Youngstown's only ambulance service informed the city it will no longer offer its service by the end of the year if they don't negotiate the current contract agreement. 

A letter submitted to Mayor Tito Brown, City Council, Fire Chief Barry Finley and Law Director Jeff Limbian stated that American Medical Response (AMR) tenders its notice of non­renewal of our Agreement and notice that our Agreement will end December 31 at 11:59 p.m.

AMR, which is based out of Denver-suburb in Colorado, stated in the letter sent to the city that "AMR, and its predecessor companies have been proudly serving the citizens of Youngstown for over 30 years without any cost to the City of Youngstown or its taxpayers. Working together with the City and its other public safety entities, we have positively impacted thousands of lives with exceptional emergency medical care whenever it has been needed."

AMR cited the need for a $750,000 subsidy as the reason for not renewing the agreement with the city, "an inadequate Medicaid reimbursement that makes up a significant portion of our services and which is below our costs." Regional Director Ed Powers told 21 News' Erin Simonek that they have been in contract negotiations with the city for 3 years and believe the city declined the subsidy because they view it as a "money grab." 

"We've been in conversations with AMR long before COVID-19 and ARP funds even existed," Powers said. 

"COVID-19 was very hard on the industry," Powers said. "Responses were up and transports were down. We looked at many different models, revenue sharing, staff sharing, that we could use to make the model sustainable in the city. None of them have been fruitful. We're just looking to create a sustainable model. We do not want to leave the city. We've been in this city 30+ years and we want to continue providing the same good service that we've provided all along."

AMR said the current Ohio Medicaid base rate for basic emergency transport is $120 and has not been re-based by Ohio in years.

"When we treat and transport Medicaid patients, we are reimbursed far below the cost of providing service - approximately 42% of our cost. More than half our transports, or 54%, are Medicaid recipients." the letter stated.

"If you're trying to operate on FIFA service revenue, you don't get any FIFA service for those responses," Powers explained. "You only get FIFA service when you provide a service."

Councilwoman Lauren McNally told 21 News the city's administration hasn't gone out for RFP, a request for proposal to see if there are any other companies who are interested in the contract. Law Director Jeff Limbian said that's because Mayor Brown supported the contract proposals from AMR. McNally also spoke on her concerns with delayed response times and poor service by the company. She explained the extra funds AMR is requesting could be put to better use elsewhere.

She told 21 News she's interested in seeing what AMR is charging other cities.

"More recently, inflationary pressures and rising fuel costs have dramatically increased the costs to provide our life-sustaining services. Any incoming private provider will have the same pressures and any in­sourcing by the city with the fire department will likely increase citizen taxes and greatly exceed private industry costs," AMR Chief Operating Officer Edward Van Horne said in the letter.

21 News has reached out to the mayor and Fire Chief Finley for comment and to discuss what the city will do for the ambulance service in 2023 and have not heard back as of Wednesday at 10 p.m.

Since January of 2022, AMR Ambulance Services has been working with Youngstown City Council because the company is in need of money to help continue to operate.

Early this year, AMR told the city that responding to emergency calls had become too expensive and asked for over $750,000 subsidy, but Youngstown City Council voted the ordinance down.

"It's definitely a challenging market to find another ambulance service," Powers added. "I'm sure you've seen many stories about EMS companies that have gone out of business. Any time you deal with public funds, city council wants to do their due diligence and make sure they're doing the right thing."

IAFF Local 312 President Jon Racco said in a written statement to 21 News that the "Youngstown Fire Fighters Local 312 urges the Brown Administration to sit with us and negotiate the future of pre-hospital care for our citizens. Now is the time to address the inequalities that have plagued Youngstown for years. We are witnessing firsthand the ramifications of putting profits over patients."

Racco's statement continued, "The citizens of Youngstown are entitled to and deserve access to basic infrastructure like public safety, which includes a sustainable, professional EMS system. The Youngstown Professional Fire Fighters urge city leaders to finally recognize our abilities to help our citizens and negotiate the implementation of a first-class pre-hospital care system.     

"We will be in a world of hurt if we don't have an ambulance company ready willing and able to conduct the service in the City of Youngstown," Limbian said. "That's a dire circumstance that we hope and plan to never have to happen here."

Limbian expects to be back at the negotiating table with AMR if they don't get any proposals from other companies, reassuring Youngstown residents they will not go without ambulance services.

"It's just untenable and it's something we can not allow to have happen," Limian concluded. 

Powers said AMR will bid on the FRP when it comes out and he hopes to work out the contract prior to the end of the year. 

AMR said if the contract is not renewed with the City of Youngstown, they will look to service other areas and more hospitals, hoping their 50+ jobs are not affected. 

AMR's current contract expires on December 31, 2022.