YOUNGSTOWN — Officials with American Medical Response, which provides ambulance service in Youngstown, say without an annual city subsidy of at least $750,000 the company could be forced to close its operations here.

AMR’s existing contract doesn’t include a subsidy, and an effort to add one was rejected in April by city council.

“Under the current terms of the agreement, which we’ve made pretty clear we can’t do, it’s not sustainable,” said Chris Stawasz, the company’s northeast director of government relations.

The company’s contract expires Dec. 31 and would roll over automatically if at least 90 days’ notice of cancellation isn’t given by one party, Stawasz said. That 90-day window is a little more than a month away.

“We’re certainly discussing (giving notice), and our goal is to not have to get to that point,” Stawasz said. “We’re going to make every effort to generate communication between the parties.”

Leaving Youngstown, he said, is “not what we want to do. But it is not a sustainable system under the current agreement.”

‘VERY LIKELY’

Edward Powers, the company’s northeast regional director of operations, said of closing its Youngstown operations if the city doesn’t agree to a payment: “That hasn’t been decided, but it’s a very likely possibility.”

He also said, “We could walk away, but that’s not what we want to do. We want to have a conversation and come to an agreement.”

The company employs about 50 full-time workers at its East Midlothian Boulevard location.

AMR officials have been asking since July 2019 for a subsidy from the city without success, he said.

The funding request was made because an average ambulance run costs about $300 and Medicaid reimburses about $130 so AMR is losing money, Powers said. About 54 percent of all ambulance calls in the city are for Medicaid recipients, he said.

There were 17,000 ambulance runs made by AMR in Youngstown last year and the expectation is for 19,000 this year, Powers said.

The company sought a $62,500 monthly subsidy — that was to be paid out of the city’s American Rescue Plan funds — that would have been retroactive to March 1 for a total amount of $625,000 for this year. While the payment was recommended by the administration, council rejected it 6-1 on April 25.

Since then, AMR officials have tried without success to meet with city council and the administration to discuss a subsidy of at least $750,000 a year starting in 2023. AMR isn’t seeking a city subsidy anymore for this year, Powers said.

“With the way inflation is, the cost of everything is going up; we’d start at $750,000, but that number would probably increase,” he said.

Powers added that it’s “mind boggling” that the city wouldn’t meet with company officials.

LETTER TO CITY

In a June 2 letter to Mayor Jamael Tito Brown, fire Chief Barry Finley and members of council, AMR officials, including Powers, wrote: “We understand and appreciate that there may be differing ideas about the long-term solution to quality sustainable EMS systems in Youngstown and the region in general. And while we are committed to helping find those longer-term solutions with you as a partner, we must first make certain that the fiscal integrity of the current model of delivering EMS in Youngstown remains sound until those solutions are attained.”

It concluded: “Our efforts to bring awareness to this situation and to seek mutually acceptable solutions have been ongoing for the last three years and have now reached a critical mass of concern for us. We hope that you understand and share that concern and will continue to work with us to seek a solution that will ensure the continuation of a successful, reliable and clinically competent EMS system for Youngstown. We ask to discuss this request with you at your earliest opportunity.”

There’s been no response from city officials, Stawasz and Powers said.

“We didn’t even receive a response — nothing,” Stawasz said. “It’s very rare that you have a level of distance between city leaders and a community provider, especially one that’s been in business this long and serving the community this long. I’ve never seen anything like it.”

MAYOR’S POSITION

Brown said: “I’d rather pay for the service than not have the service at all. We need to figure out what we’re going to do. We’re still open to (a subsidy). We need an ambulance service. We submitted to council what we believed was the best option,” and it was rejected.

When council members voted against the payment April 25, it said other ambulance companies likely would be interested in coming to the city if money was being offered.

But with the ambulance contract expiring Dec. 31, the city has neither sought requests for proposals from companies to determine the level of interest nor begun negotiations with AMR.

Brown said city officials need to determine when proposal requests would be sought and said: “We believe AMR will be head and shoulders above the rest. We need to figure out a time frame. We don’t want to lose the service. If we have to supplement, it’s not the best option, but it’s definitely needed. The safety of the citizens is No. 1 for us.”

Law Director Jeff Limbian said Finley has “done a great deal of review of other companies and believes AMR is the best option.”

AMR and its legacy companies have served Youngstown for more than 30 years. The last contract was signed in 2015 with one-year rollovers since that expired, Powers said.

‘TOO IMPORTANT’

Councilwoman Anita Davis, D-6th Ward and chairwoman of the safety committee, said: “I don’t like the idea of a (subsidy) but I’m going to talk with the mayor and law director and have a sit-down on what we’re going to do. I don’t want to see them leave. We’ll find a way to keep them here. It’s far too important to the city.”

Councilman Julius Oliver, D-1st Ward, said he’s willing to meet with AMR officials and see if the city can offer money to keep the company in Youngstown.

“None of us have a problem with revisiting it,” he said. “It wasn’t an absolute no. They’ve got to have it make sense, that’s all. It’s the biggest ambulance company in the country threatening to pull out of an area that needs more ambulances. It’s hard to ask for something and make a threat at the same time. There’s a better way to negotiate.”

Oliver said: “We don’t want to lose an ambulance service, but we don’t want to be held hostage by an ambulance service that underperforms.”

Oliver said AMR has underperformed in the city.

“I need to see something that says they’ve improved, and that’s justified,” he said.

dskolnick@vindy.com