April 01-- A company disqualified from seeking Tulsa's ambulance contract said the board vote was "completely shocking" and the first action of its kind in the company's 68-year history.
EMSA CEO Steve Williamson told Tulsa city councilors Thursday there is some discussion to reconsider the vote that disqualified Rural/Metro Corporation, the nation's second-largest ambulance company, from submitting a proposal.
"It can be done," he said.
After the meeting, Williamson told the Tulsa World that he would know more Monday, but did not elaborate.
The EMSA board voted 6-3 Wednesday to disqualify Rural/Metro Corporation from seeking EMSA's five-year ambulance contract. The action leaves AMR, the nation's largest ambulance operator, and Paramedics Plus the remaining contenders for the new five-year contract, which begins Nov. 1.
The Emergency Medical Services Authority is a government agency that supervises a contractor providing ambulance service to more than 1 million people in Tulsa, Oklahoma City and surrounding suburbs.
Paramedics Plus, based in Texas, has contracted with EMSA since 1998 to provide paramedics. Its current five-year contract was approved by the board in 2008. EMSA has paid Paramedics Plus more than $160 million since 2009, records show.
A state audit, prompted by a World investigation, noted an appearance of conflicts of interest between Williamson and Paramedics Plus. The audit found a pattern of "unwarranted and extravagant" spending at EMSA, including two $400 massages billed by Williamson to Paramedics Plus.
Both Williamson and Paramedics Plus have denied conflicts of interest and the company says it has a compliance audit done every year. EMSA has made numerous policy changes over the past several months to address issues raised by the audit.
Rural/Metro was disqualified by EMSA's board after Williamson told the board that the company had been declared in breach of its contract in Clark County, Ind. At his suggestion, the board viewed a video, posted on a newspaper's website, of county officials discussing allegations of slow response times and lack of medication on ambulances.
Williamson told city councilors Thursday it was important for EMSA to have a pre-qualifying process before formal proposals are accepted.
"There is safety involved," Williamson said. "You want to be sure that everybody that is bidding has the capability to fulfill everything that they might have in a bid."
EMSA closed the portion of its meeting during which the companies' financial capabilities were discussed. EMSA attorneys cited portions of the state open records and open meeting acts they say allowed for the executive session.
Rural/Metro, based in Arizona, was a publicly held company from 1993 until it was acquired in 2011 by the global private equity firm Warburg Pincus, LLC.
Liz Merritt, a company spokeswoman, said Rural/Metro voluntarily ended its contract last month in Clark County, Ind. Merritt said the company is ending its contract due to "communication issues" that could not be resolved with officials there.
"We brought a new management team in but ... we were truly at an impasse," she said.
Phil Forgione, Rural/Metro's vice president of national marketing, said company officials hope EMSA trustees reconsider their vote "and we will have the opportunity to bid."
"We are a 65-year-old company founded in 1948. We operate in 700 communities. ... We've never lost a contract. We never had the opportunity to even address the issues that were raised," he said.
Forgione said Rural/Metro has "never been disqualified" from bidding on a contract.
"There was no transparency in any of this. It's incredibly disheartening and incredibly frustrating."
The company holds ambulance contracts in Orlando, Fla., San Diego, Buffalo, N.Y. and other large cities, he said.
At the meeting, board members asked Williamson whether he knew of any issues with the other companies seeking qualification as bidders.
"Checking for Paramedics Plus and AMR there haven't been any breaches that I could find," Williamson told the board. "Certainly not like the loss of a contract."
Records show at least in the case of AMR, Williamson's statement was not accurate.
AMR is a subsidiary of Emergency Medical Services Corp., a publicly held company, and is based in Greenwood Village, Colo. Its website claims it operates in 40 states and 2,100 communities.
Paramedics Plus is a private company created in 1998 as an expansion of the East Texas Medical Center EMS service and EMSA, its website states. It has operations in five communities, including Tulsa and Oklahoma City.
AMR paid settlements to the federal government in 2011 and 2006 of $2.7 million and $9 million respectively. The company made those payments to resolve allegations it inflated medical claims and gave "illegal inducements" to hospitals in Texas in exchange for referrals.
In Spokane, Wash., AMR was in jeopardy of losing its contract after an audit found it overbilled residents for years. The company agreed to repay about $1 million and was fined by the city, where it still holds the contract.
Paramedics Plus, a much smaller company, was sued by AMR in Alameda County (Calif.) Superior Court and accused of underbidding its contract in that county, news reports state.
The two companies battled in Tulsa in 1998, when a newly formed Paramedics Plus unseated AMR to win EMSA's contract with a bid that was $9 million lower.
AMR's contract with EMSA in 1994 was the company's first contract with a governmental agency. That contract was signed after it purchased EMSA's contractor at the time, LifeFleet Oklahoma Inc.
Trustees concerned
Three EMSA board members -- Clay Bird, Phil Lakin and Ed Shadid -- voted to qualify Rural/Metro as a bidder on the contract. However they said they lacked enough information and time to make an informed decision.
Board Chairwoman Lillian Perryman said concerns raised in "even one town" about quality of care were enough to determine her vote.
Bird, also Tulsa's economic development director, said Thursday: "I'm not sure that we are finished in this process yet. ... It did all happen in such a short period of time. I know that there's concern at least from a couple of the other trustees."
Bird said he and Williamson "are going to visit on Monday about what we might do moving forward."
Lakin, also a Tulsa city councilor, said he would support revisiting the issue. Lakin said he believed any motion to reconsider the vote must be made by one of the six board members who voted to disqualify Rural/Metro Corporation.
Fire Capt. Chad Miller, president of the Tulsa Firefighters Local 176, said representatives of Rural/Metro met with union officials. Tulsa firefighters are first responders on emergency medical calls and must work closely with EMSA paramedics in coordinating service.
"Rural/Metro went the farthest. They actually sat down with us and talked about ways to make the bid the most beneficial to the citizens," Miller said.
Miller said because the state audit raised concerns about conflicts of interest between Paramedics Plus and EMSA, Williamson should have recused himself from the discussion Wednesday.
"We don't feel like it's just happenstance that they (Rural/Metro) have been disqualified from the bidding process," Miller said.
Williamson said, however, that EMSA's request for proposal process "is fair and transparent for all potential bidders."
"It is a proven process that takes into consideration all aspects, financial, quality and service," Williamson said in an email to the World Friday.
The audit noted that in 2010 Williamson sought and received $25,000 from Paramedics Plus to defray his travel costs as head of the American Ambulance Association. Records show the payment was not disclosed to EMSA's board.
The audit concluded the payment, while not a "confirmed conflict of interest," presented an appearance of a conflict and should have been disclosed. EMSA has since amended its code of conduct and developed a conflict of interest form that employees must sign.
In the council committee meeting Thursday, Williamson said he could not explain why the board did not choose to allow Rural/Metro Corporation's bid to be considered.
"I don't pull the puppet strings as implied in these articles and then the board members jump to what I say. This is how we have run these in the past."
World News Researcher Hilary Pittman contributed to this story.
Ziva Branstetter 918-581-8306
Kevin Canfield 918-581-8313
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