May 25, 2014

Is It Time Yet???? Is It Time Yet???? Is It Time Yet???? Is It Time Yet???? Is It Time Yet????

Wow....

It has been a very long time since last I visited here. There are times when we get a little overwhelmed in our lives and forget some of the good work we've done in the past. I got to feeling a bit nostalgic today and decided to look up my old digs.

Anyway, for those who still are out there and patiently waiting... (you know who you are)...

It seems that things are beginning to start up again... no-no.... not the "bid" process for a paramedic provider.... no-no-no.... THE GAMES!!! They're starting up playing their games everyone! And, just when you think you have it all figured out here in our beautiful city, a new bout of political games are about to begin... So, here is my helpful little plan for you... I'm going to spend the time and energy to bring everyone up to speed on the political inner-workings of the San Diego City saga, "Ambulance Wars...(a new soap-opera drama, designed and dedicated to those crazy politicians downtown, and the puppet masters that pull their strings) 

Since last I visited all of you.... Career politician Bob Filner, the now defrocked and disgraced former Mayor of San Diego, rose to power with what I thought was one of the most deceptive and underhanded political campaigns I've ever seen, defiling the good name and solid voting record of former Staff Sgt., Nick Popaditch.

A Silver Star awardee for valor under fire, the former Staff Sgt. was recruited by his community to run against Bob Filner for the congressional seat that he held at the time. Three days prior to the election, the Filner campaign spent approximately $250,000.00 to broadcast an add during the World Series, smearing the good name of Nick Popaditch, and dragging his honor through the filth of his politically twisted campaign cesspool.

It wasn't really unexpected immediately following the Mayoral election here in San Diego, to find out that Good 'ol Bob Filner had put off the upcoming paramedic services contract for a two year span, so that he could appoint a committee to "study" the whole issue of EMS delivery within San Diego, following a recent discovery of questionable bookkeeping practices on the part of Rural Metro, who was one half of the "joint venture" that the city and Rural Metro had entered into, "San Diego Medical Services Enterprise."


  • While an "independent"audit of the accounting and bookkeeping practices for San Diego Medical Services Enterprise, by Rural Metro were scrutinized by an independent accounting team, hired by Rural Metro, "found no evidence of wrong doing," what wasn't widely known was the terms of the audit agreement that the city officials bought into.... (a shoe drops...) 
  • The City agreed to a clause in the terms of the audit conducted by Rural Metro's hired accounting firm, that any wrong doing on their part had to demonstrate conclusive proof that the company had used inappropriate accounting principles in their bookkeeping and operating practices, if not found then the city would have to exonerate the company... And so, Rural Metro was absolved of the crime.... (wait for it... wait for it.... "thud"... That was the OTHER other shoe dropping) 
  • But how is it that you can't prove wrong-doing?? I mean, they couldn't find a "smoking gun" that would have proved inappropriate bookkeeping, because RM refused to provide the accounting firm all of the records that were needed to conduct a complete and through investigation, and they weren't compelled to provide the documents, because it wasn't part of the agreement terms. (God, I want to be that lawyer! He got a HUGE bonus for that clause in the arrangement... !) 
  •  It's my understanding that the terms were that their had to be some sort of conclusive proof of wrong doing.... but if your not being compelled to provide every record linked to the now defunct joint partnership, just the records from the partnership... (getting the picture?!!!)


When Bob Filner was removed or stepped down (all political correctness being observed, so as not to piss the pundits off), out the door went the "sweet-heart deal" and RM's "investment" in Mr. Filner's campaign. So, it was once again "game-on"! (Or..... maybe not.)

So, here we are... pushing on into June... where we should be geared-up to begin the competitive bidding process for the paramedic services contract the City of San Diego is required by by state law to conduct, the issue remains "up-in-the-air." Why??? Oh, I'm sure if we ask them that the city council will come up with some kind of answer. But for now kids... I want you all to put on your "special detective thinking caps" for a few minutes and consider the "unanswered" question... Oh, yes.... City Council members...  You too!!!

Questions         (You may NOT answer questions with"the citizens would suffer," If you do, you will receive a zero for your grade) 

  1. Why did Bob Filner want to give Rural Metro a 2-year extension to "study" the administration of the contract, when it was somewhat certain that the tide was going to likely run against Rural Metro???  Who was going to benefit... and who in that two years would likely suffer from such a decision?? ( Pick me teacher, pick me... I know who.... ) 
  2. What were the findings of the independent audit? Did you get to see the report? Who benefitted? who will likely suffer from this audit report?
  3. With new city council elections coming to San Diego in the near future, of the City Council members that stood against Rural Metro, feeling that there was indeed misconduct, and questionable business practices... Who would the extension of the existing contract for paramedic services benefit, and why would it benefit them? Who would stand to lose, and what would they lose, if the extension of the Paramedic Services contract is allowed to continue?
  4. Bonus Questions - (may be used for re-election extra credit)
  • Who do you think will still be in office when a new paramedic contract is ratified for the city, and why do you believe they'll be still be there?
  • Can you tell me when the present paramedic service contract for the City of San Diego is set to expire? When do you believe it will be re-bid? 
Thanks you.... Have a nice day every one!!!

Oh yea... San Diego City Council... Love ya, kiss-kiss, hug-hug!!! Enjoy your retirement...  And, Mayor Kevin... good luck... it WILL be a tough road ahead with a new City Council around the corner. 

Laurie.... Say "Hi" to Job... tell him to also say "Hi' to Phil F and Bob... 


Sincerely,

Caspar Friendly-ghost 
(aka; The Ghost Medic) 









November 07, 2011

How Do You Change 30 Years of EMS Failure? - Part 2

I'm sitting here tonight, thinking about the last 30 years and wonder what happened in all that time to get us where we are today. Back when I was going to paramedic school, California EMS was a "punchline" - a national joke that went something like “the only thing that California ever did for EMS was coin-the-phrase 'paramedic'”. 


Almost from the beginning, the system was broken and everybody who was in charge didn't want to fix it. As paramedics, our power is limited in California. I some states, paramedics have greater autonomy. They work off of standing orders and rarely have to call a base hospital for orders because there rules are so finely honed. In California, we fought and fought to be able to elevate prehospital care, but the darker power has stood in the way. 


Years ago, while paramedics were fighting to be able to intubate patients instead of using the Esophageal Airways. I recall a nurse from San Bernardino County, standing up in the middle of a debate on the topic, and stated rather frankly, “why should paramedics be allowed to do something that I am not allowed to do”. Many of us could not fathom that logic, the nurses were supposed to be on our side, or so we thought.


Being a tender young age at the time, I was ignorant and naive. But at that moment, I knew that  the emergency room nurses in San Diego had been watching the progression of the prehospital system, and were afraid. It was a moment that stayed with me throughout the years. The very nurses we worked with, viewed "paramedics" as potential threats to nursing positions in the ER, and possibly the hospital. While national momentum was heading in the direction of a prehospital delivery system, San Diego nurses knew they had to develop a way to control the juggernaut that was heading this way and reign-it-in, before it was too late.


