City punts on ambulance contract
Decision on hiring company is delayed until after the New Year
by Al Sullivan
Reporter staff writer
Dec 22, 2013 | 6884 views | 4 4 comments | 113 113 recommendations | email to a friend | print
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A TOUGH CALL – Jersey City Council has to decide between two ambulance companies and is being pressed on all sides
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The City Council has decided to postpone voting on a resolution to give a contract for basic life support ambulance service with CarePoint/McCabe Ambulance. The matter became controversial because for decades, the service has been performed by the EMS unit of Jersey City Medical Center (JCMC).

Faced with a protracted conflict over the awarding of the contract, Mayor Steven Fulop withdrew his request to the City Council just prior to last Wednesday’s meeting.

As a result, JCMC asked its supporters not to attend the meeting, and most stayed away. But supporters for CarePoint/ McCabe packed the chamber anyway, brandishing signs supporting McCabe and opposing JCMC. A number of key officials from both CarePoint and McCabe attended the meeting but for the most part agreed not to comment on the contract.

The matter is expected to come back onto the council agenda in January. Most observers on both sides of the issue believe the matter is destined for court, regardless of whom the city selects.

The city’s current five-year contract with JCMC expires on Dec. 31, 2013. In order to continue service, the council voted to extend the contract for the month of January until the legal wrangling over the contract can be decided.

Based on a recommendation by a five-member committee, Fulop asked the council to approve a three-year contract with McCabe Ambulance, which is supported in part by CarePoint Health System, a for-profit company that owns Bayonne Medical Center, Hoboken University Medical Center, and Christ Hospital in Jersey City.
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Faced with a protracted conflict over the awarding of the ambulance contract, Mayor Steven Fulop withdrew his request.
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The bid specifications were issued last September. Eight ambulance companies picked up bid packets. They also attended the pre-bid conference in which the details of the bid specifications were discussed.

Ultimately, only McCabe and JCMC submitted bids.

Performance scoring questioned

In the Dec. 16 council caucus, Councilman Richard Boggiano requested that the issue be delayed because he had questions about how the committee evaluating the bids scored each bidder’s performance. He also expressed concern about the lack of medical professionals on the five person committee.

He and others noted that even though the committee recommended McCabe over JCMC, the scoring in various performance categories showed both companies were very close but with JCMC leading in every area.

The only part of the scoring in which McCabe led was financial. McCabe has offered to reimburse the city for the cost of fire department first responders. In Jersey City, the Fire Department – which has firehouses strategically located throughout the city – sends a unit of its own medically-trained firefighters to each call for an ambulance. This helps reduce overall response time and guarantees that someone is on the scene quickly to begin life-saving measures until the ambulance and paramedics (if needed) arrive.

McCabe also agreed to not charge the city for providing its services. While this was matched by JCMC, during the previous contract period JCMC charged the city almost $20 million over five years.

Councilwoman Diane Coleman asked why JCMC felt it no longer needed the annual $4 million from the city. JCMC officials said the hospital was struggling in 2009, but now is in a better position to provide service without a subsidy from the city.

Questions raised about bid process

Both ambulance companies make their money from patients, whose insurance or other medical coverage pays for all or some of the transport. Paramedics, which JCMC currently provides, are an additional cost, and McCabe would have to subcontract those positions if awarded the contract.

John Lacy, a spokesperson for JCMC, said the city changed the rules in the middle of the process. Lacy said that the city originally proposed a profit sharing arrangement as part of the original bid.

But this, according to Lacy, would be illegal under federal law and might be seen as kind of kickback, since significant fees for transport would come from Medicare or Medicaid. When JCMC pointed this out, the city changed the specifications – which Lacy claims involved a major change in the bid specs.

The change allowed the two services a choice to either pay back some of the cost for first responders, or do away with the need entirely and use first responders of their own. McCabe opted to pay a portion of the salaries for fire fighters who were used as first responders, while JCMC opted to provide a combination of paid and volunteer responders who would serve in this capacity.

