By Mary Shinn
The Gazette
COLORADO SPRINGS, Colo. — The Colorado Springs City Council voted down a new city-run ambulance service Tuesday after months of debate about whether to take over services provided by a private company.
The council voted 5-4 not to create an ambulance service that would have been funded through fees for service, not city taxes. The vote leaves the contract with American Medical Response in place.
Colorado Springs Fire Department Chief Randy Royal recapped the pitch for bringing the ambulance service in-house during the meeting, saying it would be self-sustaining, the city could bill patients less and it would allow the department to continue adding innovative services for low-level and behavioral health calls. The department has been recognized for unique services. For example, crews in SUVs respond to 911 calls for low-level injuries such as sprained ankles that free up others to respond to critical emergencies.
Councilwoman Lynette Crow-Iverson was among the council members that opposed the project and pointed to an audit report that came out Thursday as proof the Fire Department was over-estimating its revenues from commercial insurance. As a city enterprise the service would have to pay for itself through Medicaid, Medicare and commercial insurance payments. Private insurance brings in the highest amount of revenue for ambulance services.
The audit found on average comparable cities bring in about 14% of revenues from commercial insurance companies, while the Fire Department estimated about 23% of revenues could come from commercial insurance.
AMR vs. Colorado Springs Fire Department: How competing ambulance services stack up
The Colorado Springs Fire Department wants to end their contract with American Medical Response and run ambulances themselves, much the way a majority of suburban cities in the Denver metro area do. The City Council begins weighing on Monday whether to go with the Colorado Springs Fire Department plan or renew the contract with American Medical Response.
“Their estimations were over significantly,” Crow-Iverson said. She opposed the project along with councilmembers Dave Donelson, Mike O’Malley, Brian Risley and Michelle Talarico.
As an enterprise fund, the city could not backfill any revenue shortfall with tax revenue.
Crow-Iverson said the city did not have the start-up funding for the service in hand and did not provide the council with the letters of intent from donors. It was a point that Royal disputed, saying the city had monetary commitments. But officials thought it would be premature to collect the money from donors before the council voted on the issue, he said.
“Given start-up costs, the uncertain actual payor mix, and the lag from time of service until cash is received, the EMS enterprise would rely upon available start-up cash during initial operations,” the audit said.
Crow-Iverson also noted that when AMR did not meet the city’s time limit requirements for responding to 911 calls it was by two or three minutes and that will be solved as the agency hires additional people. The company faced a shortage of employees following the pandemic.
“The free market will get back up to speed,” she said.
Councilmembers in favor of the project said they were willing to accept some risk in favor of allowing the Fire Department to innovate and potentially provide faster services
“People’s lives matter and responding to their critical moments should be and should always be our top concern,” said Councilmember David Leinweber.
AMR has struggled to meet the city’s required response to emergencies.
Data show the company paid the city more than $5.7 million in fines — largely for delayed response times — between April 2020 and January 2024.
The city was expecting to start up its new EMS service on April 1, 2025. Now, the city could put out a call for companies to apply to provide services, known as a request for proposal. AMR could be among the companies to apply and could renegotiate its contract at that time.
Mayor Yemi Mobolade, Council President Randy Helms and Royal all said they were disappointed in the council’s decision in a news conference on the steps of City Hall.
“This does set us backward, we are not advancing,” Mobolade said. "... We have got to innovate. We got to be better. We can’t just do things the same way.”
Royal said by relying on a private company to provide services the community has left $35 million in Medicaid payments on the table that could bolster emergency response.
AMR does not qualify those payments as a private company.
The Fire Department argued earlier in the year it could put would-be profits into services that could improve patient experiences and pay employees better. The department expected that if it had taken over the service it would have hired mostly AMR employees.
After nine years, the department expected to have $42 million in the bank.
“This has been the most scrutinized project I have ever been involved with,” Royal said during the meeting.
The move to in-house services also had support from the local firefighter and police associations and Dr. Robin Johnson, the medical director for El Paso County Public Health.
Curt Crumb, president of Colorado Springs Professional Firefighters Union Local 5, said the current for-profit ambulance model holds the community back from world-class care.
“If we continue in the current fashion, we will always have a competing interest,” he said.
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