Columbus, Bartholomew County and Columbus Regional Health are returning to subsidizing ambulance service for the county after an 11-year break.
Under the four-year agreement approved Monday by the Bartholomew County commissioners, an annual subsidy of $868,163 will be paid by county government, and also by the city and CRH.
Four hours after the commissioners met, the CRH board agreed to be an equal partner in subsidizing ambulance services.
It is unusual for CRH to subsidize a part of its own operation, commissioner’s Chairman Larry Kleinhenz said.
“But CRH sees themselves as a community partner,” Kleinhenz said. “Therefore, they are willing to subsidize the ambulance service to the tune of 33%.”
When the larger Columbus Regional Health organization agreed to join the city and county in subsidizing the smaller ambulance service, they did it as part of a team wanting to maintain strong and positive relationship with other team members, CRH spokeswoman Kelsey DeClue said. That team includes law enforcement, firefighters, emergency dispatchers and others that serve the community during emergencies, she added.
Kleinhenz added the subsidies give CRH an additional incentive to operate the ambulance service as efficiently as possible. The new agreement also calls for increasing the number of emergency ambulances from four to five, he said.
On Dec. 3, the Columbus Board of Public Works and Safety agreed to being an equal partner. The three-way arrangement was originally recommended by the Emergency Ambulance Services Board.
Although the Bartholomew County Council has already appropriated the funds for the subsidies, Kleinhenz said there was a lot of push back from the county – including from his fellow commissioners.
“It’s nothing I was wanting to do,” Commissioner Tony London said.
“We’re not thrilled with doing this, but we feel it’s the best we can do,” Commissioner Carl Lienhoop said.
While CRH has operated an ambulance service without government subsidies since 2014, Kleinhenz said their losses have gotten to the point they can’t continue without some outside financial help.
From what the commissioners have been told, the CRH ambulance service is collecting only 40-cents on every dollar it charges, London said. One part of the problem comes from people who refuse ambulances, while another part stems from non-payment by patients, a long, drawn-out payment schedule, and claim denials by private insurers, he said.
There is also what Lienhoop called “frequent flyers” who call for an ambulance on a monthly, if not weekly, basis.
Lienhoop and Kleinhenz said an emergency dispatcher isn’t going to argue with a caller on whether an ambulance is really needed because denial of services might lead to liability issues and possible litigation.
It is the legal responsibility of the county commissioners to provide ambulance service in the county, London said. However, he did express a degree of satisfaction that the subsidy agreement will be reevaluated every year.
“As far as I’m concerned, this is stop-gap (temporary) until we can find a better solution that may include looking at other providers,” London said.
For Kleinhenz and Lienhoop, having local government paying ambulance subsidies harkens back to a brief, but tense period of time.
During a Sept. 11, 2012 county council meeting, then-Columbus Mayor Kristen Brown argued that while city residents represented 57% of the county residents, the city was paying 62% of the ambulance subsidy. Brown felt it was only right that the county pay more money for ambulance services.
That prompted Jorge Morales – who was county council president then as he is now – to remind the mayor the county was paying a higher percentage to subsidize the 911 Emergency Operations Center.
In 2012,, the city and the county paid more than $954,000 for emergency ambulance service. But the county’s financial obligation dropped to $300,000 in 2013 – and finally to zero in 2014. At about the same time, the city also phased out its ambulance subsidies.
