September 17, 2014

Elyria
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City to LifeCare: Show us lots of your paperwork

ELYRIA — City officials want LifeCare Ambulance Inc. to provide them with paperwork — and a lot of it.
City officials, in their continuing quest to run a fine-tooth comb through the 17-year-old emergency medical services contract with LifeCare, have asked the private company to submit more information to them than does any other city that works with LifeCare.
Bruce Shade, the assistant safety service director in charge of public safety, is requesting documentation on every advanced life support call LifeCare responds to in Elyria going forward as well as in the previous six months.
“The intent is not to ask LifeCare to spend a lot of time generating reports,” Shade said. “They’ve got a very sophisticated system where they can extract data into a simple report. I don’t think it will be very hard.”
LifeCare President Pete de la Porte said he received the request in writing Friday, and while he will comply, he also knows it will be additional work.
“We will give them whatever they request and will answer all of their questions as much as we can, but this will no doubt be a lot of additional work for us,” he said. “We absolutely have that information in house, but it will add a lot of work to what we already do.”
LifeCare answers not just calls in Elyria, but also Lorain, Amherst, South Amherst and Carlisle Township. Elyria averages 400 calls a month.
The information the city is requesting includes the date, time, address and nature of every advanced emergency the company responds to; the time for when the call was received; ambulance dispatched; ambulance arrival on scene and arrival at the hospital; what work paramedics provided; and what fees were charged to the medical insurance provider and/or patient.
Shade said the request is about accountability.
In EMS contracts across the country, a slew of accountability and assessment provisions are spelled out, but in Elyria’s contract that dates back to 1996, there are few. Elyria can ask to see paramedic certifications to ensure trained help goes into neighborhoods, analyze response times to make sure help comes within a reasonable time and scrutinize what fees LifeCare charges Elyria residents and their insurance companies.
“I tried to make sure the items asked for were within the body of the contract and we have a reasonable right to ask for them,” Shade said.
Mayor Holly Brinda defended the information request as an intricate part of the contract review process the city has to take because the agreement with LifeCare has not been updated since it was signed.
“Absolutely this is part of the review process, and we are more than hopeful LifeCare will respond to our information request because we have not made a decision on what will happen going forward,” she said. “We are reviewing the contract and opening up dialogue with the company, but until all information is received I can’t say what will happen in the future.”
Brinda said it will be her, not Council, who will determine the next step, which could include keeping LifeCare with an updated contract or issuing a public request for proposals that opens the process to both LifeCare and other ambulance companies and getting the best deal for the city in a more competitive process.
Brinda said a third scenario also could come into play now that University Hospitals is taking steps to take over EMH Healthcare. With different protocols employed by UH, which will likely come into place, the integration of the two hospitals could be a game changer the city can’t anticipate right now, she said.
That development likely would become more apparent by the end of the year.
Beyond de la Porte, others also are questioning this latest request for information, which comes on the heels of Council unanimously passing a resolution calling for a Brinda to back off LifeCare.
“It is apparent she continues to press forward despite Council’s resolution for her to stop,” said Councilman Vic Stewart, D-at large. “We all said we support reviewing the contract, but this level of scrutiny appears to just be in response to Council’s commitment to LifeCare and comments that have been made public by both sides.”
Councilman Mark Craig,
I-4th Ward, also has been outspoken, urging the Brinda administration to step away from efforts that could be seen as trying to squeeze LifeCare out of Elyria in favor of letting the Fire Department take over.
“I think it’s an attempt to create an onerous burden and make it difficult for LifeCare to do business in the city,” he said. “We are not even talking about a periodic review, but so much work we will have one employee — Mr. Shade — pretty much devoting all of this time to reviewing paperwork from a private company.”
Craig said he wonders when Shade will have time to form the Ambulance Review Board, which is stipulated in the contract but hasn’t been used.
“The one thing the city is supposed to do, it hasn’t done and instead we have someone investigating this issue that should not be an issue,” he said. “We have a resource worth $77,000 — because that is what we are paying Mr. Shade — that is wasting time researching a company that provides an exemplary service when there are so many other things the city should be focused on. Economic development comes to mind for me.”
Shade said the request will not be too much work for him, and LifeCare is not a target, he said.
“We have a private company we have a vendor contract with and basically what they do and how they do it should be available to the view of the public,” he said. “We are also looking at all first-responder calls — response times and quality of care. It’s not that we are just looking at LifeCare. The Fire Department is the other side of this and we want to make sure we are being as efficient as possible and our resources are being used wisely.
“Really the goal is how we can make the service better for patients,” Shade said.
A similar request for information was made to Fire Chief Richard Benton, Shade said.
“I don’t suspect we will spend a lot of time on this every month,” he said. “Identifying those anomalies that fall outside the terms of the agreement will be easy to spot. My expectation based on what I have seen so far is those anomalies are not going to be too often.”
Still, Shade said there are areas he has to look over based on provisions in the contract. First, if LifeCare transports a patient and charges them for advanced life support at $738 a run versus $383 a run, there needs to be documentation to support the higher level of care.
“The benchmark there is theoretically a company or community could provide advanced life support merely for the purpose of charging at the hiring rate,” Shade said.
Second, Shade said a provision in the contract stipulates a 10-minute or shorter response time. Beyond that, LifeCare cannot charge patients or their insurance company for the run.
“Naturally, that was probably put in the contract to assure the public they would have reasonable response times,” Shade said. “When we are talking about critical cases like cardiac arrest, response times need to be within the 4- to 6-minute window if you want a good patient outcome.”
De la Porte said he welcomes the scrutiny if it means concerns will be put to rest.
“At the end of the day, we do a real good job for the city. We have 6-minute response times and we comply fully with the contract,” he said.
Contact Lisa Roberson at 329-7121 or lroberson@chroniclet.com.


