Ohio city fire department reaches 10th anniversary of transporting patients
The fire department says it has generated more than $7.3 million in revenue after the decision in 2009 to provide medical transports
The Repository, Canton, Ohio
MASSILLON, Ohio — In 2009, when Fire Chief Tom Burgasser was told to cut 20% of his budget, he knew exactly what to do.
Transporting patients to the hospital instead of handing them over to a private ambulance company seemed like a no-brainer, the chief recalled more than 10 years later.
It cut out the middle man. It would decrease the department's spending while increasing revenue. It would save the residents money.
The Massillon Fire Department reached its 10th anniversary of transporting patients at the beginning of the year. In a decade, the Fire Department generated more than $7.3 million in revenue and saved residents nearly $2.8 million in EMS fees.
"We did everything," Burgasser said. "We treated the patient. We responded to the scene. We did all of those things. The only thing we didn't do is put them in the back of the ambulance and take them to the hospital."
Before 2009, the city relied on two private ambulance companies to transport patients.
City medics provided initial treatment and then transferred care to one of the private companies, which would then take the patient to the hospital.
The Fire Department lost an estimated $30,000 in medical supplies annually, Burgasser said. The private ambulances received payment from insurances, which would have covered the cost of those supplies, he said.
According to city documents, council introduced the emergency medical services ordinance Sept. 21, 2009, which included a year-long trial period.
The ordinance declared council would review transportation by the Fire Department on or before Dec. 31 to determine if it should be repealed or revised.
"We met a lot of resistance initially," said Pat Perkowski, president of the International Association of Firefighters Local 251. "We were all paramedics. We had all the equipment, but we just showed up and provided initial care. ... The system really made no sense."
Jackson Township Fire Department had already been transporting successfully at the time. Then fire Chief Ted Heck was brought into a council meeting to discuss the benefits of a department doing its own transports.
According to city documents, the ordinance passed Nov. 2, 2009 with six council members in favor and two opposed.
Before the final reading, Donnie Peters, former councilman, urged his fellow members to vote against the ordinance, according to an Oct. 27, 2009 article published in The Independent.
Peters said transportation would result in additional duties for firefighters, which would generate start-up costs and lead to a tax increase.
Then-councilman Gary Anderson said the city was wasting time debating medical transportation when the current system wasn't broken.
Longtime Councilman Paul Manson, a Democrat, was first elected in 2003 and lost his bid for re-election this past year.
Manson said he supported the Fire Department from the beginning and had studied the medical transportation system at North Canton and Jackson Township fire departments.
"We were already doing it, but we weren't getting any money for it," Manson said. "It was all cost for us. Maybe it still doesn't cover everything ..., but it's sure contributing a whole lot of money to help it."
Mayor Kathy Catazaro-Perry was on council at the time and voted in favor of the city's Fire Department taking over transportation duties, according to city documents.
Catazaro-Perry, who is a registered nurse, recalled wanting patients to have continuous care without the delay of waiting for the private ambulance.
"The biggest thing was the continuity of care for the patient," the newly re-elected mayor said. "... It was very important to me to allow our department to have that continuity of the care from the time they arrived to the time they transported and left the patient at the hospital. I'm sure we've saved lives by doing it."
The year-long trial started with one transport vehicle at Fire Station 1, which handled at least 50% of the calls. That year, the Fire Department collected more than $508, 000 in revenue.
The department expanded to two transport vehicles with one at Fire Station 2 in 2011. Today, there are four transport units with three medics on each squad.
"I think it's working even better than even the most optimistic of us believed," Manson said.
Saving lives, money
The battle continued for Burgasser after the city was sued by one of the private ambulance companies it previously contracted with.
In 2006, Emergency Medical Transport was assigned to cover medical transportation runs on the city's west side while then-Summit Ambulance Service was assigned to the east, according to an August 2011 Independent article.
The city won the civil dispute following a two-day trial in Stark County Common Pleas Court.
Burgasser said he doesn't disparage private ambulance companies. However, he believed having the Fire Department do medical transportation better suited residents.
"I think we provide a way superior service than what we used to have," Perkowski agreed. "There's no middle man. We go directly to the hospital now; there's no delay."
Transporting also allowed the department to reinvest in itself by covering costs for fuel, updated equipment and medical supplies, Perkowski said.
The Fire Department's transport system was so successful, he said, other departments such as Uhrichsville, East Liverpool and Warren reached out to Perkowski to learn more.
By the Fire Department doing the transports, city residents did not have to pay a deductible or copay for services, Burgasser said. Residents are "soft-billed," meaning statements are sent directly to Medicare, Medicaid or private insurance companies, he said.
Using the Massillon Fire Department, a basic life support run would have a fixed cost plus a cost per loaded mile. A bill from a private ambulance company would have a list of itemized charges resulting in significantly higher bills, Burgasser explained.
Within four years, transports led to residents saving $1 million, he said.
"There are critics who would say we should never have done it," Burgasser said. "But if we didn't do it, I believe we wouldn't have been able to save as many lives as we have, and we probably wouldn't have as many firefighters as we have. It's been a great move for the city to have done this."
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