By Sean McDonnell
cleveland.com
CLEVELAND — Cleveland received an influx of unexpected cash from past due ambulance bills, giving it up to $19 million to spend on a wide array of needs, including returning money to projects that were left unfunded to pay for repairs at Rocket Mortgage FieldHouse and Progressive Field.
Cleveland budgeted for $16 million of EMS revenue in 2025, but the city has already received $22 million and now believes it will get $35 million by the end of the year, Finance Director Paul Barrett told Cleveland City Council.
The money comes after Cleveland started outsourcing billing for emergency medical services in 2025. For years, City Hall had its own division that collected fees for services like ambulance rides. But revenue lagged as the department was plagued by vacancies.
Cleveland went from collecting $16.8 million in 2021 to $4.1 million in 2024. This was despite Cleveland substantially raising billing rates for ambulance services in July 2022.
Quick Med Claims, hired by Cleveland to handle billing going forward, has also been trying to collect money from past years. How much Cleveland is still owed from old bills is hard to measure. Not all EMS bills are collectable because circumstances get worked out with hospitals and insurance companies, a city spokesperson explained previously.
Council passed legislation to take $18.7 million from these EMS revenues to divvy up for other needs across the city.
That includes returning $5 million to the minority business credit enhancement program, meant to include more minority-owned, female-owned and Cleveland-based contractors in development projects.
Back in December Gateway, the nonprofit that serves as the landlord for the Cavs and Guardians on behalf of the city and county, needed a $40 million bailout to pay for repairs.
Cleveland sent Gateway $20 million, taking $5 million from the general fund, $5 million for the minority-business program and $10 million that was borrowed for future construction projects.
Using the EMS revenue, Cleveland also set aside:
- $1.22 million for Quick Med Claims, who earned more compensation since they exceeded expectations on EMS revenue
- $500,000 to hire five full-time prosecutors. They’ll work the evening shift, part of Cleveland’s commitment to not hold uncharged suspects for long periods in the county jail.
- $800,000 for increased EMS pay, since the paramedics and EMTs union won higher salaries in arbitration
- $3.1 million for promotional backpay in the fire department, which Cleveland must do after a court order
- $5 million increases to Cleveland’s healthcare budget because of higher prescription drug prices
- $418,000 for two programs in Community Development, though both would need final approval from council (and may not receive it)
- $470,000 to hire seven employees across various departments
- $2.2 million diverted from the Neighborhood Equity Funds during budget negotiations
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