Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, February 7, 1995 TAG: 9502070081
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
SOURCE: DAN CASEY STAFF WRITER
DATELINE: LENGTH: Medium
Faced with a "user fee" that recoups only half of EMS operating costs, City Council this month will consider raising ambulance service prices by up to 50 percent and perhaps charging a new "assessment fee" for people who call ambulances but don't ride in them to hospitals.
The two fee recommendations are part of a consultant's report unveiled by city officials Monday. Emergency medical calls are increasing year after year; at the same time, fire-related calls are declining.
The report recommends merging the Fire Department with the city's paid and volunteer ambulance system, a move city officials call the least expensive alternative to handling surging calls for medical service.
``[Price of ambulance calls] is one aspect ... that I know will be given serious consideration during budget study,'' Mayor David Bowers said.
Paid and volunteer Emergency Medical Services ambulances answered 14,894 calls between July1, 1993, and June30, 1994, at a total cost to the city of $1.5 million.
The report, by Harrisburg, Pa., consultant CenPenn Systems, shows that low charges and a below-average collection rate for ambulance fees have left city taxpayers subsidizing half the cost of ambulance service in Roanoke.
The service is divided into two categories: basic and advanced life support. The city charges $115 for basic service and $190 for advanced service.
The city doesn't even send a bill for one out of every three ambulance calls, because patients either refuse the service or paramedics find there is no injury or illness requiring hospital treatment.
The CenPenn report recommends raising the basic ambulance rates to $130; increasing the advanced-service rate to $280; and charging a fee for each call, regardless of whether a patient is taken to the hospital.
Another problem is that fewer than half of those who get a bill pay it, according to the report. It says the industry's average collection rate is 55 to 80 percent.
Bowers and other members of council interviewed Monday declined to predict how much the fees should be increased.
Both the mayor and council member Linda Wyatt said collections, which now are contracted to an outside service, ought to be higher. Prices charged may have to be raised, but not in a way that adversely affects the poor or elderly, they said.
``I'm in favor of the city being paid as much as possible from insurance proceeds ... but the ability to pay is not the major factor in determining the delivery of emergency medical services. It's a balancing act,'' Bowers said.
``I certainly don't want the use of EMS services to create a hardship on someone who is living on the edge,'' Wyatt said.
Council member Jack Parrott believes ambulance service is overused, much as emergency rooms are. The 33 percent of calls that result in no transport to a hospital are evidence of that, he said. There should also be a charge for those calls, he said.
``I think it's being abused, and we should start covering our costs,'' he said.
On Monday, council is expected to approve the concept of merging the two departments. Once that is moved on, officials can begin working out the details, some of which, like the ambulance services charges, will be considered during a budget study session Feb. 18.
As a result of a merger, all 13 of Roanoke's fire stations would send ambulances, beginning in July. Only six fire stations now respond to medical emergencies on a ``first-responder'' basis.
City Manager Bob Herbert said adding ``first-responder'' service to seven other fire stations would cost $150,000 annually.
The report has provoked some controversy among firefighters who believe their primary mission ought to be fighting fires rather than treating ill or injured people.
by CNB