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Ambulance debate rough road: Government could grow

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Columbus Mayor Kristen Brown is OK with expanding city government if the Board of Works taps the city fire department to perform emergency ambulance service in the city, even though the financial pinch up front would be substantial.

The fire department submitted an ambulance-service proposal that anticipates almost $1.5 million in start-up costs, which would be recaptured to some extent through collections from patients, their insurance providers, Medicaid and Medicare.

Brown said it doesn’t matter whether the city pays for the service directly through the fire department or indirectly through a contract with one of the two other contract contenders that claim they would need a subsidy. Either way, the city would have to pay something, unless the contract went to one of the two companies that are proposing ambulance service with no subsidy at all.

The fire department estimates it would need a subsidy for city-only ambulance service of $980,000 for the first year, an amount that would drop in subsequent years to about $300,000. That is at least $400,000 less than what the city pays current provider Columbus Regional Hospital.

The fire department inadvertently presented incorrect numbers during the Tuesday Board of Works meeting about how much it would need in subsidies. Instead of calculating costs and income based on 3,000 runs a year, as the other bidders had done, the fire department made its calculations based on 4,000 runs. More runs meant more income, offsetting the costs. The department has since corrected its mistake to put its calculations on even footing with the competition.

Brown said she has no problem with city government taking on ambulance service again as an in-house function. The fire department provided the service before 2006, she said, and has proved its ability to run it efficiently and effectively.

The $1.5 million in start-up costs will not be a problem, she said, because the city has a healthy reserve in its general fund. Also, the state recently refunded $3.5 million to the city because of a state tax error. Brown said the city has not decided how to spend the money.

No layoffs or cuts in service will be necessary, she said.

Fire Chief Joel Thacker said none of the city fire stations would need to be modified to house the new ambulances.

He said some members of the department would love to start directly handling ambulance service again. The department would have more day-to-day operational control of the ambulance service, he said, and a direct hand in hiring, disciplining or firing personnel.

The fire department is recommending that the city go with civilian paramedics who have nothing to do with fighting fires. That’s a change from how things were handled before 2006, when cross-trained firefighters performed both duties.

Thacker said the city would not have to pay civilian emergency medical technicians and paramedics as much as they would firefighters.

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