Soon, bill may follow run in a county ambulance

By Joe Schoenmann

Tuesday, Dec. 1, 2009 | 2 a.m.

Clark County is gearing up to charge patients taken to hospitals in Clark County Fire Department ambulances.

Until this year, state law prevented the county from collecting anything from the approximately 350 people who took those rides. Private ambulance companies face no such restriction.

County Commissioners today are to introduce an ordinance that would allow the county fire department to take up to 1,000 patients to hospitals each year. The theory is that the new policy would be good for public safety, in case the private ambulance crews ever go on strike, for example.

But questions about whether the new arrangement will force taxpayers to pay firefighters bonuses have at least one commissioner ready to kill the change.

The county’s contract with the firefighters union calls for firefighters to get more money for transporting patients. Page 56, Article 34 of the 121-page contract states that if the county transports patients “then the Union and the County shall negotiate the appropriate premium pay and any change in working conditions and/or duties ...”

“ ‘Shall’ means must,” Commissioner Steve Sisolak said when the Las Vegas Sun pointed him to that section of the contract. “I can’t believe it.”

In April, Sisolak asked Fire Department administrators very directly if patient transports would result in extra pay for firefighters. Sisolak wanted the county to avoid Las Vegas’ policy of giving its firefighters bonus pay for properly filling out paperwork whenever they transport anyone to a hospital. Las Vegas Fire and Rescue emergency medical technicians get $20 for each trip to a hospital with a patient and paramedics get $30. From January 2002 through the end of 2008, those city firefighter bonuses totaled $2.6 million.

Sisolak doesn’t think firefighters should get any bonus pay for transporting patients.

“Because it’s their job, as far as I’m concerned,” he said. “Why should they get extra pay for doing their job?”

The county fire department transports a patient now only when it is in the best interest of the patient and a private ambulance company is not on the scene. Because it is more an exception than a rule, the firefighters are not collecting on the contract provision.

The relationship between county officials and the fire department has been rocky lately because county firefighters enjoy some of local government’s highest compensation packages but their union would not agree to give up any raises, salary or benefits to help the county deal with its budget crisis. The county has sought and received concessions from most unions as it continues to struggle with revenue shortfalls. The county rejected firefighter union concession offers, saying the union’s proposals would have resulted in no savings to the county. Meanwhile, the county expects a budget shortfall of more than $120 million in the next year alone. It would have to lay off about 1,400 employees to equal that amount.

The new permission from the state to charge ambulance patients was initially seen as a boon to the county, because it would allow the recouping of expenses for the county’s few patient transports. Fire Chief Steve Smith said that the 350 to 400 transports each year cost the county about $35,000 to $40,000.

Smith said Monday that he and Deputy Fire Chief Russ Cameron knew of the union contract clause about premium pay back in April, when Cameron told Sisolak at a commissioners meeting that “the plan” was to not provide additional pay.

Moments later during that meeting, Sisolak asked again.

“The individual firefighters would not get any compensation for this? Because in the city they do.”

“That’s correct,” Cameron said. “It was a policy decision within the city to do that. We’re simply asking to offset the costs of our transports.”

Cameron also said a patient’s bill for a trip to the hospital in a county fire department ambulance could range from $500 to $800.

By e-mail Monday, Smith said: “It is my position there should be NO premium pay for transport of patients due to the fact we were providing the transports before the legislation and the duties and working conditions have not changed.”

Ryan Beaman, the county firefighters union president, told the Sun by e-mail Monday that a change in the county code “will result in NO change to current practice” and “no change from our current operation.”

Even if Sisolak and other commissioners come away satisfied with a promise of no additional pay for firefighters, the county’s approval is no slam dunk. That’s because another union isn’t keen on the idea.

The Service Employees International Union represents ambulance drivers in private companies, and it is worried that the proposed change will put the private ambulance drivers’ jobs at risk, Amber Lopez Lasater, SEIU communications director, said.