This morning I'm joined by colleague uh uh Council Hogan, Council Nave, President Hudson, and myself.

This morning we are going to talk about the ambulance services with uh fire departments as well as the agreement with AMR and the details within uh so first I'm joined by Chief Mann uh.

And this is uh Craig Whitmer from API from the city.

Craig, welcome.

Um and Craig's been with us um from the time we um put out the RFP and we had an RFP committee um to ensure that the items we were asking for in the RFP eventually made it into a contract to benefit the citizens.

So he's been uh with us working through our performance metrics, going through data between the city and with AMR.

Um so he's been with us the whole time.

Um also with us today, counselor um is uh Bill McGarrity from um, he's a regional director from AMR, and I have our fire department team that has been working on this.

So I know I asked I answered a few questions during a study session and I got your questions.

Um we put it in a PowerPoint.

Okay, um, it's in the black binder, and we also have it up on the screen.

Um and I was gonna let Craig Whitmer kind of run through that because he kind of organized all of our data and information, and then we'll after that, if it's okay with you, we can ask whatever answer whatever questions you have.

Let's do that.

Uh also we are joined by Councillor Johannes Rouser uh with us, so take it away.

Okay, and so in the in your black binder is the same PowerPoint presentation that's up on the screen.

So as Craig is uh going through, he'll be able to um you'll be able to look exactly what he's talking about.

Thank you.

Go ahead, Craig.

So good morning, everyone, and thank you for the opportunity to um kind of provide some background and context for how we arrived at the document we arrived at.

Um so just to run through uh we're gonna provide some uh framing of the national and local context, provide a summary of how uh API came in and was able to sell help support this project.

We're gonna run through some contract highlights, uh happy to focus there discussing performance management and SLAs.

Um then I think happy to answer any questions that I'm able to, and then obviously the experts who uh our subject matter experts will be able to provide uh better information.

So if we could move on to the um national and local context slide.

So Dan, that's next one.

So to frame the issue, uh we saw a significant increase, and this is data from uh 2023 through 2024.

Uh we saw about nearly a 30% increase in 911 calls in Onondaka County.

Um there's a lack of access to transportation that is well known by this body of about 30 percent of folks who don't own a car.

Um it's a challenging labor market for EMTs.

Um you have a decrease in positions, um, and then generally there's a significant lack of access to uh primary care doctors in Onondaga County.

Um these factors lead to uh increased ER wait times and generally um indicates stressors on the overall health care system.

So if you recall around uh 2023, there were significant concerns around the um uh utilization of the mutual aid network.

So in this instance, it was um organizations outside of the county sending their ambulances into the city to provide um emergency medical services, and that sort of conversation and local reporting um motivated us to start a conversation and try to understand what could be done to address it.

So moving on to the next slide, please.

So it's good to recognize that um AMR is a provider of these services across upstate, and we're not the only city that is dealing uh with this question.

Um as we can discuss a little bit later, uh we were able to connect with colleagues in Seattle to provide a little bit more context on the performance management side.

But this is trying to show that this is not an issue that's local to just Syracuse, it's an issue across cities and across the country, but specifically different communities are handling it different ways.

Next slide, please.

So for some background on AMR's history in Syracuse, uh Eastern Ambulance has been operating in the area for about 70 years.

They were the first agency to be providing paramedic level service.

Um really kind of led the way when it came to certain kinds of certifications, uh, service status management.

Um in 96, Eastern Ambulance was acquired by Rural Metro, and in 2015, Rural Metro was acquired by AMR.

So while AMR is a subsidiary of GMR, a national organization, the local branch has been working in the community for over 70 years.

So we're talking about working with the largest EMS provider in the country.

Um that kind of informs and answers the question of you know, why was there only one respondent to the RFP?

And it's because AMR is one of the largest providers and is the largest provider in the country, and certainly the largest provider in the area, truly the only organization that could effectively respond to the RFP and the city's needs.

Next slide, please.

So this is a little bit more information about um SFD's ambulance organization.

So and Chief, correct me if I'm wrong here, but um SFD began operating a 24-7 ambulance service in 2021 in response to the COVID pandemic, so that required a significant amount of administrative work to gain, so you have to demonstrate the need through the certificate of need, and then um while SFD has always provided EMS services as part of its function, ramping up into the full 24-7 uh service was a significant operational uh impact.

So it's important to note here and and happy to talk about it, um, perhaps in another setting that um the administrative components, so cost of recovery for service never really matched what was being spent to provide this service.

So just a little bit more background.

Uh engine company three is staff with four members.

If needed, the ambulance will be deployed with two members to provide transport service, and operationally it severely impacts the fire suppression capabilities and is only done in hot times of high demand.

So for background on the RFP, spring of 2023, we launched the RFP.

Um by March, AMR is the only respondent with a proposal.

Um then there's obviously time in between that we'll speak to in a bit in a bit, but then in July of this year, the RFP committee met and you man unanimously voted to move forward with AMR's proposal.

So the next slide is a summary of API's engagement with this project.

So around March of 2024, we were asked to um really try to do um two things.

Um achieve service level agreements with um sort of another party that we didn't really have much leverage or by way of a um authority over, which is difficult.

Um then try to be able to uh allow SFD to focus more on their core functions.

So over the course of this engagement, we did a significant amount of data collection, analysis, validation, internal presentations, uh working with folks within the mayor's office, working within SFD, um conversations with our um colleagues in Seattle who uh ran a similar procurement transformation program that had some really important lessons for us.