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Ford Fight Threatens Ambulance Supply






DAN CARNEY 

MSNBC.com

 

A long-running dispute between Ford and its diesel engine supplier could
have an unlikely victim - the nation's ambulance operators.

Navistar last week agreed to comply with a state court order and resume
shipments to Ford of the powerful 6.4-liter diesel engines made by its
International Truck and Engine unit. That allows Ford to continue production
of its highly profitable line of F-Series Super Duty pickups.

But the court order and agreement between the two companies did not extend
to an older line of 6-liter engines used to build more than 90 percent of
the nation's ambulances. As a result, production of new ambulances has
ground to a halt and isn't likely to resume any time soon.

If the manufacturers of ambulances can't produce new ambulances, the impact
is obvious, said Fergus Laughridge, president of the National Association of
State EMS Officials: "Emergency responders are not going to have vehicles
that are of the standard [to which] they are accustomed," he said.

The clash began in 2002 when problems with the engines prompted Ford to sue
International, seeking to recover warranty repair costs. Ford withheld
payments to International as compensation for its expenses.

Navistar, exclusive supplier of diesel engines for the Super Duty pickups
since 1979, briefly halted shipments to the automaker in late February,
threatening production of a vehicle that is critical to the fortunes of the
struggling automaker.

While Navistar has agreed to resume shipments of the pickup truck engines,
Ford has already run out of the engines used for ambulances and has halted
shipments of the van chassis used by ambulance operators, according to
Kristin Kinley, a Ford spokeswoman. "Right now, we don't have any of the
engines," she said. "We have depleted our supply."

The engines are ready and waiting, according to Roy Wiley, a spokesman for
International. "You will have to ask Ford why they don't want to pay the
price for them," he said.

Ford declined to comment on Wiley's statement, with Kinley saying only that
the problem is "a supplier issue."

The issue is a minor one for Ford, because only about 10 percent of the
180,000 E-series vans sold by the company annually use the diesel engine.

But the production shutdown will affect ambulance operators and the people
they transport in all types of communities, according to Laughridge of the
EMS group.

Rural fire departments and ambulance services tend to put off replacing
their vehicles as long as possible, while urban operators run their vehicles
almost continuously. In both cases, vehicles tend to rack up so many miles
that they are worn out quickly, he noted.

The shortage could be especially critical in newly built "exurbs" that might
have to rely on vehicles based miles away if they cannot obtain new
ambulances, he said.

"The ability to expand service is going to be greatly diminished if
[ambulance services] aren't able to procure new vehicles," he said.

Ambulance operators are in trouble because the industry has settled on a a
single chassis and powertrain as the foundation of virtually all new
ambulances - the Ford E-series cutaway, said Mike Kastner, government
relations director for the National Truck Equipment Association.

That's the vehicle that looks like the front end of a van onto which
specialty constructors graft their own bodies to build airport hotel shuttle
buses, moving vans, mini school buses or the mobile emergency rooms that are
today's ambulances.

About 92 percent of ambulances based on the cutaway chassis use Ford's
E-series full-size van with International's PowerStroke 6.0-liter diesel
engine, as do 97 percent of new ambulances built on converted vans.

Because ambulance builders' parts and tooling are designed specifically for
this vehicle, it's not easy for them to simply buy another manufacturer's
chassis cab or even use a Ford product with an alternative gasoline engine,
the association said.

Ambulance operators do have options. They can put a gas engine in their Ford
van-based ambulance, use an ambulance based on a diesel Ford Super Duty
pickup truck or switch to a  different chassis supplier, such as General
Motors or Chrysler.

Bill Vidacovich, vice president for maintenance for Acadian Ambulance
Service in Louisiana,  one of the few companies that does not use the Ford
van platform, thinks switching is the solution. 

If Acadian faced a lack of new ambulances, "I would have to do what it takes
to meet my demand," he said. "If that means going to a different
manufacturer, you can bet we'd be figuring that out." Acadian uses
diesel-powered ambulances built on Chevrolet's one-ton truck chassis.

The gas engine alternative is less attractive, because the diesel engines
get better gas mileage and the cost of fuel is critical for ambulance
services such as Acadian, which used more than a million gallons of fuel in
its fleet last year, Vidacovich said.

The diesel engines also last longer, he added.

"I'm not very interested in gas engine vehicles," he said.

  _____  

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EMS Groups Agree on Industry Priorities


 
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SUSAN NICOL KYLE

EMSResponder.com News

BALTIMORE -- The Institute of Medicine report on the nation's EMS system
hasn't been sitting on a shelf gathering dust since its release last year. 

The comprehensive study has been scrutinized by representatives of many EMS
organizations, and workshops on the issues were conducted across the
country. 

Now a multiple-association committee, chaired by the president of the
American College of Emergency Physicians (ACEP), Dr. Brian Keaton, has used
the report to agree on six specific priorities. Their report is expected to
be released later this month. 

The task was daunting, given the number of recommendations and comments
received, said Dr. Robert Bass, executive director of Maryland Institute for
Emergency Medical Services Systems (MIEMSS). 

"We struggled. There were so many issues. We wondered how we would ever get
it down to five," Bass said. "It wasn't easy." 

The group -- that included representatives of national organizations --
first chose five specific categories: pediatrics, trauma, hospitals, EMS and
research. Then, each voted on their top priorities prior to last week's
meeting, called to reach a consensus. 

The EMS groups that voted were National Association of State EMS Officials,
National Association of EMS Physicians and National Association of Emergency
Medical Technicians. 

In the end, the committee agreed to support the report and show a united
front. 

The priorities include: 

*	Research 
*	Establishment of a regional system approach to EMS 
*	Categorization of EMS Centers; identifying specialty and levels of
care facilities 
*	Reimbursement for EMS 
*	Issues regarding Uncompensated Care

The group agreed that hospital boarding and ambulance diversion was such an
important issue that it was added as a sixth priority. Bass said that the
practice should end except in extreme conditions. 

Diverting ambulance crews to other hospitals puts patients at risk, and
often delays response time to other emergencies. And, EMS managers say they
also are concerned about liability. 

"The patient comes first. This can be detrimental, and we also should not be
putting our people in harm's way," said Paul Maniscalco, NAEMT past
president. 

Some crews have reported hauling a patient in an ambulance for three hours
before finding a hospital to accept them. EMS officials say that's
unacceptable, and far exceeds the provider's training. 

When a patient winds up at a hospital outside their community, other systems
are impacted as well, Maniscalco said. 

In addition to being short-changed in the DHS budget, crews also are not
being reimbursed for patient care. 

"They get nothing unless they transport to a hospital. They often treat a
diabetic, and leave. But, they won't be reimbursed," Bass said. 

The additional money could be used to offset training and equipment
expenses, and other associated costs. 

As for obtaining more federal dollars, Bass said it's an uphill battle and
the barriers are tough. EMS is still considered "the new kid on the block." 

"We need to keep beating the drums...that it's not all guns and hoses," Bass
said, adding that shifting funds away from fire and police will not be easy.


But, that won't happen until EMS displays a united front, said Jerry
Overton, past president of the American Ambulance Association. "We can't
stay the course any longer...You have to get involved." 

Overton said Congress sees EMS as fragmented, and that is hurting the cause.


Other issues listed by the group as priorities include the nationwide
shortage of nurses and trauma physicians as well as the need for EMS to
recruit a more diverse workforce. 

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