Ten years ago, my former wife and I were talking about this very topic, and she told me of a conversation she had years before with a co-worker. She told me that the co-worker (herself a nurse) would lay awake at night, worrying about what she was going to do if a less expensive paramedic, were to replaced her in the emergency department, in the face of harder economic times. 


I'm not exactly sure when it occurred, but about the time the paramedic service in San Diego was getting on its feet, San Diego county registered nurses were put in charge of the new prehospital system and the Division of Emergency Medical Services. Although doctors were the ones that oversaw this new prehospital system, it was evident that the nurses in the County were clearly running it. Additionally, they also were the same ones that were training the paramedics as well.


Seeing the opportunity to control all aspects of the prehospital system, and minimize any chance county certified paramedics would take nursing jobs, those at the helm of the County Division of EMS began to write the rules and regulations under which we were allowed to practice. The most significant was the rule that stated that in order for an ambulance to operate in an ALS capacity, there must be 2 paramedics on board at all times. A temporary exception would be granted to the ambulance provider, on a case by case basis dependent on need and reason. 


In essence, the rule was designed to keep paramedics from operating outside of the ambulance, in a hospital setting.


What made me laugh was when they tried to tell me that they made that rule to go above the national standard which was characteristically one paramedic and one EMT as a team on the ambulance. We have to remember, the San Diego was selected as a “model” EMS delivery system by the Federal Government. This was their argument, and also their justification for creating the rule.


Now, as I stated previously, several of the fire departments around the County had jumped onto the bandwagon early and had fully funded and sent personnel off to the EMS Training Office–UCSD Medical Center, in San Diego. It is an unwritten law of physical science that firemen go together with nurses, like bees to honey. Fortunately for the firemen, many of the nurses in the County would walk through the halls of the hospital emergency departments, with her eyes glazed, and their tongues wagging every time a fire department paramedic walked through their emergency room door. To this day, I can still remember a conversation I had with the nurse who told me that the reason she became a nurse was to marry a fireman. So firemen had an “in” with the nursing staff that was running the county division of EMS. The result of that cozy little alliance was the rule that an ambulance provider could only provide advanced life support service and staff paramedics if they had a 911 response area.


Since those rules were written, the County has relaxed its policy to some degree on the need for 2 paramedics on board the ambulance to operate in an ALS capacity. They still want to paramedics on the scene, but because of the City's deal with Rural Metro, one paramedic comes on the ambulance and the other paramedic comes on the fire truck. The belief being that the fire department gets there faster and can then initiate treatment sooner.


There have been several providers that have held the contract for paramedics services in the city of San Diego; Medevac, Hartson, American, etc. Today, Rural Metro holds the contract. If the city's lucky Rural Metro will be sent packing also. For the past 30 years every provider that is held the contract to provide paramedic services for the city of San Diego, has walked into the City Council chambers and promised the moon, the stars, and the heavens above if the city were to award them the contract, and of course because they are a large provider of ambulance services the city awards from the contract. Every time that contractors been awarded the provider that it has been awarded to, fails miserably and leaves the taxpayers holding the bag.


To fix this failed system we need proactive leadership on the part of both the city and  county governments of San Diego. Many years ago, I can remember when there were only a handful of ambulance providers in the county. These providers were all local hard-working entrepreneurs, who want a chance decided they wanted to make a difference and started their own ambulance services. And, for 30 years every provider that didn't have prior experience as a 911–ALS ambulance provider was not allowed to improve or to better their ability to serve the public. These entrepreneurs, these local businesses, who paid their taxes, paid their fees and supported our local government. Not one of these aforementioned ambulance providers has asked the city or the County for one dime back in a subsidy or a payment of any kind.


Today the County Division of EMS, largely ignores these non-–ALS ambulance providers, with the exception of a single representative from the San Diego County Ambulance Association. That delegate attends committees to listen and observe, but never are they allowed to vote or have a say in any of the decisions or rules they have enacted for us to operate under. So, how is this fair?


It was our founding fathers of this country who cried out before the King of England, “no taxation, without representation”. 


My resolve in this instance is clear. There is only ONE solution that is equitable for everyone except one (and you know who you are!). The rules for ALS, must be changed. Set up a system where the existing services are allowed to participate and elevate the level of service delivery to the constituents of San Diego city and county.


A change to the ordinances that preclude a provider the ability to elevate their level of services would actually benefit the county's population. By creating a system of EMS delivery in the City of San Diego for instance, where instead of a single provider with a monopoly, there were say 5 or 6 that had to meet of exceed an obtainable set of standards that were defined by the County or independent EMS Board, it would provide greater control for the city. Should a provider not measure up to the standard established by the city, it would be easier to replace them without having a disruption. Today, if the city wants to admonish Rural Metro for their behavior, Rural Metro has the council over a barrel. 


Currently, the City has had to renew the Rural Metro contract for another 2 years because they are not ready to release and RFP. I say that we use this time to open a dialogue with the county and the providers in the area. They have invested in San Diego, isn't it time that San Diego invest in them?


Given the state of our economy both locally and nationally, it would seem to make sense to have a plan, instead of trying to determine how we are going to cut funding for necessary services? Maybe then, more cities in San Diego County will be able to design a delivery model that doesn't cost the citizens a tax subsidy. 


I believe that if you research this topic, you'll find that there is a system of EMS delivery that includes public and private participation.  A google search will likely reveal this.Try the terms “EMS delivery system examples”, or better yet “EMS Structured for Quality; Best Practices in Designing, Managing and Contracting for Emergency Ambulance Service”, it's published by the American Ambulance Association. I'm sure most of you will find it very informative.


I don't have all the answers, but maybe my well of experience can help me deliver one or at least help in the search. 


I spent many years being silent, fearing retribution or retaliation. However today I'm winding down in my career, and I'd like to give something back while I can. 


With the introduction of social media; Twitter, Facebook, instant messaging, e-mails, etc., I'm afforded the chance to talk to you candidly, and not worry about those in power that pull the strings and make us dance  like puppets. I cannot speak for you, but I can speak to you. My days as “Pinocchio” are over. This is my last dance, and I truly hope that those who can make a difference will put this county first before politics, and keep the special interests and the crooks from continuing to assert their own agenda.

November 04, 2011

"Ambulance Chasers": The Closing Post On the Story...

I was sitting down tonight, conducting research for the second half of my ..."30 years of Failure..." piece, when I came upon a final and decisive "door closing" end to the "Ambulance Chaser" story... I can assure you (I say that with baited breath), that their won't be a sequel and that MONEY had the final say, once again.

Enjoy.


Rural/Metro to acquire rival


ambulance company



Rural/Metro Corp. will acquire rival PMT Ambulance in a deal that will create a dominant 911 and non-emergency medical- transportation company in metro Phoenix.

Rural/Metro, which owns Southwest Ambulance, will purchase Professional Medical Transport and its related companies.

