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While most of the country was riveted to TV sets on election night in November to see who would become the next president of the United States, many in Lincoln, NE, were immersed with the election results of a highly charged and emotional ballot issue of who would be the next EMS provider in their community.
In what would turn out to be one of this nation's most bitter and hard-fought fights between a private ambulance service and a fire department, the Lincoln Fire Department prevailed in the end. However, the road to improve services in Lincoln was laced with landmines, slick spots and roadblocks.
The battle started in 1993, when the fire department and Eastern Ambulance, Rural/Metro's predecessor, duked it out over the city's ambulance contract. The next year, Rural/Metro - the second-largest U.S. commercial for-profit ambulance provider - bought out Eastern Ambulance. Ironically, in 1992, a consultant's report recommended that the fire department take over EMS transport. The Lincoln Fire Department, however, had some hurdles to overcome prior to even thinking about EMS transport and paramedic engines. The first paramedic hired into the system in November 1994 was Bill Madison, who was appointed as the deputy chief of EMS. According to Madison, "It has been a true reward to see the system grow from 1994 to where we are now."
Jump to 1999. Don Wesley, Lincoln's new mayor, told City Council members that his office was negotiating with Rural/Metro on the renewal of its contract. He further told the council members that if it did not work out, the city would seek new bids on ambulance service. However, in the first part of 2000, the negotiations did break down and the mayor announced that the ambulance contract would go out for bid. The contract with Rural/Metro was due to expire on Jan. 1, 2001.
The plot thickens. With the contract set to expire, Lincoln firefighters made it known that they believe they could deliver superior service with more resources than the four ambulances Rural/Metro was dedicating to emergencies in the community. On the other side of the coin were those who did not want to see the fire department take over EMS.
One player who opposed the fire department was a City Council member who "carried the water" for Rural/Metro. Add the politicians, Rural/Metro and some businesspeople, and you have the makings of an interesting and bitter battle. The City Council member who supported Rural/Metro was Jon Camp. Early in the process, he tried to pass an ordinance through the City Council extending Rural/Metro's contract for two years beyond the Jan. 1, 2001, date. The council voted down his proposal by a 5-2 vote.
Add more players. If there were not enough players already lined up on different sides in this battle, another group entered the fray. Whenever a significant change may occur, egos get in the way and some people worry that they will lose some power. One such group was the Lancaster County Medical Society, which wanted medical oversight. The medical society was essentially a group of physicians, many of whom had no emergency medicine certification. Some of their reasoning for wanting control was so obtuse that they actually feared that the Lincoln Fire Department might try to use too many paramedics in the new system.
Too many paramedics?
The physicians tried to explain this non-intelligent statement by indicating the more paramedics, the less each paramedic gets to perform an advanced life support procedure - thus decreasing their skills. Fire Chief Mike Spadt obviously argued against this notion and Wesley wisely declined the society's proposal.
The ambulance contract was put out for the bid process in the spring of 2000. When the deadline arrived for ambulance bid submissions, three proposals were on the table. One each from Rural/Metro, the Lincoln Fire Department and Platte County Ambulance, which was interested only in the non-emergency service. All the information was sent to a review committee that would present a synopsis to the mayor.