It’s been 18 months since employees of American Medical Response’s Independence and South Platte Ambulance service voted to unionize and a year since their representatives began bargaining with the nationwide health care conglomerate.
But there has been little progress toward a contract, and workers are calling for Independence officials to get involved. About 100 employees are in the bargaining unit, including emergency medical technicians, paramedics and dispatchers.
The workers and their representatives complain that these emergency professionals are paid less than similar workers in the area, are required to be on call even on days off and suffer greater-than-average turnover, which threatens patient care.
AMR representatives say that they are still negotiating and that the work shifts are standard in the industry.
Andrew Warlen, Independence’s health director, said he is staying out of the worker-management dispute but that there have been no patient complaints or bad outcomes because of the turnover.
AMR is a division of Colorado-based Envision Healthcare and operates ambulance services in 2,100 communities across the United States. It bought the former Gold Cross Ambulance service in Independence in 1994.
Envision’s EmCare subsidiary manages several area hospital emergency rooms, including those at Centerpoint Medical Center in Independence and Menorah Medical Center in Overland Park. AMR also operates the Kansas City Metro ambulance service in Johnson and Wyandotte counties.
Reiley Nesbitt has worked for AMR’s Independence and South Platte service for 11 years, five as a paramedic and the rest as a dispatcher. He is concerned about the high rate of turnover, which union representatives with the American Federation of State, County and Municipal Employees say is running at 20 percent since June 2014.
“We’ve got a retention problem at AMR,” Nesbitt said.
Ron Cunningham, a spokesman for the ambulance company, disputed the 20 percent turnover figure.
“The turnover rate for full-time employees is around 2 percent per annum,” Cunningham said. “What they are talking about is a 15 percent turnover rate for part-time employees, and most of them leave because they can’t meet our minimum (work) requirement for … 36 hours per month.”
Three union members wrote to Warlen in October, asking him to provide greater oversight over AMR. They wrote that the city “should request information from AMR on a routine basis regarding turnover of personnel” and “require AMR to create a plan for addressing employee satisfaction and retention, and report regularly on efforts made and progress achieved to reduce turnover.”
The workers wrote that “a key component to retaining licensed health care providers is making sure we are treated as professionals when it comes to advocating for our patient.”
To that end, they wrote, they have proposed establishing a professional practice committee “for personnel to collectively make recommendations to AMR management on patient care issues.”
The letter said that “although AMR has agreed to such a committee elsewhere, at this time AMR has not agreed to such a committee in Independence.”
The letter also said that “fatigue and burnout is widespread” among emergency medical services workers but also is “a preventable and unnecessary risk to patients. Our bargaining team has proposed positive solutions to avoid such frequent imposition of unscheduled and involuntary overtime upon employees. We are trying to … manage a reasonable work-life balance.”
Warlen noted that the city simply licenses the local ambulance service, but “the code does not give us management authority over how they manage their operation. We do have an emergency services committee that meets monthly and has representatives from the health department, the police and fire departments, and the hospital. We go over response times as part of that. The focus is really patient outcomes.”
Any failure to respond to calls within certain periods of time triggers fines, Warlen said, and those totals have gone down each month during the past year he has been health director.
Tentative agreements have been reached on some contract issues, the union said. Both the company and the union say negotiations are ongoing and have not yet reached a discussion about pay.