When the City of Troy replaced the previous ambulance system with a private EMS contractor, residents were told the new system would ensure reliable emergency coverage for the city.
But after reviewing the contract itself, several provisions raise important questions about how the system was designed to operate, and how its performance is being evaluated. The most important issue right now is transparency. Because halfway through March, residents still have not seen the raw response data needed to evaluate whether the system is meeting its contractual standards.
To understand why that matters, it helps to look closely at what the contract actually says.
The Contract Allows a Six-Month “Tiered Response” Trial
The key operational language appears in Section 2.1 of the contract, which describes the deployment model.
Specifically, Section 2.1(a) states that the provider requested permission to operate under a Performance-Based Tiered Response Model. The contract then states:
“The City shall permit this model, as requested by Provider, on a six-month trial basis.”
Under this system, dispatch can send whichever appropriate medical resource is closest, which may include:
- a paramedic first responder
- a basic life support ambulance
- an advanced life support ambulance
- or a combination of those resources
In practice, this means emergency calls may be handled by units coming from anywhere within the regional system if they are the closest available resource. The contract also specifies that at the end of the six-month period, the City Manager (or designee) will evaluate the system’s performance and determine whether the tiered model should continue or whether the contractor must transition to the deployment plan described in the original bid specifications.
The Original Bid Required Dedicated Troy Ambulances
Immediately following the trial language, the contract describes the deployment model contained in the original bid specifications. That model requires:
- five dedicated Advanced Life Support ambulances between 7:00 a.m. and 7:00 p.m.
- four dedicated Advanced Life Support ambulances between 7:00 p.m. and 7:00 a.m.
The contract defines Dedicated ALS Ambulances as units:
- assigned exclusively to serve the City of Troy
- stationed within the city or at a mutually agreed location nearby
- not diverted to serve other jurisdictions
This is a very different deployment model than the tiered response system. Under the dedicated model, a predictable number of ambulances would be assigned specifically to Troy. Under the trial tiered model, the system instead relies on the closest available resources in the broader service area.
Why the Distinction Matters
Many residents understandably assume that when a city contracts for ambulance service, a specific number of ambulances are stationed within the city. But the contract structure shows that the system may operate differently during the initial six-month trial period.
Instead of fixed units stationed exclusively within Troy, the contractor may rely on regional deployment so long as response time standards are achieved. The city then evaluates performance after six months and determines whether the system should continue operating under that model or transition to the dedicated ambulance deployment described in the bid.
The Contract Measures Success Using Response Time Benchmarks
Regardless of the deployment model used, the contract establishes performance benchmarks that the provider must meet. These benchmarks are based on response time performance, generally requiring that:
90% of emergency incidents receive a response within six minutes.
This type of metric is common in EMS contracts, but it also means performance must be evaluated using the underlying response time data. Without that data, it is impossible to independently verify whether the system is meeting its contractual obligations.
Why You May See Ambulances Around Troy
Some residents have noted that they frequently see ambulances staged around the city in parking lots or along major roads. That observation may be anectrue. Modern EMS systems often use a strategy known as System Status Management, where ambulances are dynamically positioned in areas where calls are likely to occur.
However, temporary staging does not necessarily mean those ambulances are dedicated Troy units. Under a regional deployment model, units may move throughout the service area depending on call volume and availability. The important question is not simply where ambulances are staged at any given moment, but whether the system consistently meets the response time standards required by the contract.
The Data Needed to Evaluate Performance Has Not Been Released
This is where the issue becomes particularly concerning. As of mid-March, the public still has not seen:
- the raw response time data for January
- the raw response time data for February
- the February executive summary report
The only performance information that has been publicly discussed so far indicates that approximately 70% of emergency responses were under six minutes in January. If that number is accurate, it would fall significantly short of the 90% response standard described in the contract.
However, without access to the underlying data, residents cannot verify:
- how many calls exceeded the standard
- how long those responses actually took
- whether the deployment model is working as intended
- or whether changes to the system may be necessary
Transparency Is Essential for Public Safety Systems
Emergency medical services are among the most important public safety functions a city provides. When someone calls 911, the speed and reliability of the response can literally mean the difference between life and death. Because of that, EMS systems must be evaluated using transparent and accurate performance data.
The contract itself anticipates that the city will monitor performance and evaluate whether the deployment model is meeting expectations. But that evaluation requires access to the data. Without it, residents are left with summaries and assurances rather than the information needed to understand how the system is actually performing.
The Bottom Line
The Troy EMS contract allows a six-month trial deployment model that relies on a tiered regional response system.
At the end of that trial period, the city has the authority to determine whether the system should continue operating that way or transition to the dedicated ambulance deployment described in the bid specifications.
But before that evaluation can occur, the public deserves to see the information needed to assess the system’s performance.
As of today, those data have not been released. And until they are, residents cannot fully evaluate whether the emergency medical system they were promised is the one they are receiving.