Lacy claimed that the five-member committee weighing both bids used JCMC’s choice against the hospital, claiming that the city needed more than volunteers and first responders. JCMC claimed most of those in that role would be paid professionals, and that volunteers would make up only a portion of the group.

Big money is at stake

The core of the conflict for both companies is the financial benefit any provider would get from the contract.

A related issue is where patients would go once they are picked up. McCabe and CarePoint claim that JCMC has for decades bypassed Christ and other hospitals to take patients to JCMC.

CarePoint – which has canceled agreements with nearly all insurance carriers – gets a huge financial benefit from ER admissions. By state law, insurance companies must pay full price for services administered to patients coming in through the ER.

Bayonne Medical Center was recently named the most expensive hospital in the nation partly because of how much it charges for its medical services. CarePoint officials said these charges are designed to push insurance companies into providing lower reimbursement rates.

Awarding the contract to McCabe could guarantee Christ Hospital its fair share of emergency room cases, something CarePoint claims it does not get under JCMC service.

While JCMC has denied bypassing Christ and other hospitals, its policy for EMTs, implemented in 1992 and updated yearly up until 2012, directs its ambulances to bring patients to JCMC unless otherwise directed by the patients or medical need.

JCMC officials say they follow a computer model that dictates which hospital a patient goes to. But JCMC policy pages obtained by The Reporter appear to give McCabe ammunition to make its case.

As the official trauma center for Hudson County, JCMC must get some of the more serious emergency cases anyway – something that would not change regardless of which company gets the contract.

Some believe the loss of the contract could put JCMC, a not for profit hospital, in financial peril, since it also depends on the stream of patients that come through its ER. JCMC has a fleet of about 35 ambulances. Some questioned whether McCabe, which has a fleet of 16 ambulances, can handle the larger volume of calls in Jersey City.

Mikey McCabe, owner of McCabe Ambulance, said his company has already begun to upgrade in anticipation of possibly being awarded the contract, and would purchase additional vehicles if they win the bid.

Bayonne and Jersey City differ

While McCabe has run an ambulance service in Bayonne for more than 40 years, Boggiano said Jersey City is dramatically different in structure and size, and asked how McCabe intend to respond to emergencies quickly.

McCabe said he intended to set up four locations in the city where ambulances would be housed, each able to respond to emergencies quickly.

“Everything is technology these days,” he said, noting that McCabe ambulances are equipped with the latest in navigation devices.

Some residents speaking at the public portion of the Dec. 18 city council meeting expressed concern about relying on technology, noting that JCMC has covered the city for 130 years and its drivers know some of the more complicated parts of the city.

A municipal ambulance service?

By withdrawing the resolution, Mayor Fulop will allow the council to review many of the details of the selection process.

At the Dec. 18 meeting, Councilman David Rivera said he has not yet made up his mind, but suggested that the city might look into developing an ambulance service of its own, operated by the Jersey City Fire Department.

He said two people close to him have died in ambulances, one operated by McCabe, and other by the Jersey City Medical Center.

“People keep talking about this as a loss of life decision, but I’ve already lost two lives,” he said.

While he said he didn’t blame either service, he said it did give him a painful perspective as to how serious a decision this is and how much responsibility the City Council has.

Flooded with emails and phone calls from both sides, Rivera said, “We get it.”

Al Sullivan may be reached at asullivan@hudsonreporter.com.

Comments
(4)
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mrfaisel
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December 28, 2013
Jersey City residents are in desperate need of change, after 130 years! Awarding another EMS service the EMS contract does not preclude them from expanding the business. In fact, this is what any wise EMS business administrator would do with a new city contract. JCMC EMS needs competition. Right now they have no desire to be the best. Let the NEW EMS service for Jersey City show they are better. Jersey City: do not accept the status quo as the best situation. Lest we forget: price gouging, diverting of patients to JCMC and missed emergency calls are some of the many complaints from Jersey City residents. My friend(Perelman_19104 on twitter) is the victim of ongoing gang-stalking which JCMC EMS drivers willingly participates in collaboration with OEM/HLS director W. Greg Kierce. This has gone on for four years. City taxpayer money should not be awarded to an organization that knowingly disrespects Jersey City tax payers.