Terms of the deal between the privately owned companies were not disclosed.

The transaction will reverberate through city halls across the region because Southwest and PMT often sparred with each other over municipal 911 contracts. With the companies combining under one owner, it gives metro Phoenix cities and towns one less option when contracting for emergency medical service.

Still, both parties said the combined company will be financially stronger as g overnment agencies, such as the state's Medicaid program, cut reimbursement.

For customers, "it will be business as usual," Rural/Metro CEO Michael DiMino said.

If the combined company's service slipped after the merger is completed, consequences would be severe, he said.
"This is a highly regulated situation in Arizona, and we could easily lose our ability to serve," he said.

Ambulance companies are required to hold a "certificate of necessity" to provide emergency medical service to communities. The Arizona Department of Health Services requires ambulance companies to submit paperwork when they seek to transfer such certificates because of ownership changes. Municipalities that contract with PMT Ambulance also may be required to review their contracts with the company following the ownership change.

Bob Ramsey, who owns StarWest Associates, the parent company of PMT Ambulance, said he fielded several offers to sell his Tempe- based ambulance company. He sold to Scottsdale-based Rural/Metro because he believes the former competitors make a good fit.

Ramsey also cited a competitive ambulance industry, with smaller companies pairing up with larger companies as governments have reduced payments for ambulance service.

"It was just time to go to the next level," Ramsey said. "We really achieved everything we set out to do."

The deal also marks a return to Ramsey's roots. Ramsey founded Southwest Ambulance in 1982 and grew the company, securing several municipal 911 contracts before selling the company to Rural/Metro.

After Ramsey sold Southwest Ambulance, he launched PMT Ambulance with Pat Cantelme, a former Phoenix rire captain.
Since 2005, PMT Ambulance secured 911 ambulance service in Scottsdale, Paradise Valley, Tempe, Guadalupe, Peoria and parts of Chandler. All those municipalities were previously served by Southwest Ambulance. The service change came after sometimes contentious City Council votes, most recently in Peoria.

"In some ways, we are putting it all back together," DiMino said. "Since I got here over a year ago, I have learned to respect Bob. I think he was a good competitor. You always want to team up together if you can."

Even though Southwest Ambulance and PMT Ambulance will be owned by the same company, they will continue to operate under their existing names, both companies said.

DiMino and Ramsey said they don't expect job cuts as the two companies merge. Southwest Ambulance employs about 1,200, and PMT Ambulance has more than 600 employees.

Rural/Metro will also take ownership of Lifestar Ambulance, Lifestar Ambulette, ComTrans and American Ambulance.
Ramsey will not be employed by Rural/Metro, but he will serve as a consultant to DiMino. Ramsey also will maintain ownership of StarWest Associates and its subsidiary,

StarWest Tech, which provides technology services to ambulance companies.

But Ramsey said he has no plans to launch another ambulance company, and he agreed to not compete with Rural/Metro as part of the deal.

"It was time to look out for the long-term interest of our employees and our companies," Ramsey said. "That is really what drove me to do this."

Ken Alitucker - The Arizona Republic

November 02, 2011

Before I go on to Part 2.... A Peek Into Our Future

I will continue with the dark and hidden shadows of our EMS history in my next article. However, I ran across this article that was printed in 2005, when a certain company that runs San Diego's EMS services was on the receiving end of some shady dealings in their own back yard.

It involves a gentleman that I actually know who use to own the largest "911 Emergency" ambulance service in the greater Phoenix region, and Rural Metro - the company he sold his ambulance service to - and how he had received as my father would always say with a chuckle, "the short-end-of-the-stick", from Rural Metro.

Bob Ramsey had a Southwest Operation in San Diego County many years ago as I recall, and was a character study indeed. But I found this "David and Goliath" story humorous. And, when all is said and done a few years from now, I think a little bit of this story's history may repeat itself out here in San Diego.

This one is on me, the "Ghost Medic of San Diego" !

Enjoy...


Ambulance Chasers 

Winning ambulance contracts? It's all about who you know.
(Unless it's about the dirt they've got on you.)

By Sarah Fenske Thursday, Oct 27 2005 - Phoenix NewTimes News


He's not your stereotypical firefighter: beefy, deliciously cocky, over-the-top charismatic.

Instead, Pat Cantelme is a small man with a soft voice and a certain reserve. In his polo shirt and wire-rimmed glasses, he looks like a guy who'd do your taxes, not lead a firefighters union.

But that's what he did, and he did it so successfully that his name is still legend in the Phoenix Fire Department, nearly seven years after his retirement.

At 18, Cantelme was the youngest firefighter the city ever hired. He made captain at 25 -- again, the youngest ever. He was elected president of the firefighters union in 1978 and kept the job for 20 years.

It's hard to find anyone in the Valley's union brass who doesn't consider him a personal friend. More than that, everyone agrees that he's responsible for winning local firefighters the clout they currently enjoy.

Now Cantelme's banking on his legend status, hoping it will help him crack a virtual monopoly that's worth millions of dollars.

He wants to make a name in business the way he once made it in union politics.

He wants to take your 911 call.

More specifically, Cantelme's new business, Professional Medical Transport, wants to supply the ambulances and paramedics that respond to emergency calls.

In some ways, it's a natural fit. Cantelme learned the ambulance business during his years as a Phoenix firefighter, when he helped the city set up its own ambulance service. Why not take what he learned in the public sector and help a privately run ambulance company work better?

"This is something I know how to do," he says, and there is no braggadocio in his voice.

But there is one small problem.

The company that currently has a lock on the market is a union company. Its emergency workers, in fact, organized under the International Association of Fire Fighters -- with the help of Pat Cantelme.

And now, Cantelme's company, which isn't unionized, wants to take their jobs.

Understandably, Cantelme's plan is creating no small amount of tension within local fire unions. On one hand, there's the guy who made them what they are.

On the other: their own union brothers.

The fight has become vicious. It's turned brother against brother, local union against local union. There have been allegations of corruption, anonymous e-mails, grand conspiracy theories.

And, shocking everyone -- including, apparently, Pat Cantelme -- a set of long-hidden financial transactions has come to light, transactions that raise serious questions about Cantelme's actions during his union heyday.

As it turns out, even while he was working as union president and a full-time Phoenix firefighter, Cantelme was making money on the side. A lot of money.

He was being paid by a company whose employees he'd helped to organize under the International Association of Fire Fighters.

Despite little evidence that he actually showed up to work, Cantelme made $40,000 a year for three years. When the company sold, he got a check for $2.3 million.

He was supposed to be helping his union brothers. He even chaired the IAFF's anti-privatization committee.

But at the same time, he was working for a private ambulance company and launching a business venture with its owner, Bob Ramsey, a guy reviled by the union rank and file.

The union working for that company knew nothing about it. And though the union members were never happy with the deals they were getting, they were assured by none other than Pat Cantelme that everything was all right.

It's no wonder that the news of Cantelme's financial dealings has rocked his former union brethren -- or that they're now trying to use it against him as he enters the ambulance market.

