A proposal in the city's new Act 47 Recovery Plan has set off alarms at AMED.
The proposal, on Page 151 of the electronic version of the document, calls for investigating the feasibility of establishing a full-fledged emergency medical service within the Fire Department to replace AMED, at least within the city.
If the city follows through on this to preserve union jobs, it would destroy AMED, AMED Deputy Director Gary Watters said.
Moreover, it wouldn't work, financially or in terms of service, he said.
The proposal calls for adding four EMS-cross-trained firefighters per shift along with two advanced life support ambulances to handle EMS calls. It would bring the department's "minimum manning" total to 17, calming concerns that the department doesn't meet national fire protection standards, the proposal states.
It would also "eliminate duplication of services," and it would net $120,000 a year, the proposal predicts.
Such an arrangement in Wilkes-Barre clears about $400,000 a year, according to the proposal.
Bryson Peterman, president of Local 299, International Association of Fire Fighters, the city's firefighter union, declined comment late Wednesday, saying in an email that this specific proposal is "an operational concern outside my control."
Peterman referred the Mirror to Fire Chief Tim Hileman for comment. An attempt to reach Hileman for comment wasn't immediately successful.
It is unclear whether firefighter cuts would be recommended if the EMS proposal is not part of an approved Act 47 plan, John Espenshade of consultant Stevens & Lee said.
For years, firefighters have been providing "quick response service" for ambulance calls, often arriving before AMED to stabilize patients and prepare them for the arrival of ambulances, and the new arrangement would build on that.
The proposal vastly overestimates the profitability of EMS, Watters said.
Due to declining reimbursements, an increase in the number of Medicaid patients, an increase in the number of uninsured - leading to unpaid bills - and annual inflation, AMED barely breaks even anymore, Watters said.
It netted $120,000 in 2011, but may net nothing this year, largely thanks to $837,000 it has had to send to collection, he said.
That is a sign that it "will only get worse," he said.
Median Medicare reimbursements are 1 percent less than ambulance service costs, he said.
The fire department would have even less chance to make money, because pay and benefits there are much greater than at AMED, Watters said.
Firefighters' salaries range from $52,300 to $53,600 a year, he said.
AMED paramedics earn from $36,700 to $42,800; emergency medical technicians - half the workforce of 83 - earn $26,800, Watters said.
Assistant fire chiefs earn about $65,000, while AMED supervisors earn between $48,700 and $57,200, he said.
Firefighters also earn more sick days, pay less for health care and get paid 100 percent of their salary through special worker's compensation - compared to AMED workers' two-thirds pay, based on regular workers' compensation, he said.
Firefighters can retire with defined benefit pension after 20 years, while AMED workers retire in their 60s with defined contribution plans. Firefighters also can get extended health care during retirement, while AMED workers cannot.
The only way AMED is able to make ends meet now is to run a "multi-faceted" service, including critical care runs to tertiary hospitals and wheelchair transport, services that would be difficult for the firefighters to duplicate, he said.
Watters also questioned how the fire department could ensure it had enough firefighters available for fires and enough ambulance workers available for ambulance emergencies, when both were needed simultaneously.
Founded as a joint city and Logan Township authority in 1981, AMED has expanded over the years and now serves all or part of 23 municipalities in Blair, Centre, Clearfield and Huntingdon counties, at no cost to the governments of those municipalities, Watters said.
Ruining the organization could leave many of those areas without ambulance service, Watters said.
Despite his opposition, Watters said he "doesn't begrudge them. If I were worried about my job, I'd be fighting for it too."