City, county at odds over ambulance
Published 6:04 pm Saturday, August 6, 2016
An apparent discrepancy in the number of runs made in the county by the Vicksburg Fire Department’s ambulance service and how much the county was charged for them has stymied city-county negotiations for a new interlocal agreement to continue city ambulance service in the county.
And at least one Warren County supervisor has said he would be interested in considering a private ambulance service to provide emergency medical service to county residents.
The city and county presently have a one-year agreement in which the city provide emergency medical service to the county at a charge of $300 per run regardless if a patient is taken to the hospital or receives medical assistance.
But city officials said a recent review of ambulance calls for the year indicated they did not charge the county for runs where ambulances were called and then either were not needed on arrival or “turned around” en route to the call, and it’s the amount of those uncharged calls and whether the city will try to recoup the missing money at the center of the impasse for a new contract.
“We don’t charge them for that, but my understanding is if they’re dispatched at all, they should be charged,” Vicksburg Fire Chief Charles Atkins said. “They should be charged, but I don’t know if that’s not the case.” He said the city has not charged the county if its rescue unit responds to a county call with an ambulance.
“It appears that our ambulance service numbers and what we’re being charged is very controversial and it is right opposite from what you would think it was,” District 1 Supervisor John Arnold, who is considering recommending a private ambulance service, said. “We’re being billed less than what we’re showing being dispatched out of 911, so now the city has realized they have not charged us for all the runs that have (been) run out.”
Both sides say they do not yet have an accurate count on those uncharged calls, and with the city and county required by state law to have their fiscal 2017 budgets approved by Sept. 15, getting the problem resolved has become a pressing matter as they complete budget meetings.
Warren County Administrator John Smith said the county’s present budget for ambulance service is about $680,000 a year, adding the county has so far spent $597,000.
He said a list of ambulance calls he received from the Vicksburg-Warren 911 Communications Center indicated city ambulances received 1,931 calls for assistance in the county from July 1, 2015, to July 2015, but added three of those months, July, August and September, were in fiscal 2015, when the city was charging the county $146 per run.
“The call numbers we have don’t correspond with the billing we received from the city,” he said. “We’re tying to get accurate numbers from the city so we can see what we need to do.”
“We’re just getting bits and pieces of information,” Supervisor Charles Selmon said. “It’s just hard to make a decision when you’re talking about thousands of dollars.”
He said he wants the boards to meet and work out the problem.
“That clarification will help us a great deal in making whatever decision is going to be made,” said Board of Supervisors President Richard George, who added he would prefer to stay with the city service.
North Ward Alderman Michael Mayfield, who has been the point man for the Board of Mayor and Aldermen on the ambulance negotiations, and Atkins, said they are working to get numbers for comparison to resolve the issue.
The uncertain numbers loom even larger, because city officials are considering a one-year contract and raising the fee to $400 or $450 per run in the county. Mayfield and Atkins said the increased fee will help the city cover the cost of fuel and equipment when the ambulances make the county runs.
Atkins said when an ambulance goes on a call, it required by state law to use an ALS, or advanced life support system. If an ambulance makes a call to Redwood for a heart attack and takes the patient to Merit Health River Region Medical Center, he said, the minimum service cost of the run would be $650. The county’s fee would pay part of that cost with the balance either picked up by the patient or their insurance.
“In most cases you’ll find they don’t have insurance,” Mayfield said. “We’re losing money.”
Each time an ambulance and the rescue truck leaves, Atkins said the run is considered an active run.
Whether to charge the county for the unneeded calls, Mayfield said, would be up to the board with the advice of the city attorney and the accounting director.
“Personally and professionally, I don’t see where you would be able to recoup those dollars, mainly, because who do you blame? The county or the city? Both of us are at some fault.
Flaggs said Friday he believes the county should pay for the unbilled runs, and he has talked with George and Smith about arranging a settlement to cover the unpaid runs. “I think we can negotiate a solution,” he said.
Arnold believes using the city’s ambulance service may end up being too expensive for the county.
“We’ll look at it. If they go back and back-charge us, or even moving forward from this point, it appears the funding from the city ambulance and rescue is more,” he said. “It seems like for the county, we could come out better going to a private ambulance service and running our own rescue truck.
“It’s not that I like one any more than the other, because we’ve always gotten good service out of the city. It appears that it (the cost) is just getting out of hand, and it’s a whole lot about expenses. If the city’s costing us two-thirds more of what we can get private service for, then I think we have to look at that,” he said.
“I’m very open minded; which every works out. I never had a question about the service from the city, but at some point sometime you just get completely out of hand with the price. I hope we’ll make a decision next week.”
“We’re trying to get this cleared up,” George said. “I would much prefer to stay with our proven service and the quality of it and being a local service. We probably would have had it settled if it were not for this report on this number discrepancy. When the discussion on that is held, we should be able to go ahead and make a decision.”