No one's accusing Cantelme of breaking the law. No one is calling for a criminal investigation.

But they are asking questions.

Cantelme's union brothers never would have thought it possible that he would betray his union ideals for a buck. But now they wonder: Did he do it for $2.3 million?

The way it used to work, if you called 911 in the Valley, your fate depended on the luck of the draw. A host of private ambulance companies took the calls on a rotation system -- which meant proximity didn't matter, skill didn't matter, customer service didn't matter.

The only thing that mattered was which company was next in the line.

With life and death in the balance, such a disorganized system was bound to cause problems. Ambulance companies fought over jobs in areas where patients were likely to pay their bills -- but not everyone was so lucky. Some ambulances even carried credit-card machines to make sure patients were good for the money before giving them a ride to the hospital.

The state of Arizona stepped in, and now each municipality inks an exclusive contract with the company of its choice.

Back in 1985, the state licensed six ambulance companies to take emergency calls in greater Phoenix. But today, if you call 911 from almost anywhere in Maricopa County, you're going to get the same company: Southwest Ambulance.

The company, based in Scottsdale, has a virtual lock on the Valley. Along with its parent, Rural/Metro, Southwest handles the majority of 911 business in Maricopa, Pinal, and Pima counties. (The biggest exception is the city of Phoenix, which has run its own ambulance service through the fire department for more than 20 years.) But now Cantelme and his partner, Bob Ramsey, hope to break Southwest's dominance.

Their new company, PMT, made a pitch for the Scottsdale contract this summer and was selected by the independent committee that the city commissioned to evaluate proposals. The Scottsdale City Council is expected to approve a contract with PMT this week.

Cantelme and Ramsey are also gunning for the contract in Chandler.

There, city officials opted against automatically renewing Southwest's contract this summer. Instead, they issued a request for proposals. They'll likely choose between Southwest and PMT by the year's end.

By then, Tempe's contract is due to expire. Cantelme and Ramsey are eyeing that, too.

Their aggressive positioning could lead to a major blow to Southwest: three major municipal contracts, gone.

Southwest is livid, and it's fighting back. It's challenging the proposals on a municipal level; through its employees and consultants, the company is also attacking Cantelme and Ramsey, raising questions about their tactics, their history, and even their integrity.

But Cantelme vows there will be even more showdowns in the future.

"They've got a monopoly, but we're trying to create a performance-based system," Cantelme says. "We're saying, if we can do it better, let us do it."

His point is only slightly complicated by an odd twist of history: It was his own partner, Ramsey, who created the monopoly that exists today.

For it was Bob Ramsey who started, and then sold, Southwest.

So when Cantelme and Ramsey challenge Southwest's monopoly, they're actually fighting Ramsey's former company and the people he sold it to.

And when Southwest employees argue that Ramsey is a jerk, they're talking about their former boss.

Bob Ramsey is a big man, although not as big as his detractors insist. They'll tell you he's morbidly obese, but he's really just soft, with a fleshy face and a thick torso.

It's his personality that fills the room. Naturally, Ramsey's critics warn about this, too. They say he takes credit for inventing the strobe light, that he brags endlessly, that he calls himself the father of Valley ambulance service.

But despite an interview that lasts well more than an hour, he never mentions the strobe light. And though he does use the word "father" in connection to himself and the current ambulance system, he's 100 percent deserving of the title.

As Ramsey tells it, he was always interested in emergency service. As a kid growing up in south Phoenix, he put together a bicycle Safety Patrol that, he says, was written up in Boys' Life. (Naturally, he remembers the year: 1957.) As a young man, he adds, he helped put together the first EMT training for Indian reservations in the country.

But after a few years of working for other people's ambulance companies, Ramsey was itching to branch out on his own.

In 1982, he rounded up some investors, one of them his dad, and started a company. He called it Southwest Ambulance.

He was successful, wildly so. By the time he sold his holdings to Scottsdale-based Rural/Metro in 1997, Ramsey ran four companies that tackled various parts of the ambulance business, from billing to supplies.

His growth didn't come without controversy.

He and Southwest were indicted for fraud, theft and racketeering in 1991. The county attorney alleged the company had a habit of overbilling insurance companies. The judge tossed out the charges within a few months.

A few years later, one of Ramsey's original investors sued, alleging Ramsey had bilked him out of his share of the profits. The suit was dropped without resolution, other than fat legal bills. (The investor has since died.)

Ramsey can be gregarious, but he's also notoriously tough on his employees. He ran a tight ship, employees say.

Jim Hayden, president of the emergency workers union from 1991 to 1995, wrote in a letter to the IAFF this September that Ramsey's relations with his employees were unpleasant.

"It is fair to say our membership did not care for Mr. Ramsey and only thought he was out for himself in making more and more money for his pocketbook," he wrote. Turnover was high.

But profits were high, too.

Selling to Rural/Metro netted Ramsey more than $16 million in cash, with stock options worth more than $11 million.

(That part he doesn't volunteer, not even in a self-effacing way. The details come from Securities and Exchange Commission filings.)

The sale made Ramsey one of Rural/Metro's biggest individual shareholders. He was named executive vice president and joined the board of directors, vowing to help expand operations.

He lasted all of two years. In January 2000, Rural/Metro's CEO resigned, and less than a week later, Ramsey was gone for good.

His detractors say he was forced out. But Ramsey insists that the decision to leave was strictly his own.

"Public companies tend to be short-term thinkers," he says. "They resolve problems by closing operations rather than making them work. That's not what I do. I build."

He admits that his departure didn't exactly leave him in an ideal position. True, he was rich, but he's also a guy who likes to build. He wasn't ready to retire. And he had one big problem. For all his entrepreneurial skills, he knew how to build one thing -- ambulance companies. And he knew one area: greater Phoenix.

Rural/Metro had signed him to a non-compete agreement that applied specifically to ambulances. In Phoenix.

He wasn't entirely idle. On Ramsey's way out the door, Rural/Metro sold him rights to an ambulance company it had been planning to launch in Las Vegas.

So Ramsey built his Vegas operation. He made an unsuccessful attempt to enter the market in Contra Costa, California.

He bided his time.

When his non-compete agreement expired in 2002, Ramsey was free. Almost immediately, he started buying small ambulance companies in the Valley: American LifeStar, ComTrans, American Ambulance.

He could only get so much traction. The state keeps a tight rein on the ambulance market, and no company can operate without a very specific state-issued "certificate of need." And, like liquor licenses, a new certificate of need can be almost impossible to obtain.

So while Ramsey's new companies were licensed to transport patients from nursing homes to hospitals, they didn't have the right certificate to take 911 calls.

Ramsey plotted ways to get back in the 911 business. He wanted to partner with a municipality and get the certification through it, but the Arizona Department of Health Services refused to sign off on the idea.

At another point, he vowed to get 911 certification for American LifeStar, but the process proved too onerous even for Bob Ramsey.

