By Derek P. Jensen
The Salt Lake Tribune
SALT LAKE CITY — Arguing the financial pulse with its current contractor is about to flat-line, Salt Lake City is proposing to plunge into the ambulance business.
The anatomy of the deal -- to be presented to the City Council today -- calls for the Fire Department to begin providing in-house 911 service when the city can better afford it, probably in a year or two.
But adding an ambulance fleet, equipment and 62 new paramedics and support staff would bleed the budget $1.6 million into the red the first year, plus $300,000 more in year two. A capital ambulance service would not break into the black until 2014.
Still, the city insists its hand is being forced. This spring, contractor Southwest Ambulance issued a letter saying it is losing big money on the current deal and would have to renegotiate before renewing for four years this December.
Fire Department spokesman Scott Freitag says that could spell an additional $300,000 a year the city cannot afford.
“We weren’t looking at it before then,” Freitag says about a city-run service. “We were happy with the service we were getting. It is out of necessity that we are going through this process.”
Mayor Ralph Becker and new Fire Chief Kurt Cook support the idea, but say start-up costs and the recession’s grip would force them to move slowly.
“The mayor believes that, from a service standpoint, this outcome would be in the best long-term interest of the city,” a memo from Becker’s chief of staff reads. “However ... he believes that our ability to realize this goal is at least one to two years away.”
Southwest’s current four-year contract expires Dec. 21, although it is licensed until next April. State law calls for ambulance contracts to run four years, so the city has contacted the Utah Attorney General’s Office about granting a rule change. If all parties agree to an extension of one to two years, Freitag says, “the state would probably agree.”
“We told Salt Lake City that we would be happy to extend our contract temporarily for one, two, three years,” says Raleigh Bunch, division general manager for Arizona-based Southwest. “But we can’t continue to lose money.”
Bunch would not say how much more Southwest needs, but insists the company has failed to break even in Salt Lake City the past several years. A billing provision under state law requires ambulance companies to reimburse city fire departments for their paramedic services -- a figure Southwest is threatening to slash.
But Southwest’s hand too may be forced, since competitor Gold Cross holds the exclusive rights to transport patients from hospital to hospital, a massive moneymaker. For the past three years, Southwest has tried -- and failed -- to crack that monopoly at the Legislature.
“We can’t compete,” Bunch says.
Councilwoman Jill Remington Love, who is “very resistant” to a city-run service, says “we all wished legislation was passed to help make Southwest profitable.” Now, she says, there are few good options. And budget constraints, she maintains, make a deal for city service unlikely before year’s end.
Freitag sees an upside to city ambulances. The move, more about creating efficiencies than a fiefdom, would bring a centralized 911 service to a single communications center, introduce ambulances for nonemergency calls, and provide a springboard for paramedics-in-training to become firefighters.
“It’s sort of like a farm team,” he says.
Whatever the arrangement, officials emphasize there will be no disruption in 911 service. Gold Cross, dumped by the city for Southwest in 2005, has offered to be a “stopgap,” Freitag says.
The proposal, already vetted by two independent consultants, may face a third outside review if the City Council so orders. Yet Council Chairman Carlton Christensen remains leery.
“I’m not sure we should get into the patient-transport business,” he says. “If you have a shortfall, you have to pay for it with general tax revenue.”
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