By MATT OLBERDING
Lincoln Journal Star (Nebraska)
A committee charged with trying to fix the city’s ambulance service issued a 20-page report Monday with nearly two dozen recommendations.
But its main conclusion boiled down to a few words:
Bring in more money and spend less.
To achieve that, the committee offered short- and long-term fixes for the city-run ambulance service, which has lost about $1.8 million since the Lincoln Fire Department took it over in 2001.
Among them:
*Increase rates substantially and immediately.
The committee called for an increase of 22-23 percent as soon as possible and another increase of 4-6 percent at the start of the next fiscal year.
It also called on the city to lobby the state and federal government to pay more for Medicare patients, which comprise about 40 percent of all calls. The city now gets about 55 cents on the dollar for Medicare patients it transports.
*Lower personnel costs.
The committee recommended studying several possible changes, such as using on-duty personnel for standbys, instead of paying overtime, and employing some paramedics who are not trained as firefighters and possibly could be paid less. It also recommended a study of staffing levels.
The committee did recommend adding a position:a battalion chief with sole responsibility for overseeing emergency medical response.
*Consider having the city Finance Department or a public-private partnership with hospitals handle ambulance billing.
The city contracts with Accumed to handle its billing — to the tune of about $250,000 a year.
*Study low-priority calls to see whether fewer resources could respond to them and whether some could be transferred to a private company.
According to the report, Lincoln Fire and Rescue responded to nearly 1,700 Alpha calls — the lowest priority and considered non-emergency — in fiscal 2004-05.
Other recommendations ranged from putting vehicle locators in ambulances to identify and dispatch the closest unit, to educating the public and community agencies on when it’s appropriate to call for an emergency response.
The committee also suggested tapping the Community Health Endowment or another third party to coordinate and implement its recommendations.
The city took over ambulance service after voters were convinced it could deliver the service faster, better and cheaper.
Lincoln businessman Russ Bayer, chairman of the committee, said the report needed to be taken as a whole — and all the recommendations implemented.
“I believe if you do every recommendation â?¦ we can bring this back to even and eventually bring in a little revenue to pay off past debts,” Bayer said.
But achieving financial stability will be a slow process, he said.
“Don’t expect this to be fixed between now and the end of September,” he said.
City Councilman Jon Camp, who organized the committee after the Fire Department requested a $250,000 city subsidy, said the deficit had grown to $1.8 million.
After the report presentation, Camp challenged council members and city administrators to buy into the course urged by the committee.
“I can’t see how we would not want to proceed and solve the problem,” he said.
But buy-in might be difficult. Mayor Coleen Seng was skeptical about some parts of the report.
“I am concerned that some of the operational proposals might cost more, slow response times and decrease the quality of care,” she said in a statement.
Fire Chief Mike Spadt, who sat on the committee, also expressed concerns — particularly about the proposal for nonfirefighter paramedics.
Under that plan, he said, the current quality and experience in those positions could be “out the window.”
While many of the recommendations are needed, he said, he doesn’t want to see quality emergency care suffer in the name of money.
“The No. 1 priority is high level of service,” he said. “The financial aspect is secondary in my opinion.”