"It's probably easier to fly to the moon," he says. "It's easier to buy companies."

This past January, Ramsey and Cantelme purchased PMT. Unlike Ramsey's previous purchases in the Valley, PMT had the proper 911 certification.

After almost five years of waiting, Bob Ramsey was back in the 911 business.

He had the license. (Finally.)

He had the will. (He'd proven that, from his days in Boys' Life to the three years he spent trying to reenter the 911 market here.)

He also had a business partner with enviable connections.

And that, of course, was Pat Cantelme.

When it comes to ambulance contracts, it's all about the people you know.

After all, you can't win the contract by promising cheaper rates. The rate is set by the state. In Maricopa County, it's $621, plus $12 a mile.

You can't win by promising to sweeten the deal, either.

Most "extras" that ambulance companies have attempted to offer have been deemed illegal under federal Medicare rules, since Medicare ultimately foots the bill for most ambulance trips and doesn't want to waste federal dollars to subsidize municipal coffers.

In the end, it comes down to a few key players in the city and whether they trust you.

There are the firefighters, because they have to work with the ambulance companies. (A fire truck usually arrives on the scene before an ambulance and administers first aid until the ambulance workers take over.) Even beyond that, their word is trusted as an important voice for safety.

City officials are key, too. Even though they often know nothing about the ambulance business, they make the ultimate decision as to which company is hired and for how long.

And when it comes to both firefighters and city officials in metropolitan Phoenix, no one could be better connected than Pat Cantelme.

He learned how to deal with one by fighting for the other.

When Cantelme was elected president of the union, back in 1978, firefighters earned 14 percent less than cops, and the Phoenix City Council was disinclined to change that.

And the council members could do that. Because they were all elected at-large, the council's main constituency was a cozy group called the Phoenix 40, the businessmen who ruled the town.

So Pat Cantelme changed the rules of the game: In 1982, he and his union pushed a citywide initiative to elect council members by district.

They were outspent by $340,000.

They won anyway.

That accomplished, they recruited candidates who could win.

The city's old guard never recovered. And the firefighters got their raise.

"Here was this young firebrand who had the audacity to think firefighters should make as much as police officers," recalls Billy Shields, a Cantelme lieutenant for years who himself became president of the United Phoenix Fire Fighters Association when Cantelme retired.

"He was taking on a city council hostile to unions, a power establishment hostile to unions," Shields says. "But he changed the way the government worked. And the world changed."

The old guard didn't give up without resistance.

Phoenix Police Chief Ruben Ortega went after Cantelme with a vengeance. His officers arrested Cantelme for conspiracy and distribution of cocaine just two weeks before the election to change the council system. (They dropped the charges almost immediately after the vote; turns out the only evidence was that one guy claimed to have witnessed Cantelme doing a few lines.)

And when Ortega's department sought to sting a host of politicians and players with bribes in a major operation called AzScam, Cantelme was one of the major targets. He was also one of the only guys who didn't take the bait.

The harder they fought him, the stronger he got.

For Cantelme didn't stop with the Phoenix City Council. The firefighters became a potent political force. And because the law forbade them from campaigning for candidates in Phoenix, Cantelme formed regional alliances, says Rick DeGraw, a former political consultant who now works in public relations. (DeGraw himself copped to a misdemeanor in the bribery sting.)

A host of fire departments ended up joining the Phoenix Fire Fighters Association: Glendale, Chandler, Peoria, Tempe. Each department got a vice president -- and they all answered to Cantelme.

The members diversified. They volunteered on nonprofit boards. Cantelme joined the boards of a number of pension funds and, for a while, ran the Central Arizona Labor Council.

The firefighters made friends everywhere they went.

"They built a very broad base," DeGraw says. "When businesses had something they needed to get done, they knew to turn to the firefighters." And when Cantelme needed a favor for his men, there were few players who wouldn't take his call.

When Cantelme retired in 1999, he went into the political consulting business. His firm, Cantelme Kaasa, played a role in electing half the people currently serving on the Phoenix City Council. It also ran Phil Gordon's successful mayoral campaign.

People who've worked with Cantelme say he's consistently one of the smartest guys in any room. They rave about his memory and his grasp of the details. He is a master of old-school politics. Shields recalls him making a point to come to family funerals, ready with a personal check to show his sympathy.

There's something about him that makes people listen.

In meetings with the community's big guns, the usual suspects talk on and on, reveling in the sound of their rhetoric. During all that, "Pat never says anything," Shields says.

But when the big talkers are done, Shields says, "Pat will start talking, very quietly. And he'll put a solution on the table that just brings everybody together.

"And everybody in the room just goes quiet, looking at him. Everybody knows he's right."

Pat Cantelme first went into business with Bob Ramsey in 1994. But that's not a detail he necessarily volunteers. When he tells New Times the story of how he got into the ambulance business, in fact, he skips five years and starts with his retirement, in 1999, and the company he started with Ramsey in Las Vegas.

He explains that he wanted to use the knowledge he'd picked up organizing municipal service for the city of Phoenix. And that involved partnering up with Ramsey.

"So we started a private company in Vegas," he says.

Later in the interview, he is asked to return to the same point: When did he start working with Bob Ramsey?

"I'd spent 30 years on the Phoenix Fire Department," he says. "After I retired, my partner and I had an opportunity to start a company in Vegas. . . . Because I knew the business from the emergency side, it seemed like a pretty good opportunity."

It is only when asked, again, exactly when he first went into business with Bob Ramsey that Cantelme remembers a company called Southwest General Services.

According to paperwork filed with the secretaries of state in both Arizona and Texas, Cantelme and Ramsey started Southwest General in April of 1994.

The other officers were Barry Landon, who was one of Ramsey's top lieutenants at Southwest Ambulance, and Patrick McGroder, a prominent Phoenix personal injury attorney who recently defended Bishop Thomas O'Brien at his hit-and-run trial.

Three years later, when Ramsey sold his holdings to Rural/Metro, he sold Southwest General Services, too.

Landon and McGroder each got $500,000. Ramsey got $2.6 million.

Cantelme made $2.3 million, according to SEC records.

Financially, it was a huge deal for a municipal firefighter. And it wasn't Cantelme's only profit from a Ramsey company during his tenure as a union officer and city employee.

In 1994, Ramsey hired Cantelme to serve as a trustee for a stock option plan he'd set up for his employees. Cantelme was paid $40,000 a year, according to company records obtained by New Times.

And even though records from the stock plan show that Cantelme only held the trustee position for one year, he continued to earn his $40,000 salary for two more years.

It's not like someone just forgot he was on the payroll. In 1995, he even joined the Southwest Ambulance 401(k).

Cantelme claims that he served as the stock plan trustee for all three years. But that's flatly contradicted by the annual reports that the company was required to file with the Department of Labor. Those reports show that Cantelme did not serve as the plan's trustee after April of 1995.

Ramsey admits that he can't explain why Cantelme stayed on the payroll for another two years after that. He suggests his CFO might have been paying Cantelme without his knowledge.

