Ambulance Service needs resuscitation

[BFD Medic424]

I read this on the front page, and was a little suprised. I am 40 miles down the road from Lincoln and the situation is completely the opposite as far as recovering costs go, I think last year we collected around 75% of what we billed out. Personally I don't really care that much if we collect one dime or not, because that isn't what EMS should be about,:soapbox: but this is interesting. Here's the article:
Ambulance service needs resuscitation


Like cynical Capt. Louis Renault in “Casablanca” the Journal Star was shocked, shocked! to learn that the Lincoln Fire Department needs a subsidy for ambulance service. Not just a few pennies, either.



Turns out that the fire department went almost $500,000 in the red last year. Lincoln Fire Chief Mike Spadt last week asked the City Council for $250,000 to cover the loss.

This certainly wasn’t what Spadt promised five years ago when the fire department muscled aside the private company that provided ambulance service in Lincoln. Back then Spadt said that the fire department could do it “faster, safer, cheaper.”

The fire department knew how to get what it wanted. Members of the union that represents fire department personnel made political contributions and volunteered their time to help elect a bloc of City Council members and Mayor Don Wesely.

They won.

Now the taxpayers are paying the bill.

The fire department hasn’t even entirely paid back the $1 million it borrowed from the city treasury to finance its takeover from the private company.

In one of the weird aspects of the current situation, the fire department has been paying interest on the loan, apparently so it could be counted as an asset on the city books.

So now taxpayers apparently will find themselves paying a subsidy so that the fire department can continue to pay interest on the, uh, asset on the city books.

Since Spadt has only asked the council for a subsidy to cover half this year’s deficit, it’s not exactly clear where the rest of the money will come from.

Apparently Spadt thinks the Lancaster County Board or some other arm of local government might cough up a few bucks since the fire department provides ambulance service outside the city limits.

That wouldn’t provide much relief to Lincoln residents, of course, who ultimately will pay the bill regardless of whether it comes from the city or county.

The prospects of an improvement are bleak. The biggest reason for the department’s financial problems are that federal Medicare reimbursement rates are dropping, continuing a longstanding trend. Ambulance service all over the country faces the same problem.

The bright spot in the situation is that the fire department’s record of professional service is exemplary. Fire fighters’ dedication, expertise and professionalism at the scene of emergencies are admirable.

But when it comes to finances, it’s the department that needs the emergency help.

And it’s the taxpayers who have to ride the to rescue, siren blaring and lights flashing, to staunch the flow of red ink

Anybody else facing similar situations?

[smurfe]

Well, to a minor extent, I have to disagree with the mind frame that EMS shouldn't cost anything. I personally feel that the taxpayers should be held responsible for the costs to "Have" the EMS service. I then believe it is the responsibility of those that "USE" the service to support it by billing for services rendered.

My last employer was a tax based municipal service. There were many citizens that were outraged when they would receive a bill for services stating they paid taxes for this service and the Fire and Police didn't charge for services. (BTW which is not true. PD receives funds from citations and many FD's receive funds from inspection permits and the such) Anyway. this service indeed was tax based "at the same rates from 1983 when the service was created and at a level that would support 4 units in 1983. They now operate 12 units, have various divisions such as training, public relations, operations, communications, etc.

So you can see, yes they collect taxes. These taxes justify the service to exist. It is the users responsibility to fund it to operate. I do not feel it should be free. We already are overloaded with calls that do not require the services of the EMS unit or personnel. I have experienced even more system abuse in areas that provided the service for free and those that needed it truly suffered.

Now in regards to the state situation. I have seen this way too often. A proposed new service will estimate the call volume and then base income on 100% payment. The call volumes are normally inflated as well. I have normally found that a service can expect approximately 50% of what was estimated and anticipated. Municipal organizations face dilemmas as well due to union contracts and municipal purchasing requirements.

I remember reading the Lincoln FD pursuit of the EMS service and had a feeling this situation would arise due to the route they went to gain this service. The taxpayers submitted to the requests of the initial request. It was the responsibility of the management to make these requests reality. It actually shows very poor management skills that there is this much deficit in this short time frame. Why are the managers or chiefs not being fired for this event to be occurring? They are responsible for managing these municipal funds. I never could understand why a Fire or EMS chief wasn't held accountable to the same standards as the CEO of any company.

Also, it is kinda weird but cool when you read a story on the front page and it is local for you. The other day, there was a story on the front page that was local for me.
Baker ends fire, medical service to Jetson center, FEMA village



By JAMES MINTON

Baker-Zachary bureau

BAKER -- Expressing frustration and anger, Baker officials said Thursday its Fire Department will no longer respond to fire and emergency medical calls at Jetson Correctional Center for Youth and the Groom Road travel-trailer park for hurricane victims on Jetson property.
The ban on first-response calls to the two areas went into effect at 4 p.m. Thursday after the city's pleas for financial assistance went unheeded, Fire Chief Danny Edwards said.

He said his department will assist any other fire department that needs help in fighting a fire at either facility, but he said the Jetson property is not in an established parish fire protection district.

The Legislature appropriated $90,000 this summer for Baker to use in extending service to Jetson, but the state pulled the money after hurricanes Katrina and Rita left a huge hole in the state budget.