  • James Coleman

    Let’s see now councilmembers…avg. of 400 calls per month in Elyria @ $383.00 minimum rate only…more than covers the time and expense! Perhaps these council members receive campaign support from the “de la profit…or porte gang.” A 17 year monopoly run has been a great gig for LifeCash…sorry, Lifecare! The citizens of Elyria deserve competition.

    • JCW

      Way to ignore an obvious smear campaign. That view of the sand down there must be nice.

    • Brian_Reinhardt

      You also have to remember, those ambulance runs are not being paid by taxpayer money, they’re paid mostly through PRIVATE entities. The city has no business putting their noses into business transactions between citizens and a private company. Again, your business may be next in line for scrutiny.

      • JCW

        Well said, sir.

    • johns62

      every time you see Metro land at EMH, remember this number 15K. That the going rate for lifeflight to come to EMH because the ER only wants the tough stuff. Too many flight calls end up treated and released a few hours later.

  • Bob

    Firefighter that has a bad attitude about his last Union Contract, and who looks at the people of Elyria as Low Life Second class citizens because they are not of the same upper class pay scale as them. Further you talk about campaign support , this is exactly that , the Mayor is openly trying to push through a Payback to EFD for there support in getting Brinda elected. More of the Good Ole Boy BS that has been going on for years. I personally don’t want some FF that has been on shift for 23 hours prior coming out to give me emergency medical care. This mayor has already convinced me that she is not the one to vote for in the next election. This is not at all about getting the best for the people of Elyria , it is strictly about getting more money in the pockets of EFD employees. Give me a Break !

  • Brian_Reinhardt

    Residents in the city of Elyria need to pay close attention to what is happening here. Your “government” is going after a private company providing you a reasonable service at a reasonable price. For Mr. Shade to assert that Lifecare is not a target after the recent activity by Brinda and now these current “demands” is a joke. If you stand by and allow this to happen, your business may be next.

  • casheetz

    I don’t understand what is going on here. Council has told the Mayor to knock it off – so to speak – and she is continuing on with this. If she succeeds and EMS is placed with the fire department, our taxes will increase to cover the expense. Bruce Shade was EMS commissioner in Cleveland for some time (I think that was his title). Is he wanting to be in charge here in Elyria? Why try to fix something that isn’t broken? I’m willing to listen to an explaination that makes some sense, so far nothing the Mayor says on this makes any sense.

    • JCW

      Smells like a vendetta to me.

  • alphaz_1

    I’m glad someone is taking this company to tas. When it costs a citizen almost 1,000.00 for a short ride to the emergency room, something needs to be done.