In the end, both men claim amnesia.

"It's difficult to tell you what I did 11, 12 years ago," Cantelme says.

It's odd that Cantelme, a guy known for his smarts and his good memory, would fail to recall a $40,000 annual salary.

And his initial failure to remember the $2.3 million he earned from the Southwest General Services sale seems even stranger.

The whole deal is somewhat bizarre. Documents filed with the Securities and Exchange Commission show two preliminary sales agreements, one from February 1997 and one from that May. In neither agreement is Cantelme mentioned as a shareholder in the company.

Only the final sales agreement shows his name -- in an amendment noting that Cantelme actually owns almost half of the stock previously listed as being owned by Ramsey.

Neither Cantelme nor Ramsey can explain why. Ramsey says he doesn't remember the details. Cantelme offers a long explanation, but it doesn't quite make sense: something about two different companies being merged at the last minute.

And it's clear that Cantelme's initial failure to mention the deals to New Times wasn't a one-time lapse. An October 2 story in the East Valley Tribune, for example, describes Ramsey "recruiting" Cantelme for the Vegas deal, with no mention of any previous dealings.

Billy Shields, who was Cantelme's lieutenant at the time and a good personal friend, says he knew Cantelme was working for Ramsey, even though he didn't know the details.

But Shields is the exception. Most of Cantelme's fellow union officers seemed to have been in the dark until recently.

Brian Tobin, for example, is a Phoenix firefighter who rose to become president of the state firefighters union. He considers Cantelme a friend; a few years ago, they even purchased a condominium together in Rocky Point, Mexico. (Cantelme has since sold his interest in the deal, Tobin says.)

Tobin says he didn't know that Cantelme was in business with Ramsey in the 1990s. He didn't know about the $2.3 million payday.

Neither did Chris Medrea. A Mesa firefighter and former vice president of the state organization, Medrea says he used to hear grumbling that Cantelme was in Ramsey's pocket.

At the time, he responded angrily to the rumors.

Ramsey was, even then, known for his tough dealings with his workers, and the men in the emergency workers union were frequently vocal about their dissatisfaction with conditions at his company.

The rumors, Medrea says, seemed like dirt designed to hurt Cantelme.

"I put my political reputation on the line by strongly arguing to the contrary," he says. "And it concerns me now, because Pat let me do that."

Many firefighters have businesses on the side. It's perfectly legal.

But Cantelme's business was a bit more complicated. After all, the company he and Ramsey owned, Southwest General Services, had a contract with the City of Phoenix -- Cantelme's employer.

A setup like that raises some serious questions.

In fact, during the time that Cantelme had an interest in Southwest General Services, the company handled billing and collection for the city's ambulance service, which was run by the very fire department where Cantelme worked.

According to city records, the contract was worth about $477,000 annually.

While Ramsey secured the contract in 1992, prior to going into business with Cantelme, records show that the contract was set to expire in 1996. At that time, of course, Cantelme was a firefighter, president of the firefighters' union, and one of the company's owners.

And rather than go out for bid or ink a new contract at that point, city officials simply extended the contract for another two years.

By the time it was re-bid in 1998, Cantelme and Ramsey had sold their interest in the company.

The company was clearly worth more with the Phoenix contract than without it; the Phoenix account was one of just three that the company held.

Cantelme says he had nothing to do with the Phoenix contract. He says his sole activity with the company was working on its second big account, one with the city of Dallas.

As he tells it, it was a case of connections leading to a rich business opportunity. Cantelme was friends with the union president in Dallas, he says, and thought he could apply the methods Ramsey was using in Phoenix to help that city get a better rate of return.

Sure enough, Southwest General Services snagged the Dallas account just three months after it incorporated.

"The work I did in Dallas was not related to anything going on here," Cantelme says.

Still, his name was on the corporation's paperwork -- and that corporation had a fat contract in Phoenix, the city where he worked as a firefighter.

Arizona law bars city employees from even having an interest in municipal contracts, unless those contracts are bid competitively. Also, during the bidding process, employees must disclose their interest.

The idea: The taxpayers shouldn't get hosed because a city decides to go with a guy who has connections.

There is no record that Cantelme disclosed his interest in Phoenix. And while the original contract, pre-Cantelme, was bid competitively, there's no record indicating that happened with the renewal.

Renewals are typically not competitively bid, so it's nothing extraordinary. And no one has suggested an investigation. But it does raise ethical questions.

Tim Hogan, executive director of the Arizona Center for Law in the Public Interest, is unfamiliar with the situation. But he believes that, as a hypothetical situation, the facts may point to a violation of the law. 

"This looks and sounds bad," he says. "It does seem as if you have a direct violation of the conflict-of-interest provision in state law."

Any potential problem on the city level, though, is so old and so mired in complicated details that it's no more than a footnote next to a bigger issue: the problems that Cantelme's association and resulting profits are now causing him with his fellow union officials.

Federal law bars union representatives from taking payments from private employers that work with their unions. It also requires union officers to disclose with the U.S. Department of Labor any time they receive something of value from a private employer or company, be that their employer or not, says Roger Gayman, a Labor spokesman in San Francisco.

"The idea is to avoid conflicts of interest, to make sure everything is aboveboard," Gayman says.

The feds take the law seriously.

For example, last year, they prosecuted a union official in Miami who'd taken money as a "consultant" from a host of private companies. The feds argued that the official, Walter J. Browne, had taken the money not to unionize the company's workers.

A jury agreed. Browne was sentenced to 70 months in prison.

As Cantelme is quick to point out, there's an exception in the law: Unions that consist solely of public sector employees don't fall under federal guidelines. They don't even have to file the paperwork.

(The Department of Labor is hoping to expand the provisions to some public sector unions in the future. Naturally, the unions are fighting the change.)

Legally, Cantelme is off the hook.

But that doesn't answer the ethical question.

And there's a group of guys who believes that, even if it was perfectly legal, Cantelme's business with Ramsey was a major conflict of interest.

Those guys are Ramsey's former employees -- some of Cantelme's brothers in the International Association of Fire Fighters.

They're livid.

Their union, the United Emergency Medical Professionals of Arizona, formed in 1991. In some ways, Cantelme was directly responsible.

The workers organized because they were unhappy with working conditions. Ramsey could be an extremely tough boss, they say, and the question was not whether to unionize, but who to unionize with.

Some firefighters sneered at the idea of letting ambulance workers into the IAFF.

Cantelme wasn't one of them. He supported the union's formation, and even helped them haggle with Ramsey for the terms of their first contract in 1992, signing it as a union negotiator.

Todd Denny, then the secretary of the union, remembers that union members were disappointed with the contract.

But Cantelme praised it.

"This is about the best contract you can expect as a new union," Denny recalls him saying.

Two years later, Cantelme went to work for Ramsey.

And even then, he continued to be helpful to the union.

The Phoenix firefighters union let the emergency workers hold meetings in its office, recalls Michael Quen, who was then on the emergency workers' executive board.

