Your questions about Gateway Ambulance

Earlier I published an analysis of our contract with Gateway Ambulance (…/lets-talk-gateway-ambulance-caf021ccff…). A lot of neighbors raised great questions and important additions. This post follows up to offer more depth on some of the topics I’ve heard many neighbors ask to learn more about.

My original analysis started from the question, “How did we know things were working *before* Gateway?” That question didn’t lead to the data, but to our Fire Chief, who has always personally heard almost every single emergency call on his radio. Our Fire Chief said that for now, Gateway has performed comparably to what we had before.

The biggest problems with our contract are long-term. One of the main reasons for outsourcing ambulance service was that our City was unable to collect on more than $1 million of unpaid ambulance bills. Ambulance service was losing the city money at a dangerous rate. When a private company collects less than they were expecting, they can only (1) cut service or (2) over-charge those who are able to pay. Our contract did not put in place effective mechanisms to detect these problems early and exit the contract if things start to go wrong. Also, we should have negotiated for less than a 5-year term, to have the flexibility to address problems moving forward.

We can point our political process toward solutions. We did need to reform our old ambulance system to improve public safety. However, outsourcing was not the only way to achieve that outcome, and above all we needed an inclusive discussion about the best way to make the reforms. Instead, we had one solution rushed through without citizen engagement. When things went wrong, our government did not respond. Our neighbors brought serious concerns about failures with Gateway. Just because a system is working on average, that does not mean that things do not go wrong. There should have been a thorough investigation to bring clarity, closure, and make sure public safety is protected better in future.

We also need a government that takes action. With the switch to Gateway, we lost our cooperative EMS agreements with nearby cities. But with negotiation, we can still re-establish them.


Here are answers to some of the questions raised about the last post. This does not address every aspect of this complicated issue, but offers short summaries and policy ideas for neighbors interested in engaging more. Please reach out if you’d like to talk further!

What does U City’s data show?

U City’s data show that Gateway is faster. To be clear: Gateway does not drive faster, but its drivers can wait for calls behind the wheel of the ambulance instead of in a fire station, allowing them to start driving sooner. Read more:…/learn-more-u-citys-ambulance-data-fa6b…

How do the qualifications of Gateway medics compare to our firefighters? Gateway’s medics pass the same state certification exams that our firefighters do. However, that does not mean Gateway medics are using that training with the professionalism our residents deserve on-scene. We should establish a system to follow-up with residents who use ambulance service, and study the quality of care they receive. Read more:

Was fatigue really a problem for our ambulance drivers? Yes. Before our contract with Gateway, U City ambulance drivers were working 48-hour shifts. That is standard for firefighters, but there are many more ambulance calls than fires. The data shows—and our Fire Chief confirms—that the 48-hour shifts were exhausting for our ambulance drivers. Changing to 12-hour shifts was an important improvement to public safety. Read more:

Where did this data come from? This data has been publicly available for a while. The response times were sunshined and published on Nextdoor months ago. The only new piece of data here was the geographic data of where calls were coming in from, used to create a map of U City ambulance calls. Several residents asked to learn more about the team involved in the work, you can read bios here:

Finally, read here to learn why Gateway’s data is different from U City’s, and what we can do to get reliable data:…/learn-more-why-are-gateways-and-u-city…