Fate of Mich. city’s ambulance service to be determined by tax increase vote
Traverse City voters will decide if they want to tax themselves more to have the FD takeover transport from Mobile Medical Response
By Jordan Travis
TRAVERSE CITY, Mich. — Voters in Traverse City could decide whether to tax themselves more to have their fire department take over as the primary ambulance transport agency.
Making the switch would require hiring 10 more people, including another captain to manage the department’s EMT division, city Fire Chief Jim Tuller said. It would also come with some hefty startup costs. But, he told city commissioners at their study session Monday, it’s a move that would be worth the cost as the demand for service from medical first responders continues to grow.
“Yeah, the first-year startup is pretty scary, but that will result in Traverse City, the citizens owning their own EMS transport agency and serving the citizens of Traverse City with the best care possible,” he said.
That “scary figure” he referred to would be a total of $1,801,700 in the first year, including one-time costs for buying medical equipment, another ambulance — the city would eventually need another — and extra training for personnel so the city could take over as primary transport agency, according to information Tuller provided.
Net costs for the city to run its own ambulance service are estimated at $911,000 to $1,376,700 per year. That assumes the department would take in $425,000 by billing a patient’s insurance, although fire Capt. Steve Ball said the actual income could be closer to $1 million.
Currently, Mobile Medical Response serves as the primary transport agency, while city firefighter paramedics respond to medical calls and stabilize a patient until an MMR ambulance arrives, Ball said.
The city department’s average response time to medical calls is 3 minutes, 56 seconds, Tuller said.
Meanwhile, the city’s contract with MMR requires the service to respond to 90 percent of all Priority 1 calls — serious emergencies like heart attacks — in nine minutes or less, Tuller said. That’s a metric the nonprofit company based out of Saginaw had previously missed except in June, when it met 91 percent of those highest-priority calls in the required timeframe.
For lower priority calls, it’s not uncommon for city firefighters to wait 15 minutes or so for MMR to respond, Ball said. It’s led to some awkward situations where city personnel wait to hand over a patient to a second ambulance.
Plus, Traverse City’s older population is a sizable percentage — 55 percent of households have a head of household 55 years or older, Tuller said.
“So why do I bring that up? ... The reason is that those are the people that make up proportionately some of the larger share of our responses for emergency calls,” he said.
Hiring more firefighter paramedics would cut down on the need for mandatory overtime, Ball said. With current staffing shortages, the department has already racked up more than 150 mandatory overtime shifts in 2023, and lately spends about $350,000 a year on overtime.
Ultimately, bringing the service in-house would mean the city has control over the employees, what kind of training they receive and how many are available for a given shift, Tuller said.
Commissioner Tim Werner still wasn’t convinced. He asked Tuller why the city needed to take over the service and how to justify asking city taxpayers to pay more taxes to do so.
“I hear there’s frustration, I hear there’s awkwardness waiting around,” he said. “How many lives have we lost the last few years? I know that gets awkward to talk about but if that’s what we’re talking about, let’s talk about it. How many lives have been lost because our guys or gals are not the ones transporting?”
Quantifying that would be difficult, Ball said. Commissioners asked him and Tuller to put together some more specifics for commissioners at their Aug. 7 meeting, including a presentation laying out the proposal to take over primary transport services and their case for doing so.
Interim City Manager Nate Geinzer agreed to get draft ballot language for a proposal that could go before city voters in November if commissioners resolve to do so. Aug 7 is the last regular meeting before a deadline to get that on the ballot. Commissioners didn’t discuss an amount, but Tuller pointed out in a memo that increasing the operating millage by 1 mill would bring in about $1,173,500. Any increase would require voters to override a state law capping that operating millage.
Monday’s discussion followed on a long-smoldering debate over the city fire department’s role in ambulance transport, one that predates MMR taking over for North Flight EMS in October 2020. City commissioners requested a study of what the fire department taking over as primary transport agency would entail in June 2019, finally receiving a report in December 2020. The discussion continued after that.
Commissioners also briefly mentioned an estimate from firm Tower Pinkster that building two new fire stations would cost about $13.2 million. Tuller said those station upgrades would be required if the city takes over as primary ambulance transport agency, but he and commissioners agreed that discussion — and questions of how to pay for the project — should wait until Tower Pinkster’s study of city and county facilities is complete.