoming posts.

      You raise good points, i.e. we cannot/should not be alarmist or engage in fear mongering. I started this blog to have a place to channel fact-based posts and discourse that centered around sourced facts vs. conjecture, speculation, and assumptions which often can lead to misinformation and be counterproductive.

      Also, this cannot/should not be anti-Fulop, anti-JCMC, anti-private provider, etc. I’m a Fulop supporter – I worked my personal networks before he was councilman to get his name out for mayor, and I was repeatedly engaged with him on school issues. I volunteered in his campaign office (doing data entry) a few times when he was running for mayor. I point this out to hopefully shed some transparency on my agenda, i.e. for me, this is not anti-establishment or anti-Fulop. This is about the best quality EMS for my kids and family, and for my neighbors for that matter.

      Re: the point about the 5-person panel. Normally, I’d agree with you and not question the city’s processes. But my trust factor in the city government has gone down in the past 6-8 weeks (I explained a bit of that in my “Get Civic” post). My sense, frankly, is that things are being rushed in City Hall. The timeline of this bid process and that there were problems justifying the delay of the vote only hours before the vote feeds my concern. So, yes, the city has its processes, but when the public is left to feel a decrease in confidence, it’s in our right to question…not to be alarmist, but to question, probe, and say “wait a second, hold on…what’s really going on here.”

  2. The BRIDGE WILL BE GAPPED. An alternative company winning the JC contract is not precluded from expanding, hiring or buying equipment and vehicles. Mrfaisel34

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