Task force ends ambulance workSuperior’s Ambulance Task Force has decided to finish its work next week. After three months of discussion and exploration, members of the task force will each weigh in with their thoughts before deciding on a recommendation to send to the council.
By: Shelley Nelson, Superior Telegram
Superior’s Ambulance Task Force has decided to finish its work next week.
After three months of discussion and exploration, members of the task force will each weigh in with their thoughts before deciding on a recommendation to send to the council. In spite of any recommendation, each of the panel members will share their individual views on a proposal by the Superior Fire Department to run its own ambulance service.
Those decisions came Monday night after the task force weighed collection rates that could make or break the city budget.
Dr. Robert Sellers proposed wrapping up the committee’s work March 8 with each panel member writing out their thoughts on the pros and cons of creating a fire department-run ambulance service in Superior.
Chris Bronson, the city’s internal auditor, conducted the study that looked at comparable cities to determine whether the collection rates would support the proposed service in Superior. What he found was there is no common factor that determined success or failure in collecting service fees for ambulance services.
In a report presented to the panel, Bronson highlighted several findings about the potential revenues that could be generated for the department. Collection rates varied from a low of 40 percent in Beloit to a high of 89 percent in Oshkosh. In Stevens Point, which has a population that closely matches Superior’s, the city collected 51.4 percent in revenue, resulting in net revenues of $1.2 million, less than projected by the Superior Fire Department, said Superior Finance Director Jean Vito.
Of the four methods of paying for the service – Medicare, commercial insurance, private pay and medical assistance – Medicare made up an average of 44 percent of revenue the fire department-run ambulance services were able to collect. Only 25 percent of revenue, on average, came from commercial insurance, 18 percent from private payers and 13 percent from medical assistance. Medicare pays a fixed fee. While it allows for mileage charges, disposable supplies and fees related to residency are not allowed.
Fire Chief Jim Rigstad proposed raising rates if the ambulance service proved to be less profitable or required taxpayer subsidies, but some task force members noted that probably wasn’t realistic.
“It’s interesting though that there is no scenario that projects an increase over the fire chief’s numbers,” said Douglas County Board Supervisor Jack Sweeney, a member of the task force.
“One of the biggest points I can take away from what Chris has put together is you can’t compare Gold Cross’ 33 percent to 70 percent in Ashland,” Vito said. “There is not a common denominator.”
Vito said the key will be to figure out the number of runs that would actually generate revenue for the city.
“When we think of [ambulance] runs, we think of revenue that can be generated from runs,” Vito said. “I think this is an excellent summary. When you look at all of these communities – look at Janesville; they have total billable runs of over 4,000. We’re talking about the highest billable runs at 2,810 for us. Their net revenue collected is just over $1.2 million. We’ve got revenue estimates here saying that we’re going to take in $1,515,000.”
She said it’s the same story in a variety of communities that provide public ambulance services – a greater number of runs with revenue near projections in the fire department’s proposal, creating a “huge” gap between what is proposed and reality in communities around the state.
“I see big deficits here that concern me greatly,” Vito said, estimating that the cost to the city could be up to $600,000 in a year – paid by taxpayers.
In 1996, when the county eliminated its ambulance service, Douglas County taxpayers were subsidizing that service by more than $500,000 annually during the last five years of operation, costing taxpayers nearly $2.8 million.
Sellers said he agreed with Vito’s summation.
“It’s really bothersome to me the deficit we could be going into,” Sellers said.
Currently, taxpayers bear no burden for operating losses Gold Cross may incur.
Sweeney said the report helped make things clearer for him. While the committee hasn’t looked at the expenses of operating the service, he said already the panel was looking at big deficits in a city-run service. Sweeney said while the chief proposed raising rates to avoid a deficit, there are limitations such as Medicare that would prevent that.
Of the communities surveyed, Ashland is similar in terms of population of citizens over 65 who rely on Medicare: Nearly 60 percent of the revenue Ashland collects comes from Medicare, which limits what the service could receive.
Superior firefighter and paramedic, Les Luder, challenged the numbers, pointing out that Gold Cross remains in operation in the region for a reason: “Clearly this is a profitable business for Douglas County and southern St. Louis County. If it wasn’t, Gold Cross wouldn’t stay here and would gladly hand it over to us. This is a profitable business.” He said he believes the fire department can run the service and profit.
Taxpayers subsidized ambulance services in communities surveyed “virtually across the board,” Vito said.
The panel meets for the last time at 4 p.m. Monday in the Government Center Board Room to make its recommendation to the council. That recommendation goes to the council’s committee of the whole meeting March. 16.