City Commissioners unanimously approved an amendment to the agreement for medical transport with Great Falls Emergency Services during their Sept. 20 meeting.

It’s the second amendment to the agreement that was originally approved in 2014.

The city contracts with GFES for ambulance transport services of 911 medical calls for those in the city limits and the contracted fire districts that Great Falls Fire Rescue protects.

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The original agreement requires that all ambulances in the city 911 EMS system be staffed with a paramedic to provide Advanced Life Support services during patient transport. The agreement didn’t specify how many ambulances will be staffed in the city EMS system, but that a paramedic must be on the ambulance.

The original agreement does not allow for Basic Life Support ambulances, those with two emergency medical technicians and not paramedics, to operated within the city 911 system.

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Paramedics have higher levels of training and certifications, which come at a higher cost, and are able to perform more medical services on a scene and during transport.

In 2018, GFES approached the city for an amendment to the agreement since the agency was having trouble staffing paramedics. That amendment allowed GFES to operate BLS ambulances in the city 911 system through May 2019.

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GFFR Chief Jeremy Jones told commissioners that GFES had again approached the city requesting an amendment since “they are once again having staffing issues in regards to retention and recruitment of paramedics.”

The amendment approved by commissioners during their Sept. 20 meeting is similar to the previous amendment and will allow GFES to provide a minimum of two ALS staffed ambulances, meaning paramedics are onboard, at all times and any additional ambulances above the minimum to be staffed at the BLS level and those can take non-emergent calls, according to GFFR.

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The amendment will be in effect through May 2024.

Justin Grohs of GFES told commissioners that they’ll staff the two BLS ambulances and anything over that will depend on their staffing.

The city has an emergency medical dispatch system that allows for triaging medical calls to determine the level of care needed on a call, allowing for ambulance allocation based on need, according to GFFR.

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Last summer, GFFR stopped responding to minor medical calls due to limited resources and an increasing call volume.

All city fire engines have a paramedic onboard and the engine company at Fire Station 4 cross staffs the ambulance at that station to provide ALS transport if needed.

GFFR has a second ambulance that can also provide ALS services when needed.

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If the dispatch system sends a BLS ambulance to a call incorrectly based on the information provided, but it’s determined an ALS ambulance is needed, GFFR would respond to increase the level of care, according to GFFR.

The GFFR ambulances respond to emergent medical calls when know private ALS ambulances are available, and that will be done before a private BLS ambulance is sent on those calls.

“This may lead to an increase of patient transports by GFFR during times the EMS system is busy and a reduction in fire protection,” according to GFFR.

Earlier this year, GFFR also partnered with a third-party vendor to bill for transport services, so if GFFR transports increase due to the amendment with GFES, the city has a cost recovery mechanism for those services, according to GFFR.