"Pat Cantelme was pretty much our go-to guy," Quen says.

Even with the IAFF's help, though, the emergency workers found Ramsey difficult to deal with. He was notoriously tough in negotiations, they say, and wages stayed extremely low.

"Ramsey was a tyrant as a boss," says Jason Payne, who started in 1996 at $4.50 an hour and is currently vice president of the emergency workers union. Workers were so badly paid, Payne says, that after Ramsey sold the company, they all got a 22 percent raise.

A New Times column in July 1997 ("Ambulance Chasteners," Barry Graham) detailed some of the workers' complaints during the Ramsey era: Starting pay was ludicrously low. Raises were hard to come by; 24-hour shifts were the norm.

It was Cantelme who rose to Ramsey's defense.

Ramsey, Cantelme told the writer, "put a high premium on service delivery, and sometimes that requires people to work harder than they may feel that they should work. But I've never known him to be unfair or malicious."

He did not mention that he'd been in business with Ramsey for the past three years.

He did not mention that, just one month before, Ramsey sold his holdings to Rural/Metro and Cantelme had received $2.3 million.

The union guys didn't mention the payday, either. At the time, they didn't know about it.

They didn't find out until this year, when Cantelme and Ramsey made their bid to take over ambulance service in the Valley -- and take away their jobs.

Their union contract allows them to ask for certain company records. And a secret source, one they won't name, suggested they ask for records that pertained to Pat Cantelme.

Sure, it was probably someone who had a major ax to grind against Cantelme, someone at Southwest who was eager to keep the former union leader out of the ambulance market. Clearly, the information was released to tar Cantelme.

With members of the emergency workers union, it certainly did the trick.

They couldn't believe it.

"Pat Cantelme is a very revered person among labor leaders in Arizona," explains Payne, vice president of the emergency workers union.

"It was almost like he was up on a pedestal. He made labor in Arizona what it is today."

To realize that the guy they'd respected, the guy they thought was on their side, was actually on their former boss's payroll, was shocking.

"It was so hard to believe," Payne says. "I was just astonished."

They got over their shock soon enough, though. And then they were ready to use the information against Cantelme.

Executives at Bob Ramsey's old company, Southwest, felt his shadow looming for years. Rural/Metro had bought him out -- but they knew he'd be back in the business.

Ramsey didn't hide his intentions to return. He bought three smaller companies, after all, and announced, more than once, that he would be applying for 911 certification. He also met with fire officials and plotted ways to get around the state's onerous licensing process.

Southwest officials tried to stop him every step of the way.

For example: In 2001, Ramsey was trying to buy a company called American Ambulance, then in bankruptcy. Southwest actually bought the rights to an $84 coffee bill that was past due when American filed for bankruptcy.

Having rights to the account allowed Southwest to intervene in the bankruptcy and try to block Ramsey's purchase.

And when the block didn't work, Ramsey says, Southwest sued the state Department of Health Services, arguing that it shouldn't transfer the bankrupt company's license.

Ramsey not only got the transfer, but Southwest was required to pay both his legal fees and those of the state, too, he says.

The turf war was bitter enough that Billy Shields, president of Cantelme's old union, attempted a mediation. He met with Ramsey, Cantelme, and both Southwest's CEO -- a former employee of Ramsey's named Barry Landon -- and one of Southwest's lawyers.

The group considered a number of options.

"I thought there was enough business to go around," Shields says. "That's what Pat always said."

But in the end, the parties reached an impasse.

"There's no way I could do business with those people," Cantelme says.

"I failed," Shields says. "There was just too much bad blood."

He blames Landon, Southwest's CEO.

"Pat is a compromiser, and while Bob had a lot of hard feelings, [Bob's] point was, 'These don't have to be personal attacks.' But Barry was just acting like he was there because he had to be. All he'd say was, 'I can't meet then. I've got budgets to do that day.'"

Landon points to more of a philosophical difference.

"In the final analysis, we concluded that the business opportunities were limited and the cultural differences were too significant," he says.

He won't elaborate on "cultural differences."

As bad as the fight was behind the scenes, it didn't really become public until this year. That's when Ramsey finally bought PMT, a company with the right certification to do 911 service.

And that's when things really heated up.

First, there was the Scottsdale request for proposals -- the first head-to-head competition between Ramsey and his former company. PMT is expected to win the contract this week.

Southwest has protested bitterly, arguing that the process has been more than a little suspicious. After all, the city set up an independent committee to evaluate the two proposals, and even city council members have been barred from seeing what each company promised.

City councilman Ron McCullagh says that the idea of an independent committee is highly unusual. Mike Phillips, a spokesman for the city, doesn't answer the question of whether Scottsdale has ever used such a committee before. (He does say that the idea was discussed in an open meeting, and any objections could have been raised then.)

Meanwhile, the City of Chandler opted against automatically renewing Southwest's contract. It, too, issued a request for proposals.

Southwest, again, protested. The company believes that the city's requirements may violate federal anti-kickback statutes.

(Chandler is asking for the ambulance companies to pay the city to house ambulances in city stations, pay the salary of a new city staffer, and pay overtime salaries for Chandler firefighters to staff some ambulances. Because so many ambulance bills are paid by Medicare, the federal government has argued in the past that it ends up subsidizing such perks -- and that it isn't legal to offer them.)

"What we're after is a fair and open competition that improves public safety," says Landon, Southwest's CEO. "That's what Southwest Ambulance is about."

As for the company's protests in Scottsdale and Chandler, Landon says, "They speak for themselves."

Company insiders at Southwest acknowledge, privately, that the company needs to work harder on the public relations front. Landon, they say, is a good boss to work for, but he's a numbers guy.

He can't compete with Cantelme and Ramsey when it comes to charm or the ability to schmooze.

Indeed, in an interview with New Times, Cantelme accused Landon of being "the Tom DeLay of this thing" -- meaning, apparently, that he's orchestrated vicious attacks on his opposition.

Rather than refute the charge, Landon confesses that he doesn't know who Tom DeLay, the recently dethroned and extremely high-profile Speaker of the U.S. House of Representatives, is. "I'm not a political guy," he says.

His opponents are.

Back in his consulting days, Cantelme ran the political campaigns of dozens of city officials around the Valley, from Phil Gordon on down. He's also made generous financial contributions to any number of local candidates and issues for the past decade.

This past May, Cantelme and Ramsey hired Tempe Vice Mayor Mark Mitchell to work for PMT as its director of public affairs. Mitchell's father was a longtime council member and is currently a state senator. He was also recently elected chairman of the Arizona Democratic party.

Mitchell's previous job? Sales manager, at Tempe Paint and Decorator Center.

Thanks to Cantelme's connections, PMT has also been able to neutralize the power of the firefighting unions.

Under different circumstances, one of Southwest's aces in the hole would be its employees' membership in the IAFF. Mainly because of Pat Cantelme, the firefighting unions in the Valley are strong, highly political, and highly connected.

