AMR witness says proposed American Ambulance Bridgeport branch likely insufficient and could harm regional EMS stability

William Schietinger, AMR’s regional director for Connecticut West, testified at a Department of Public Health hearing on docket 26-011 that American Ambulance Service’s application to open a Bridgeport branch with three ambulances would be insufficient to meet the transfer volume the applicant reported and could destabilize local EMS capacity.

Schietinger, who was sworn and described himself as AMR’s regional director covering the Bridgeport business unit, told the hearing that AMR currently staffs 29 ambulances at its Bridgeport headquarters and employs roughly 220 people, including about 40 paramedics. He said AMR has provided interfacility transfers (IFTs) for St. Vincent’s Medical Center for decades and that historical contracts included performance measures. "For those calls, you're looking at a minimum of five to six units, especially at peak time," he said when asked how many ambulances would be required to meet the application’s projected volume and a 90% on-time target.

Counsel for the applicant asked Schietinger to review the applicant’s corrected Attachment E4 and Attachment 3A reporting. The application claims the proposed branch would support roughly 400 behavioral-health transfers per year and nearly 5,000 other IFTs from the emergency department and inpatient units. Schietinger said the AMR reports in Attachment 3A show monthly on-time performance (OTP) summaries but lack detail on time of day, day of week, lead time, or the duration of each delay. "The charts don't tell you whether a delay was one minute or one hour," he testified, and added the reports do not identify the specific causes of delays.

Schietinger detailed multiple causes for IFT delays inside hospitals beyond ambulance availability, including elevator breakdowns, missing paperwork, unit staff availability, and delays locating discharge summaries. He said those factors “add time on our task” and that hospital internal delays are a recurring operational issue at St. Vincent’s.

The hearing also addressed rates and cost claims. The applicant asserts a large cost reduction for Bridgeport–Westport transfers. Schietinger testified AMR previously charged an on-contract rate that used Medicare pricing, and that AMR’s usual practice when no signed agreement exists is to bill the maximum allowable or usual customary rate. After a brief dispute about admissibility of an RFP response, parties agreed the witness could testify to the proposed rate in the RFP but not introduce the RFP document itself; Schietinger described the proposed RFP rate as Medicare plus 10% (about $443 one-way for an 11-mile trip if first-call) or Medicare plus 25% (about $500) if volume is shared.

Schietinger said AMR’s internal analysis and staffing standards do not support three ambulances and 17 crew members as described in American’s filing. He estimated that, to achieve a 90% on-time performance standard for the application’s projected volume, a minimum of five to six ambulances would be needed during peak periods and many more crew members than the applicant proposes. "If they’re only talking about having those three ambulances available during peak time and they start entertaining mutual aid, you’re going to be late on those calls," he said.

Counsel put an American Journal of Emergency Medicine article into the record by administrative notice that documents paramedic attrition and staffing shortages in Connecticut and references a statewide task force and training programs. Schietinger said AMR runs recruitment programs such as "earn while you learn" and tuition reimbursement partnerships to increase workforce supply, but the programs are costly and have not fully solved attrition and recruitment challenges.

Schietinger also testified that a prior AMR internal memo temporarily reclassified St. Vincent’s to a lower dispatch tier amid changes in which providers handled some transfer volume; he said the internal note was later redacted. Counsel examined a hospital discharge challenges report that lists transportation and logistical barriers among common avoidable causes of delayed discharges; Schietinger said adding ambulances can help but disagreed that the applicant’s proposed three-ambulance branch would necessarily resolve bottlenecks that also stem from internal hospital processes.

The hearing record shows monthly OTP percentages in Attachment 3A that fall well below a 90% target in many months (for example, the table shows 69.89% for January 2024 and mid-50s figures in late 2025). Schietinger acknowledged the low OTP figures but disputed that the OTP percentages alone prove ambulance delays are the principal cause of ED boarding or throughput problems.

The hearing officer reserved rulings on late filings and the potential sealing/admission of the RFP content. After additional cross-examination and a brief break, the hearing continued.

The record of Schietinger’s testimony centered on three factual points: the applicant’s projected volumes, the granular limits of AMR’s OTP reports, and AMR’s operational view that the proposed staffing and fleet in the application are inadequate to meet the stated demand without affecting AMR’s existing coverage.

What happens next: the hearing officer has taken administrative notice of the cited journal article, has allowed limited testimony about the RFP’s proposed rates (without admitting the RFP document itself), and has reserved decisions on late filings and any sealed exhibits. Further scheduling and rulings on exhibits and filings remain pending in the docket.