Delaware County reviews two years of AMR ambulance contract as officials weigh rebid or extension

Delaware County officials on Feb. 1 discussed two years of data from the countywide ambulance contract with American Medical Response (AMR), with staff reporting improved response times and collection rates but leaving the decision about whether to extend the contract or issue a new request for proposals to the public safety committee.

The county’s EMS coordinator, Maggie Wilson, told the county legislature the AMR contract went into effect Dec. 1, 2022, and the presentation covered activity from Dec. 1, 2022, through Dec. 31, 2024. “We are in our last year of the contract with AMR,” Wilson said, and staff compiled monthly call reviews to support a committee recommendation on whether to extend, renegotiate, or rebid the contract.

Wilson said the county measures “patient contacts” as the times the county-contracted ambulance went to assist someone, including lift assists and stabilization until another unit could take over. County figures show net revenue per transport rose from $482.99 in 2023 to $597.21 in 2024. Across the two-year-and-one-month term, the county billed roughly $2,700,000 and collected about $1,400,000 (about 35% of billed gross charges), Wilson said. She explained that government payers — Medicare and Medicaid — reimburse at a set rate (Wilson said roughly $250 for a basic life support transport) that is well below the county’s gross billed rate (about $1,500), which limits recoverable revenue.

Wilson and others credited a recent statutory change that routes ambulance-billing payments directly to ambulance companies rather than to patients; Wilson said that change has improved collections. She also noted operational benefits in the contract: AMR provided new equipment (three cardiac monitors she estimated at about $32,000 each and a continuous-compression device she estimated at about $13,000), covers vehicle and building maintenance, and made staff available so the county saw no break in service.

Operational details presented included two county-contracted ambulances (both Basic Life Support units) and a paramedic-only “fly car.” One ambulance is stationed in Hamden and the other in Fenders Corners; the fly car is based in Hamden. Wilson reported AMR vehicles logged about 148,514 miles over the contract term. The legislature heard that AMR’s crews are largely local — Wilson said about 85% live in Delaware County or contiguous counties — and that AMR employs six full-time dispatch staff plus two full-time mechanics working from the county station.

On response times, Wilson said the AMR average from tone to on-scene was about 14.2 minutes in the last month reviewed. She contrasted that with earlier conditions, when response times could be substantially longer when the county relied on scattered mutual-aid providers. Supervisors asked whether that 14.2-minute average is skewed by call concentrations near Delhi or other population centers; Wilson said the average reflects the distribution of calls and noted some areas are much faster while others are much slower.

Several supervisors pressed operational questions. One legislator noted AMR handled roughly 2,236 ambulance calls in a year (about 86 per month, roughly six per day) and asked whether AMR could provide a third ambulance if the county chose to increase contracted coverage. Bill, identified as AMR’s regional director, said AMR values the county partnership and that AMR could discuss operational options with county leadership. Phil Peters, identified as the local operations manager for the AMR mutual-aid operation, said crews “are very happy” with the county partnership and that his team values the relationship.

Supervisors discussed two procurement options: a contract extension with AMR or putting the service back out to bid. Staff cautioned that rebidding could raise the county’s cost if competing companies priced differently; several legislators observed that having two ambulances in a geographically large county can leave coverage gaps and said the public safety committee should model scenarios — including the cost of adding a third ambulance or additional fly-car coverage — before making a recommendation.

Wilson said the county will present the data and options to the public safety committee, which the legislature expects to return a formal recommendation. No formal vote or contract decision was taken during the Feb. 1 session.

The county’s discussion highlighted trade-offs officials face: the contract reduces budget volatility (AMR covers equipment, maintenance and staffing under current terms), improves response times compared with earlier mutual-aid patterns, and provides access to state pilot programs; but reimbursement rates from government payers and the county’s geography leave questions about long-term costs and whether additional contracted units will be needed.

County legislators asked staff for further scenario modeling, including (1) the cost and operational implications if local volunteer services decline and AMR were required to cover additional territory; (2) what a third AMR ambulance or a second fly car would cost and how that would change response-time coverage; and (3) more granular breakdowns of where calls originate (Wilson offered to pull how many calls went to specific facilities such as the Delhi campus on request). The public safety committee will consider those scenarios before recommending whether to negotiate an extension or seek bids.