Theoretically, Southwest's ambulance workers could mobilize their union brothers in Scottsdale, Chandler and Tempe to argue that Southwest's losing its 911 contracts would be a loss of union jobs.

After all, PMT is not unionized. And even though Cantelme and Ramsey swear that they're interested in unionizing the workers there, none of the other companies in their stable has a single union employee.

In August, one of Southwest's ambulance workers went to their Vegas company. The worker, Adam Lizardi, asked about getting a job there.

According to a memo he later wrote to his union brothers, the human resources coordinator assured him that there would be no union in the company's future.

Some employees, she told him, had attempted to organize only a few weeks earlier.

"It took us all of three days to squash it," Lizardi reported her saying. (Ramsey dismisses the memo as "absurd.")

But despite that, few other firefighters unions in the Valley have been willing to come to the Southwest workers' aid.

Chandler and Tempe, after all, are part of the union that Pat Cantelme built. The top union officials for both departments serve as vice presidents in the Phoenix firefighters union -- Cantelme's old stomping grounds. And they have insisted on staying neutral, which is almost unheard of when IAFF jobs are at stake.

Some union officials are convinced it's because of their friendship with Pat Cantelme.

(It's worth noting that the vice president representing Tempe, Rich Woerth, has a limited liability company with Cantelme dating back to 1999, according to state records. He did not return calls for comment.)

Meanwhile, the current president of the Phoenix union, Billy Shields, is not just staying neutral. He's openly critical of the emergency workers' efforts.

The reason, he says, isn't his friendship with Cantelme. It's because the emergency workers won't look at the big picture. They wouldn't write a letter supporting the Scottsdale firefighters' bid to keep ambulance service for itself when the department became municipal.

And they don't want to unionize PMT, he says, even though Cantelme has asked them to do so.

"They said, 'They're going to take our jobs! You have to help us!'" Shields says. "But I asked them, 'What did you do for the union in Scottsdale?' They wouldn't help because they're afraid of losing their jobs. And that's not a real union. That's a company union."

As for Scottsdale, its union, too, is refusing to support the emergency workers' efforts to block PMT.

Unlike Chandler and Tempe, Scottsdale's firefighters have their own union, not one organized under Phoenix. But even in the Scottsdale union, there's a financial connection: Bob Ramsey is an investor in a bar owned by the union president, Steve Springborn.

Springborn says that Ramsey's interest is only about 5 percent. He says it has nothing to do with his unwillingness to support the emergency workers.

Like Shields, Springborn accuses the union of fighting for the company's interests rather than its own.

"It seems like the leadership at [the emergency workers union] only wants to get involved if it benefits them," he says. "If it's someone, the same rules just don't apply."

Payne, the emergency workers' vice president, estimates that if his company loses 911 contracts in Scottsdale and Chandler, his workers may survive. They'd lose overtime, but probably not their jobs.

But if Cantelme and Ramsey also take the contract with Tempe, it could mean the loss of as many as 24 jobs.

Cantelme has vowed that PMT will hire any Southwest workers who lose their jobs. But Payne says many of his members have worked for Bob Ramsey before.

They don't want to do it again.

By September, tensions in the IAFF headquarters in central Phoenix had escalated to the point that emergency workers -- who sublease an office for their union on the second floor -- were sending nasty anonymous e-mails to officers in the Phoenix Fire Fighters Association, who own the building and office on the first floor.

"How can you stand by and let the I-60 membership down?" demanded one anonymous e-mail, obtained by New Times. "We have lost our jobs to a scab company that has been charged with unfair labor practices. This is going to get ugly and we are afraid we cannot protect you any longer."

The state union president, Brian Tobin, replied that he wouldn't respond to anonymous e-mails.

Billy Shields was less polite.

"If you are a legitimate member of the IAFF, and wish to file charges against any or all of us with [the union], it is your right," he wrote back. "You have no right to harass me."

"I know the truth hurts Billy," the anonymous e-mailer responded. ". . . you have lost the respect of many."

At that point, Rich Bauer, the union's sergeant at arms, had had enough.

"Bill has lost the respect of no one," he fired back. "Grow some hair one [sic] your nuts and let us know who you are!

"Come to the office and sit down and talk.

"Like a man!"

A meeting of the state union executive board last week also turned unpleasant.

Dave Manning, president of the Flagstaff local union and an officer in the state organization, says the Phoenix firefighters union is only staying neutral because of "skewed loyalties."

"The word I use is cronyism," he says. "What I have a problem with is turning our backs on our union brothers and sisters who've done a good job and paid their dues -- and now their jobs are being threatened by a company without union jobs."


Others seconded Manning's call, including Ty Perkins, president of the Mesa firefighters union.

Shields was livid.

"Billy Shields has himself a pretty good Irish temper," Manning says. "I don't think he was happy about it. But I think I had good support from the other state board members at the meeting."

In September, the emergency workers union lobbed a bomb at Bob Ramsey, Pat Cantelme, and PMT.

Most of the ire was directed at Cantelme.

The bomb came in the form of a seven-page letter to the International Association of Fire Fighters, coupled with an appendix that runs several hundred pages long.

In it, the union's vice president, Jason Payne, details Cantelme's involvement with Ramsey back when Cantelme was a union officer.

It raises the potential conflict of interest, taking care to note that, at the time Cantelme was working for Ramsey, he was chairing the IAFF's committee fighting privatization.

The filing also notes that, even though Ramsey says he wants to unionize, he's made no attempt to do so in Las Vegas, where he's held contracts for five years.

"This is a transparent effort to legitimize himself with old union friends so that, unimpeded by union interference, he can take contracts and jobs away from bona fide, dues paying IAFF members," Payne wrote.

The letter asked the international union to declare PMT a "hostile/rival organization."

The IAFF responded later that month. It denied the request. It didn't even touch on the allegations against Cantelme.

(IAFF spokesman Jeff Zack declined comment.)

The attack definitely caught Cantelme's attention.

"Look what they're doing," he says. "They're trying to discredit Bob and I, and PMT, on every front they possibly can. It's just an onslaught. They're doing everything they can to stop us -- except compete!"

He vows to win at least two of the three contracts that are on the table this year: Scottsdale, Tempe and Chandler. And he's not stopping there.

He's now looking to Peoria. And Glendale. And Mesa.

Maybe at some point, he says, he'll even come knocking in Phoenix.
That was his own turf, turf he fought to defend for the firefighters, and from private companies, for years. But there's room enough, now, for a private company to take some of the business.

And if it has to be a private company, why not his?

"All they've done is made us more determined," he says.

Shields, the union president in Phoenix, says that he couldn't support a move like that.

But Cantelme may have the power to outflank his old union buddy.

After all, earlier this year, the Phoenix Commission on Salaries recommended a major pay increase for city officials here. Under its recommendation, city council members would be bumped from $51,000 to $62,000. And the mayor's salary would increase to $88,000.

After the commission lobbied for the increase, voters approved the changes last month.

The man who chaired that commission was Pat Cantelme.