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Ind. city looks to double ambulance fees

Proposed increases expected to bring controversy

By Sue Lowe
The South Bend Tribune

MISHAWAKA, Ind. — Common Council members are being asked to more than double some of the fees charged for city services.

Members of the Budget and Finance Committee and a few other council members had their first look at new fees proposed by the administration Wednesday.

The full council probably will hold a public hearing on the fees at its March 15 meeting.

If the proposals are approved, people will pay more for things such as a ride in an ambulance, a copy of a police report, a permit to build a house and a request to annex property.

Staff attorney Cory Hamel told council members he’s afraid proposed increases that would more than double the fees for some ambulance service will bring some controversy.

Hamel said he hopes he’s wrong because the purpose of increasing fees is to help cover costs.

The greatest proposed increases are for ambulance rides coupled with services such as an IV, cardiac monitor and two or more drugs.

The city would like to raise the fee for a city resident from $325 to $815 and for a non-resident of the city from $400 to $1,087.

Brian Thomas, the city’s emergency medical service division chief, said those bills for most people probably would be covered by insurance or Medicare and supplemental insurance.

And that kind of intense care is the type provided the least by the city.

Thomas said there have been only 21 of those kinds of runs since October, when the city signed a contract with AccuMed for the company to do ambulance billing for the city.

The proposed increases are based on the newest Medicare payment figures.

Thomas said standard practice for ambulance services is to charge 150 percent of the Medicare payment for residents and double the Medicare payment for non-residents.

He said even the new higher fees would not quite cover the cost of city personnel on the runs. And that doesn’t include the cost of the vehicles they drive.

There’s no proposed increase for the service provided the most - treatment of a city resident who isn’t taken anywhere in an ambulance. It would remain $100.

But Thomas said that kind of service isn’t always covered by insurance.

He said 63 percent of patients treated by ambulance crews are old enough to be on Medicare and 85 percent are residents.

Thomas said the new fees would put Mishawaka’s ambulance fees above South Bend and Goshen, but Mishawaka’s would be based on the latest Medicare payment figures. He said the other cities’ fees are based on Medicare payments from a year or two ago.

The larger increases proposed in fees charged by the planning department are fees that would be paid by contractors for things such as applying for annexation of more than 10 acres of property, zoning changes and special-use permits.

Mike Danch, with Danch, Harner & Associates, said during a telephone interview Thursday that some of the increases “will start making a difference” for smaller contractors building one house.

But, he noted, it’s just part of the cost of doing business for larger developers.

Danch said planning departments in St. Joseph County historically have had very low fees. The Area Plan Commission of St. Joseph County raised some of its fees in 2009.

Mishawaka building commissioner Brock “Bo” Hundt proposed raising the fees for some basic permits.

He also wants to separate the building permit fees for residential and commercial property.

The new schedule wouldn’t raise the fees for residential permits much, but the fees for commercial building permits would go up more.

Hundt said his department did not have trouble covering its operation with the fees charged until last year.

He said his department is down to four people from six and a half people in 2003. He would like to be able to add one more inspector.

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