    • JCW

      As opposed to what the ER and associated physicians’ costs are? Gimme a break … it only gets that high if there are extenuating circumstances. What were -yours-?

  • elyrian64

    You can always find the data you want if you look hard enough. “Figures can lie and liars can figure” so I have no doubt Mayor Brinda will find the info “she wants”to side with her trying to eliminate Lifecare. It seems odd to me that Lifecare was never an issue until Mrs. Brinda became mayor. It also seems to me that she has a vendetta of some sort against Lifecare. Anyone that I have know that has used Lifecare have been satisfied with their care. You can’t tell me that if EFD would be anymore efficient or cheaper than Lifecare. I agree they should do all the proper paperwork but stop nitpicking Mayor Brinda. What is the real reason you want Lifecare out and EFD in…..maybe a conflict of interest?????

    • JCW

      ” It also seems to me that she has a vendetta of some sort against Lifecare.”

      Indeed, indeed. I am moved to wonder if the issue is personal … if she or her staff have an active interest in who may be affected by the cuts. It’s okay to be concerned and seek ways to be safe, but doing so with the power of an elected office in the name of the very people that you may leading a witch hunt against spells but one thing … cronyism.
      It may happen all the time … as many are wont to say … but this isn’t even subtle.

      The next mayoral election cannot come soon enough.

  • johns62

    in the same line of questioning, how much expense does the city occur rolling an engine for ambulance calls?

  • Bob

    Why is the mayor trying to fix something THAT IS NOT BROKE? Why not concentrate on bringing businesses to the area and all the closed up building around the city. How about this: take down the partially burned building on the corner of Olive St. & Taylor St.. that has been there FOR YEARS ! The reason why she is so concerned about the fireman is because her brother is a fireman. She will not stop. Hey Mayor put your time and OUR TAX PAYERS MONEY to better use then to investigate a company that has been truly dedicated to the city of Elyria unlike you are !

    • jschwimmer

      I think what is broken is the reimbursement rate. The average Paramedic Salary is 40-50K and Lifecare makes a bundle. The De La Portes should pay their workers a better wage.

  • bigmacky

    hmmm – LifeCare has operated in Elyria for years with not even a second glance by the city brass – yet now with the current mayor its LifeCare this and LifeCare that – here is an idea – stop hiring so many “supervisors” that have retired from public service and are rehired once again into public service – i.e DOUBLE DIP – if you didn’t want to retire – then don’t or if you do – go private sector you’re second go around and give someone else a chance – I bet Elyria has an over abundance of the double dipper at the tax payer expense – one of the reasons the city got out of ambulance service is that it was NOT cost effective – so let a private company do what they do best and serve the city at NO COST – unless you like sending 3/4 of EFD to every accident/medical emergency – oh and why does a fire dept get hazard pay when it is their job to fight fires???? audit? I think not – mcgraf (sp) spelled it out yet they whined and had that report tossed – public servants my eye – only out for themselves – try working a 40 hr week like the rest of us folks

  • JColt

    Politics as usual Carry on.

  • My Opinion

    If LifeCare is completely above board, this level of scrutiny should not be a problem. In fact for a company, any company to have a contract since 1996 without it being put out for RFP occasionally is not good business, but an invitation for corruption. Mayor Brinda should look out for the best interests of the citizens of Elyria, not worry about the good ‘old boys club.

    • Brian_Reinhardt

      Then all she had to do was open the service for competitive bidding, not go on an obvious witch hunt. Let either the “market” decide who is going to provide the service or leave it as it is. Do not try to destroy it underhandedly and possibly unconstitutionally. Someone needs to do a FOIA request on every e-mail and piece of paper generated by the City of Elyria regarding this whole fiasco. Brinda is looking “too hard” at one service for it not to be a targeted “review”. Her motive is now apparently clear and it will take little to find the proof.

    • elyrian64

      Is her level of scrutiny like this for everyone or only a company she has a vendetta against OR that she has another motive that is clear to some of us but maybe not others. I say Lifecare should do all the proper paperwork but then again EVERYONE should do it not just who the Mayor decides should be targeted. Sounds like a smaller version of the IRS only in our local government.