Council Approves Ambulance Fee Rate Hikes

In an attempt to shore up the city’s balance regarding unpaid bills for ambulance service, the Lamar City Council approved rate increases for seven different levels of service. Lamar Fire Chief Jeremy Burkhart listed the current fees, the suggested range of increases considered by the council and the final fee schedule.

The fee increases were based on an independent study which compared Lamar’s rates to other comparably sized Colorado communities. Chief Burkhart told the council that Lamar was under the average rates paid elsewhere.  “They told us that our rates are simply behind the times for what we charge,” he explained.  Council members discussed the pros and cons and the basic needs for the increases for a lengthy time before making their decision.  City Treasurer, Kristin McCrea said there is a yearly shortfall on the ambulance services which is about $71,000 and has to be off set from the general fund.

Burkhart took a number of questions from the council, explaining the types of services listed in the breakdown and the frequency of response by the Lamar Ambulance Service. ALS stands for Advanced Life Service.  Chief Burkhart explained that the Level 1 Non Emergency Category has never been used, but a fee was affixed to the service.  “This is where we would have an ambulance run to, say, Penrose Hospital where we would have the patient under medical care, such as intubation and monitoring, during the course of the transport.  He explained the ALS Level 2 category is rare; perhaps less than twelve calls a year.

On the other side of the scale, Burkhart said the Treat No Transport category refers to instances when there is an ambulance response, but the crew did not have to offer any medical treatment once they were on the scene. “If we’re there and we just check over a person and they refuse any medical treatment, there is no charge involved.”  He explained the increase now will be for a base level of treatment such as some medicines or other medical materials.  Burkhart said this category has shown a significant increase over time.  “We can’t refuse anyone medical treatment on a call, based on their ability to pay and we’re getting more and more of these types of calls,” he said.

Councilman Kirk Crespin voiced a concern about the increases, asking, “If they’re (patient) already having difficulty paying for the services, and we’re having trouble collecting for the services, how much does this really help us if they can’t pay $100 and we’re charging them $300?” Treasurer McCrea said, “Over 50% of our billing is Medicaid and Medicare and they set limits on compensation.  Medicaid only pays about 25% of what their cap is and Medicare pays 75%.  Increasing the rate isn’t going to collect anymore in those two categories.  The only category that we see getting any more revenue would be your private insurance.  This would be a piece of revenue if we could collect it.”

City Administrator, John Sutherland offered a comparative example for the situation with the city’s ambulance service, “We are running on zero cash. We are running a business that has no cash and can’t pay its payroll.  If we had to pay every one of our responders a legitimate salary, at what point do you sent up a flag and say we have to do something, and when you have a professional service recommend you have to make a change, we need to act.  We’ve made changes, trying to do something with billing and software, but we’re past the point where we can’t do anything.  We are $71K in the hole to the general fund.  On a cash bases the general fund is supporting our ambulance crew.  Our responsibility is to make sure this works for the entire community.  We’re having 50% of your customers who aren’t paying you anything or a small fraction of what you’re trying to bill.  Someone has to bear the cost or we go to the taxpayers and we say we need a quarter percent sales tax increase or we have to create a special district.  We need a way to fund this project unless you’re willing to continue to fund it from the general fund.  That’s our only alternative.”

By Russ Baldwin