SONU MUNSHI
East Valley Tribune (Mesa, Arizona)

Mesa has no way to track whether its ambulance provider is responding to life-threatening emergency calls as required under a contract between the city and the company.

A city audit released last week found that neither Mesa Fire Department dispatchers nor Southwest Ambulance have the ability to consistently log the types of emergency calls coming into the system or the responses to those calls.

The result is "data inaccuracies prevented us from assessing Southwest Ambulance's compliance with the contract's primary performance measure, which is response time to 911 calls," the report states.

Mesa has a three-year contract, until 2010, with Southwest Ambulance, a private ambulance provider.

For serious emergencies, Southwest Ambulance must arrive within nine minutes of being dispatched, at least 90 percent of the time. Such calls represent less than 5 percent of all calls, but these are critical calls, because they "often involve patient survival," the report adds.

"Neither side had a very consistent manner to record the information," said Jennifer Ruttman, Mesa's senior internal auditor. But she also said while the issue is the inability to get accurate data, there is no evidence to suggest Southwest is not complying with its contractual obligations either.

Southwest Ambulance spokeswoman Holly Walter said their company has had a long-standing relationship with the city and has "fully cooperated" with the audit.

"Anything that might need review, anything that comes out of audits like this, is great, to make any adjustments required going forward," Walter said.


Mesa fire department officials have responded to the audit, saying they're already working on rectifying these issues in conjunction with Southwest Ambulance.

Among other findings and suggestions, the audit shows that Mesa fire officials may have been "under-imbursed" by $12,000 in 2008 and may be currently short-changed $2,000 a month as a result of missed cost-of-living increases. Southwest typically has to pay Mesa if the city's paramedics ride in Southwest ambulances. The state Department of Health Services approved the increases in 2006.

Both Mesa and Southwest Ambulance are figuring out the missed reimbursements.

The report also recommends Mesa set other performance measures, besides response times, like patient and fire department paramedic satisfaction ratings, accident rates or equipment failure rates. There's also a lack of enforcement mechanisms to ensure contractor performance, that is, there's no way right now for Mesa to get cash reimbursement if Southwest fails to perform according to the contract, the report states.

"Mesa Fire Department does not adequately document contract monitoring efforts, including known performance issues such as complaints lodged by MFD staff or patients."

Also, unlike Chandler, Tempe and Scottsdale, Mesa's ambulance contract doesn't charge for contract administration costs, which it suggests Mesa could do in future.

Councilman Scott Somers, chair of Mesa's audit and finance committee, said the audit is particularly timely, because next year, once Mesa's three-year contract with Southwest expires, the city is planning to enter into a regional contract along with Gilbert, Queen Creek and Apache Junction. The plan is to use the audit's recommendations and incorporate them into the new contract.

Copyright 2009 East Valley Tribune
June 2, 2009