JCMC EMS has forgotten that Jersey City residents are the “LIVES THAT MATTER,” not theirs.

Mary Mills
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December 24, 2013
THERE IS NO SUCH THING AS A FAIR SHARE OF ER PATIENTS! ALL PATIENTS ARE TAKEN TO WHERE THEY CAN BE TREATED FOR THEIR CONDITION IN AN EMERGENCY, AND ONLY TO WHERE THEY CAN GET TO FASTEST. YOU CAN GO TO THE HOSPITAL OF YOUR CHOICE WHEN CARE FOR YOUR CONDITION AND TIME ARE NOT FACTORS. RECEIVING HOSPITALS EXIST TO TAKE CARE OF THE PATIENT. OTHERWISE THEY SHOULDNT BE ON THE SYSTEM. IF JCMC IS PROVIDING EXCELLENT CARE WHY CHANGE? YOU HAVE TO WONDER WHY THREE VERY WEAK HOSPITALS THAT HAVE NEVER OPERATED THEIR OWN AMBULENCE SERVICES, ARE NOW SO INTERESTED IN DOING IT. BAYONNE IS OUT OF NETWORK FOR MOST PLANS. IF A PATIENT ENTERS THROUGH THEIR ER, THEY CAN DENY THE PAYMENTS AND NEGOTIATE A HIGHER PAYMENT, IN THE MEANTIME RUINING YOU FINANCIALLY. THEY DONT EVEN TAKE MEDICAID FOR THOSE SENIORS WHO ARE UNABLE TO PAY THEIR CHARGES. HOW ANYONE COULD ARGUE THIS LOWERS PAYMENTS OR MEDICAL COSTS IS BEYOND ME TO FATHOM. JCMC IS A NATIONALLY AWARD WINNING NON PROFIT JUDGED SO BY THE INDEPENDENT ACCREDITING ORGANIZATION THE FEDS AND PRIVATE INSURERS USE TO DECIDE WETHER A HOSPITAL MEETS STANDARDS AND SHOULD BE PAID TAXPAYER MONEY IN THE FORM OF MEDICARE MEDICAID AND OTHER PAYMENTS. (JACHO)

THE REVIEWS OF THE OTHER THREE INSTITUTIONS ARE LESS THAN STELLAR. NO SURGICAL RESIDENT, OR SURGEON IS WAITING FOR YOU WHEN UOU ARRIVE WITH A STAB WOUND AT ANY OF THESE SMALL WEAK HOSPITALS. I THINK JCMC PROBABLY TAKES MORE TRAUMA TO CHRIST THAN IT CAN HANDLE.
mrfaisel
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December 23, 2013
Mayor Fulop and Jersey City Council: PLEASE DO NOT SUPPORT JCMC EMS contract renewal with the city of Jersey City. Apparently some lives matter, but my friend's don't. JCMC EMS have been involved in the harassment of my friend for nearly four years now, in conjunction with the OEM/HLS W. Greg Kierce.

On Sunday 12/22/13 at around 4:00 a.m. a brick was thrown through my friend's (Perelman_19104 on twitter) window. This is what it has come to. His storm window was completely shattered. There was glass all over the place. Fortunately, no one was hurt. It would have been a serious dilemma attempting to call JCMC EMS for emergency help.

Jersey City is in desperate need of a change from JCMC EMS' long held monopoly on city ambulance services.
marbs
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December 22, 2013
According to other articles in the papers and online Micky McCabe is a minor partner NOT the owner of McCabe Ambulance. It was reported that he sold a 70% interest in his company to CarePoint. Can the reporter Al Sullivan please verify or disprove this.