Catherine Heitman, spokeswoman for the state Office of Youth Development, said her agency's head, Simon Gonsoulin, is working with the state Division of Administration to resolve the issues.

She said Gonsoulin spoke with Baton Rouge Fire Chief Ed Smith "and has full confidence there will be a response at Jetson, based on how the emergency services program works."

If Jetson has an emergency but Baker refuses to respond, a parish mutual aid response would be triggered, she said.

"We hoped it wouldn't come to this, but we will push it to a resolution," Heitman said.

Baker also was counting on federal financial aid to serve the trailer park.

Edwards said the decision to halt service to the area is one of the hardest he has made in his career.

"I probably won't sleep tonight because I'm worried that something will happen," he said.

The fire chief also said he is angry.

"I could bite a nail right now," Edwards said of his last-minute negotiations with Federal Emergency Management Agency officials that he said hit a roadblock Thursday.

FEMA operates the trailer park, known as Renaissance Village, and Baker officials were negotiating with the agency with the assistance of the state director for U.S. Sen. David Vitter, R-La.

The fire chief and Mayor Harold Rideau said FEMA promised, before Renaissance Village was built, to fund a fire station on the west side of the railroad tracks in Baker if the city would provide fire protection.

"We haven't got anything," Rideau said.

"It's a shame that government bureaucracy will let this get to this point. They seemed to think we're bluffing. It's amazing; with all the people they have, no one can make a decision," Edwards said.

Edwards announced last week the city would discontinue service on Wednesday, but, as the deadline approached Wednesday afternoon, he and Rideau said they would wait 24 hours because negotiations were continuing.

The fire chief said FEMA had agreed to sign a two-year contract with the city for about $750,000 and provide a place to house firefighters on or near the site. The agency balked at the last minute Wednesday at providing a fire engine for the area and did not change its stance on Thursday.

"We cannot respond carrying buckets of sand or buckets of water," Edwards said.

Edwards said he wanted a firetruck stationed in the area to be sure that the department could serve the areas outside the city without jeopardizing fire protection in the city limits. The close spacing of the thin-skinned trailers is another reason for having a firetruck nearby, the chief said.

Likewise, the city opened a second fire station on Lavey Lane on Aug. 1 after being assured the state money would be coming in quarterly installments.

"Our first obligation is to the citizens of Baker," Edwards said.

Without the state appropriation, the Fire Department is eating into its regular budget to operate the Lavey Lane station, Rideau said.

"Eventually, we're going to have to close it," the mayor said.

Click here to return to story:
http://www.2theadvocate.com/stories/121605/sub_fireservice001.shtml


This is a local story for me. If I hadn't retired, I to would of ran numerous calls to this FEMA camp and have ran many in the prison stated in the story. This FD even moved an Engine company into one of our stations (the 2nd station on Lavey Lane in the story) so they would have closer response to that area. This was a municipal department who's chief IS doing what is in the best interest of the taxpayers who support his department by not letting a situation like this corrupt his budget and put his department in the red.

BTW, this FEMA camp was placed in the response area of the busiest truck this service area. I bet it is pure hell to work that truck now. All I have to say is I am glad it isn't me. I had one of my former co-workers over to the house last night, This gal is about to crack from the increased calls and the forced overtime. These people think this is a free service and think they have the golden spoon coming to them and call for any and all reasons (Toothaches, hemorrhoids, cold symptoms, ingrown toenails, diarrhea, constipation, insect bites, etc. etc. etc.)

I feel for the people affected by the hurricanes but I am not going to support you. You go out and find a job and move on. We ran a help wanted ad in the paper a month ago. We did not get one response to it. Normally when we run one we get dozens of applications.You can not get people to apply for jobs here now as everyone is living off their FEMA money and free housing. As a taxpayer, this makes me sick. I to was affected by the hurricanes but I moved on.

Man, how the hell did I get off the tangent like that. Anyway, thank you for the interesting post. I truly hope they get things worked out there in your area. I am sure the medics provide a great service there. I just hope their managers can get their act together and make the system support itself for the sake and service of the taxpayers.

Smurfe:beer:

[BFD Medic424]

Well, to a minor extent, I have to disagree with the mind frame that EMS shouldn't cost anything.


Just to clarify, I meant that I don't agree with the concept that some services (transfers, standbys, etc.) should be cut due to not being paid. We (the service I work at) are supported by taxes, so if we get paid for everything we do, great, if not oh well. It annoys me when I hear somebody say, "We shouldn't even take this transfer because we probably won't get paid for it" To me this is a service not a business. Just my own little soap box.:soapbox:

[smurfe]

Just to clarify, I meant that I don't agree with the concept that some services (transfers, standbys, etc.) should be cut due to not being paid. We (the service I work at) are supported by taxes, so if we get paid for everything we do, great, if not oh well. It annoys me when I hear somebody say, "We shouldn't even take this transfer because we probably won't get paid for it" To me this is a service not a business. Just my own little soap box.:soapbox:

Jeremy, now that is a different statement and one I totally agree with. A tax supported entity should never go after you "next born". The tax based service should base their revenues on billing, not 100% tax base. As I stated before, Police and Fire Departments do have other income sources besides the tax base. It is no different than your water and sewer bill which normally goes to a municipality.

Smurfe:beer:

[BFD Medic424]

Glad I could clear that up for you Smurfe:D :D
:beer: