AMED workers rescue the injured and ill for a living.
In the last few days, AMED management has mobilized to rescue the organization itself from a potentially fatal proposal in the city's Act 47 distress recovery plan.
At a regular board meeting Monday for the joint Altoona-Logan Township ambulance authority, Deputy Director Gary Watters spoke of presenting written evidence to plan consultant Stevens & Lee why AMED believes it makes no sense to give all the city's ambulance business to the city fire department.
The plan calls for the city to investigate the feasibility of establishing a full-fledged emergency medical service within the department to replace AMED, in the city at least.
The plan cites potential savings of $480,000 a year over four years to the city.
But the plan cites no real evidence, Watters said.
He hopes to supply evidence that the proposed change would not create savings for the city, but just the opposite.
Not only is the authority not about to earn this year as much as the $120,000 surplus it made in 2011 - an audit figure Watters suspects is the basis of the plan's projection - but it's likely to run a deficit, due to declining reimbursements and lots of unpaid bills, he said.
The fire department could hardly do better financially than AMED, given that it would presumably be limited to service in the city, firefighters earn higher wages and better benefits and the city would need to make a startup capital investment, Watters said.
Moreover, taking away AMED's core territory would put its service to the rest of its territory at risk, creating problems for the other municipalities that rely on AMED, authority officials said.
AMED officials don't necessarily think that city officials support the EMS proposal. But the plan is the consultant's to amend, and City Council will need to approve it as a whole or reject it as a whole Dec. 19, they pointed out.
They don't want to risk the provision, even if it's just a recommendation to explore the possibility of the change, remaining in the plan.
"I don't trust anything where politics are involved," Watters said.
AMED representatives will also present evidence at a mandatory public hearing on the plan Nov. 28, officials said.
AMED also plans to work with its solicitor, who works for a firm that has dealt with other EMS providers besieged in similar fashion, Watters said.
A local representative from the American Federation of State, County and Municipal Employees is working with AMED to oppose the takeover proposal on behalf of the AMED workers he represents, Watters said.
Most galling to Watters is the alleged inconsistency of the proposal with a major overall thrust of the plan - intermunicipal cooperation.
The plan touts such cooperation as the ultimate solution for the city's systemic money problems.
Created in 1981, AMED now serves all or part of 23 municipalities in four counties.
The authority is the epitome of intermunicipal cooperation, Watters said.
AMED workers have been worried, and management has been working to reassure them, according to Watters.
Likewise, city workers have been "very concerned" about the plan's implications for job security and benefits, said Councilman Bill Neugebauer, who sat in for a time Monday for Mayor Bill Schirf, who has been answering questions from workers and residents about the plan.
Those city employees have "been encouraged" to write down those concerns and present them to City Manager Joe Weakland for delivery to the consultant, Neugebauer said.
The consultant can present a revised plan Dec. 7, based on oral and written comments from the public, employees and other stakeholders.
The proposed EMS change would be an extension of the fire department's existing quick response service, by which the 911 center dispatches city firefighters to emergencies in which a patient is unconscious or in cardiac arrest or if the only ambulance is coming from Duncansville or Bellwood, which means a longer-than-ideal response time, Watters said.
The firefighters are limited to "basic life support" services: mainly automated external defibrillation and oxygen.
The department doesn't get reimbursed for the work.
The current policy is fine with Watters.
For a while, around 2005, at the request of the fire chief at that time, the 911 center was dispatching city firefighters to more kinds of calls, including those for chest pain, shortness of breath and falls with simple fractures, Watters said.
That led to situations where five emergency workers would stand around patients in living rooms, he said.
"We had several meetings over it," he said.
Ultimately, the city backed off, because of the extra costs, he said.
Speaking generally, Ken Brody, a lawyer for Page Wolfberg and Wirth of Mechanicsburg, which represents EMS clients, said fire departments that take on responsibility for ambulance work get ambulance reimbursements and may achieve economies through operational consolidation.
"In some circumstances, it makes sense, and in others, not particularly," he said, emphasizing that he isn't familiar with the Altoona case.