After months of meetings during which city officials explained the city’s emergency medical response codes, requirements and the performance contract for ambulance transport, City Commissioners unanimously approved a new four-year contract for ambulance transport with Great Falls Emergency Services during their Dec. 19 meeting.
Justin Grohs, manager of GFES, said during the meeting, “we do find it acceptable from our perspective.”
Commissioner Joe McKenney asked if the contract required staffing levels for how many ambulances are on duty.
It’s a point that has been discussed during commission work sessions for months this fall and in previous meetings about the same provision.
GFFR offers new ambulance transport contact to GFES
The previous contract, that was awarded in 2014, didn’t set a specific number of ambulances required to be on duty but they were required to have a paramedic on any ambulance operating in the city’s 911 system, making it an advanced life support, or ALS, ambulance.
In 2022, commissioners approved an amendment to that agreements, similar to one they’d approved in 2018, allowing 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 basic life support, or BLS, level and those can take non-emergent calls.
City approves amendments to emergency medical code
During those instances, GFES had trouble staffing paramedics and had asked the city to allow some BLS ambulances into the 911 system, meaning they only have emergency medical technicians on board and no paramedics.
The 2014 contract didn’t allow for any BLS ambulances in the city’s 911 system.
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.
McKenney was a commissioner whey they discussed and approved that amendment in September 2022, which has been in place since.
The language approved in the new contract is similar to that 2022 amendment and requires GFES to provide a minimum of two ALS ambulances, meaning a paramedic is on board; and a minimum of one BLS ambulance with at least two EMTs on board, 24 hours a day, seven days a week.
GFFR Chief Jeremy Jones said those are the minimum staffing requirements but that doesn’t necessarily mean those ambulances will be dedicated to 911 work.
In November, GFFR officials reviewed the proposed contract details with commissioners again after updating the city’s emergency medical system code earlier this fall.
During that meeting, commissioners said they were comfortable with moving forward with GFFR offering the contract to GFES.
City amends ambulance transport agreement [2022]
In recent months, there’s been some discussion essentially asked GFFR officials to negotiate a contract with GFES, to which Jones said during the Nov. 21 meeting that “we never negotiate performance contracts or what our expectations are.”
Jones said they took input from GFES, but would not negotiate a performance contract since the city’s obligation is to provide quality emergency medical response to the community. Staff did make some modifications that GFES requested.
City to consider proposed changes to emergency medical code
The previous contract was set to expire in May and GFFR officials have spent the last few months updating the city’s EMS code and educating commissioners on details of the performance contract to ensure high quality EMS responses within the city.
In October, commissioners approved updates to Title 8, Chapter 5 of city code, which pertains to emergency medical services and makes the city responsible for the EMS system, including fire, medical, hazmat and more.
City considering changes to emergency medical code
GFFR Chief Jeremy Jones said it’s an all hazardous force and the code makes the city, specifically GFFR, responsible.
The only area they contract out is ambulance transportation, since they don’t have enough staffing or vehicles to take that on entirely. GFFR does have some ambulances and will provide transport when necessary.
In 1994, GFFR began responding to all emergency medical calls and commissioners formally established the city’s EMS system in 2007, according to GFFR’s annual report.
City code establishes the provisions used to develop an ambulance performance contract.
At the time, there were multiple ambulance companies in town and there were issues getting the appropriate resources to an emergency in a timely fashion, according to GFFR officials. That lead the city to establishing the EMS system that currently exists.
The code changes are separate from the performance contract itself.
GFFR conducting high rise training
Jones told commissioners during a November work session that the language in the contract is “really what we’ve been doing in our system today.”
Jones told commissioners that some of the changes are updating the contract language to what’s in existence today since some of the verbiage was leftover boiler plate language from when the code and contract were first established in 2008.
GFES has been the city’s ambulance transport contractor since the EMS code was adopted.
