Contractor fails with timely ambulance service, city and county say

City and county officials are grappling with how to handle ambulance services.

The company American Medical Response leases an ambulance license from Doña Ana County, but officials say the company does not always respond to calls within a timely manner.

“The city is alleging that AMR has consistently failed to meet these response time standards so far throughout the entire life of the agreement,” City Attorney Brad Douglas told city councilors and county commissioners during a joint work session last week.

Las Cruces Interim Fire Chief Sean Heck told the Las Cruces Bulletin that the city entered into a contract with AMR in 2024 that included criteria for response time based on the severity of the call. For example, AMR was expected to respond faster to more urgent medical calls.

However, the city and county allege AMR has not been meeting those obligations and this has led to them needing to pick up the slack.

“There are many complexities with response time data, and measuring performance with the data provided by the City has been challenging,” an AMR spokesperson said in an email statement in response to inquiries by the Las Cruces Bulletin.

While the city and county allege AMR has not been meeting its contract obligations, AMR’s spokesperson said the company has concerns about the accuracy of the response time data. According to AMR, the company has shared those concerns with Las Cruces and is “committed to continuing to work with the City and the County to develop an accurate data set.” 

Assistant County Manager Stephen Lopez said during the tail end of 2024, the county transported about 225 patients a month due to AMR’s alleged inability to meet its response time obligations. 

“That is greatly concerning to us, because we lease our license for ambulance service to AMR and we are concerned about the safety and wellbeing of our constituents, and so we are working with the City of Las Cruces to find the best path forward to ensure overall public safety,” Lopez said.

AMR disagrees with the assertion that the county has had to transport more than 200 patients each month “simply because of response time delays by AMR,” the company spokesperson said in the email.

“It has been our experience that Doña Ana County Fire Rescue transports patients for reasons other than delayed ETA’s, such as a direct patient request, without any shared written protocol or guidelines,” the spokesperson said. “Doña Ana County has not previously expressed concerns to AMR about either the frequency of ambulance transports or their inability to bill patients for those transports. We have been fully engaged with both the City and County and remain committed to resolving these issues, while continuing to provide high-quality prehospital emergency medical care to the community.” 

The county cannot bill the health insurance companies for those transports because it leases its license to AMR. This has impacted the county to a tune of $1.4 million. AMR’s spokesperson described this as a “solvable issue.”

Lopez said that $1.4 million is in addition to the $3 million the county has already paid to cover the contract. He said Doña Ana has not had to cut any services, but it has tapped into its reserves to cover the costs.

Under the contract, Heck said if AMR doesn’t meet the response time requirements, the company is required to pay liquidated damages. These are essentially compensation for breach of contract.

During the joint County Commission and City Council meeting last week, Douglas said AMR has incurred $450,000 in liquidated damages in the first quarter, $973,000 in the second quarter and $867,000 in the third quarter.

Heck said the issues Las Cruces is having with AMR’s service are “frustrating,” but the city has set up measures to address them.

“We have our own ambulances that we've been using for the past five years to address what was initially a very limited use that has just progressed over the years to more and more and more use of our ambulances that are within the fire department,” he said.

At the same time, Heck is understanding about the challenges AMR has faced. He said the Ambulance Oversight Committee meets on a quarterly basis.

“We've been talking with them, working with them, just try to see what's going on, if it's going to improve, what steps they're making,” he said. “At the end of the day, sometimes, it's personnel issues. Do you have enough people? And it's a struggle across the entire country, having enough workers to do the job.”

While Heck understands the challenges organizations face with not having enough staff, he said “we can't allow that to stop performing.”

Heck said the city cannot allow AMR to use that as an excuse not to fulfill the duties it committed to when it signed the contract.

“They're working on it, we talk about it, we communicate with it, but we're hitting this point...where it's been a year in and we really haven't seen great improvement,” Heck said.

Both the city and county say they have been able to respond to all of the calls for service that have come in.

Heck said in incidents where it is not a pressing medical emergency, the city will wait 21 minutes and, if AMR has not responded, the fire department sends out its ambulance.

Meanwhile, Lopez said Doña Ana County has added additional staff and equipment and is preparing for the possibility that it could need to take over all emergency ambulance service in the future.

Both Heck and Lopez said that people will receive help if they call 9-1-1 and the city and county are committed to responding to those calls in a timely fashion.

“If you have a problem, please, if you have an emergency, please call 911 and someone will be there,” Heck said. “We will be there. Las Cruces Fire Department will always have somebody there as soon as we can.”

He said Las Cruces has the resources to make sure people who need ambulance service get to the hospital. 

Lopez expressed similar commitments to Doña Ana County residents.

“We have been developing plans, we've been developing the resources, and we want to ensure that their safety is priority number one and we are going to work to that end,” he said.