City approves 3-year contract with EMS Unlimited
The city’s role as owner/operator of a fire-based ambulance service will come to an end next month as the Aurora City Council voted unanimously to approve a three-year contract with Colorado-based EMS Unlimited.
Under the terms of the agreement, which was signed July 15 by Aurora Mayor Marlin Seeman and company founder and CEO Ebin Latrimurti, EMS Unlimited will provide 24/7/365 emergency ground ambulance service for Aurora, Hamilton County and assigned mutual aid areas. The contract is set to begin Aug. 18 and will run through Aug. 17, 2029, with up to two additional three-year renewals by mutual agreement.
The city’s ambulance service has been the focus of much discussion and sometimes heated debate over the past two years after an audit revealed that the ambulance budget had soared to more than $2 million while also depleting the city’s cash reserves. City Administrator Adam Darbro explained during Tuesday’s council meeting, which drew a small crowd of approximately 15 people, that the contract provides a guaranteed cap on the city’s financial commitment to the service.
“The decision by the city council demonstrates their commitment to maintaining high-quality emergency medical services while taking a sustainable and responsible approach to taxpayer dollars,” he said. “This partnership allows the city to improve its financial position, create long-term budget stability, and continue prioritizing the safety and well-being of our residents.”
In the first year of the agreement, the city will provide $700,119 in ambulance subsidy, which equates to $58,343 per month. The second year, that number drops to $622,194 ($51,849 per month) and the third year the subsidy goes down to $549,548 ($45,795 per month.)
Through the new agreement with EMS Unlimited, the city’s maximum annual subsidy will decrease from nearly $800,000 expended in fiscal year 2024 to $402,119 in fiscal year 2026.
Darbro provided more details as to why the city’s “out-of-pocket expense” would be considerably less, explaining that EMS Unlimited has agreed to pay $48,000 per year to lease the city’s ambulances, communications and equipment, as well as the ambulance building. Also taking into consideration the county’s $250,000 annual contribution to the ambulance service, he said the city will pay $402,119 the first year of the contract, $324,194 in 2027, and $251,548 in 2028.
When asked about the existing contract with the county, Darbro said he has already had conversations with members of the county board of commissioners on the subject.
“I wanted to wait until we had this agreement before we actually start negotiating,” he said. “Those conversations will happen.”
EMS personnel
Another key factor in the council’s recent discussions about considering a private EMS service is the impact on existing personnel. Some EMS employees, who are part of the IAFF Local 4956 union, expressed during public meetings that they would resign if the service goes private, though Darbro noted that all current employees were offered the opportunity to stay on through the transition.
“They (EMS Unlimited) reached out to the staff and they had the opportunity to apply,” he said. “If they applied, they are guaranteed a position. Some have chosen to do so. Some have not. He’s still in the process of interviewing people and I would say he has three-quarters of the staff built, so they’re progressing that way. I know there have been quite a few applicants.”
IFT revenue sharing
A key factor in the city’s EMS operations since taking over what had been a county-run service in 2019 has been inter facility transfers (IFTs). Utilizing ambulances to transfer patients to and from various hospitals in the region is a source of revenue, though those revenues proved to be inconsistent, and for various reasons not always profitable for the fire-based city operation.
Darbro reported that the contact with EMS Unlimited includes a revenue credit sharing clause, which could help reduce the city’s expense further still. He also reiterated that the company may perform inter facility transfers, though 911 coverage takes absolute priority over routine IFT activity.
“As part of the IFT operations there is a revenue credit share,” he said. “Our monthly subsidy for the first year is around $58,000, so for example, if they were bringing in $60,000 in revenue on the two ambulances they are leasing from us, that extra $2,000 would be credited back to the city the next month. There is revenue sharing there if they exceed the dollar amount on the facility transfers with the ambulances they are leasing from us.”
The city currently owns four ambulances. The newest model, dated 2025, will be fully paid for this September. The 2023 and two 2019 ambulances are fully paid for, and all will remain under city ownership.
“If there is maintenance that has to be done on the ’23 or ’25 they have first right to the 2019s as a backup during that maintenance period,” Darbro explained. “It’s something to look at if we want to trade or sell one of the 2019s, but until we make our final payment in September for the ’25 we can’t sublease a lease. So after September, then we can probably look at that.”
Another service outlined in the 38-page contract, which is available upon request for public review, is the use of staffed ambulances for stand-by duty. Darbro reported that EMS Unlimited has agreed to provide dedicated standby services for up to 40 hours per year at no charge, while also providing non-dedicated standby on request.
“The non-dedicated means, so let’s say at a football game if we have ambulances sitting there and they get called out, they have to leave,” he said. “If they are dedicated, that means they have to be there. They can’t leave. So we will decide what events we want them dedicated at. As for the non-dedicated, they’ll do as many as we want, as long as they can leave to go on a call.”
Darbro also noted that Latrimurti has indicated plans to work on mutual aid agreements to help clarify roles when responding to fire calls.
“He wants to put into effect so that ambulances will respond to all the fire calls in the county, but they just won’t be fighting fires,” he said.
That’s a notable differential with the city’s fire-based service, which included training so that EMTs and paramedics could assist with fighting fires.
Exit clause
Another concern raised during recent discussions about going with a private service was the exit clause written into the contract. Should the agreement not work out for any reason, either party must give 180 days notice of a pending change.
“That 180-day notice is listed in the contract,” said City Attorney Ross Luzum when asked to address the issue. “The city would pay for whatever services have been provided up to that point. That’s if there is no event of default. So for whatever reason if the city wants to get out of it or the city doesn’t like how it’s going, provide notice and you’re out of it within 180 days. If there’s an event of default, you can terminate it immediately.”
Mayor Marlin Seeman made a few brief comments during the meeting.
“I appreciate all the comments and questions and the community debate over the months, and actually years,” he said.
With that, Councilman Paul Lackore moved to approve the agreement, with a second coming from Councilman Dick Phillips, followed by a unanimous vote. The council discussed the issue and responded to questions from the audience for about 15 minutes in a meeting that last just over half an hour.