A new emergency ambulance contract among Columbus, Bartholomew County and Columbus Regional Hospital will go into effect Tuesday, changing the home locations of two ambulances, forming an oversight board and significantly reducing the costs paid by the city and county.
The new ambulance contract was approved Dec. 18 by the Columbus Board of Public Works and Safety and Thursday by the Bartholomew County Commissioners. It was the product of months of debate and negotiations this summer among the city, the hospital and three private ambulance providers that hoped to take over the contract.
Mayor Kristen Brown said she thinks the final outcome was worth the agonizing process.
“We have got effectively the same service, arguably a little better service in the number of ALS (advanced life support) ambulances out there,” Brown said. “And we’ve got the ambulances in better positions for response times in the city.”
This year, under the existing contract, the city and the county paid more than $954,000 for emergency ambulance service. Under the new contract, the city and county will pay $150,000 each for a combined $300,000 subsidy next year and then will have no subsidy in future years.
Bartholomew County Commissioner Carl Lienhoop said the commissioners started the ball rolling for the ambulance contract almost a year ago, when they challenged CRH to provide the service without a city and county subsidy. But Lienhoop said the commissioners took care not to micromanage the process, recognizing that they were not doctors or paramedics.
“We don’t want to tell them how to run their service,” Lienhoop said. “But they felt like if they had some flexibility, they could achieve that benchmark that we put before them a year ago.”
Lienhoop said the commissioners are happy that the process led to retention of the hospital as the ambulance provider.
“CRH is our hospital,” Lienhoop said. “They have done a great job the past six or seven years with the previous contract. We think that it provides employment in the community. It gives ownership to the community, and it is staying in local hands.”
Dan Spartz, director of ambulance and pulmonary services for CRH, said the hospital will be able to operate without subsidies because it is starting up a private ambulance transport service to help offset the cost. A Lean Sigma team helped the hospital streamline processes and make the ambulance operation as cost-efficient as possible.
Spartz said there is no immediate plan to change the rate structure because of the new contract. The ambulance department gets monthly reports from the hospital accounting office and constantly evaluates whether the costs are being covered by the charges to the patient, Spartz said.
One of the biggest changes in the new contract is relocation of two of CRH’s four advanced life support ambulances. The hospital will move an ambulance now stationed in Jonesville on County Road 450S to city Fire Station 5 on Goeller Boulevard, Spartz said. A second ambulance now stationed on Progress Drive, off of Indianapolis Road, will be moved to Fire Station 1 at Washington and 11th streets.
Lienhoop said he was confident the hospital would deliver appropriate response times to county residents, although all of the ambulances will be stationed inside the city limits. He said there is no way to completely guarantee that an ambulance will be available at all times or at a conveniently located station.
“We have beat this horse to death a lot over the past 11 months. And just because you have three or four strategically placed ambulances, there is no guarantee that at any given time that those strategically placed ambulances might not be where they are parked — they might all be on the road,” Lienhoop said.
Brown said the city’s goal has been a standard response time of nine minutes within city limits, 90 percent of the time. Brown had insisted that all of the ambulances should be based in the city to improve response times.
But county residents won’t be suffering, she said. If the county had gone it alone, it could probably only afford a single ambulance. With the city-county contract, there will be more ambulances available as the county gets to piggyback on the city-based ambulances.
“People who live in the city of Columbus pay a lot higher property taxes for public safety,” Brown said. “They have an expectation that if they are living in the city limits, the ambulance will be there in less than nine minutes. And they should have that expectation.”
The contract outlines the composition of an oversight board that will meet quarterly to review response times and other metrics of service. Among the members will be a representative from the chiefs of the county volunteer fire departments, who were vocal critics of plans they felt would increase response time to rural residents.
Rodney Ferrenburg, chief of the Columbus Township Fire Rescue, said the chiefs will appreciate having a voice in the oversight board.
“I think it is best in emergency services to involve the people directly involved in providing care,” Ferrenburg said. “The people that provide the care, provide the emergency services to the county and community, those are the ones who need to be advising our elected officials.”
But Ferrenburg said there is no way to make every volunteer chief and rural resident happy.
“We could put ambulances in every fire station, and it is still going to take too long for somebody,” Ferrenburg said.
But German Township Trustee Chris West said he has few concerns over slower runs to his end of the county. Before the contract with CRH, the city ambulance, Medic 1, was also stationed at Fire Station 1, and there were few problems, West said.
“My concern is that Indianapolis Road is not an easy road to make passes on in an emergency vehicle,” West said. “As long as they can continue to meet their requirement times, we have done it before.”