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City may keep ambulance fees

Looking at the numbers across the City of Mercer Island’s two-year budget, city officials knew something had to go, or money needs to come in. The city believes it may have found an option to save some major cuts over the next two years by taking over what private ambulance services have done for years on the Island — transporting patients to local hospitals and collecting fees of hundreds of dollars per trip.

A proposal will go to the City Council at the Dec. 6 regular meeting, after last Monday’s special meeting was canceled due to bad weather.

City Manager Rich Conrad said the concept of taking over transporting patients came up as staff looked at fees and charges during the budget deliberations this summer, but originally the City Council members resisted the idea. But several of the dissenters changed their minds, wanting to learn more, so city staff and the fire department worked up a proposal to show exactly what it would look like.

Mercer Island Fire Chief Chris Tubbs said that now if a patient requires being transported to a hospital and is not critical, a private ambulance is called and then the private company takes the patient.

“We’re eliminating a step,” said Tubbs. He said in some cases the Mercer Island department does take patients to the hospital, about 100 a year.

Private ambulances have taken a majority of the transports since the late 1970s, Tubbs said, after a major house fire on the south end of the Island occurred when the only on-duty unit was available at the time — before the south end station was staffed full time — causing enough public uproar to change the policy. The City Council directed the fire department not to transport patients any longer. Even after Station 92 was built and staffed to serve the south end, the policy not to transport patients off-Island remained.

Since then, the policy has softened a bit, but still hasn’t ever officially changed.

Conrad said the city staff knew coming into this budgeting process it was going to be a tough year. Looking at all options was a must, he said.

According to Conrad, Eastside Fire and Rescue, which operates in Issaquah and the cities of Sammamish, North Bend and Snoqualmie, has decided to take back directing patient transportation, along with the city of Kirkland, while Bothell and Shoreline have already changed to a similar policy.

“We’re certainly not reinventing the wheel,” said Conrad. “We saw this as a leveling of the playing field.”

Private ambulances, which most often take patients from the Island to Overlake Hospital in Bellevue, generally charge around $770 a patient, which is most often billed to insurance. Conrad said the city will be charging the same rates and will be billing insurance companies. He said the private ambulances also charge a mileage fee and bill patients for whatever cost the insurance companies don’t cover, neither of which the city will do.

The obvious concern that the fire department has already heard about with the proposal is what risk this puts the rest of the Island in, should someone need service. Tubbs said the data they have looked at has shown the risk is small.

“The data suggests the risk is low,” he said. In researching the proposal, the department found there were very few times when there would have been serious incidents in progress on the Island. In 2010, there were 2,000 total incidents requiring the department’s service, of which six were fire calls that the department considers to be more substantial, and aid calls. Of those six, Tubbs said, one call had all units canceled before they responded and the other five were very minor calls, such as small kitchen fires, which generally were extinguished before firefighters arrived.

After evaluating all the calls made in the past year, they found that transporting patients added approximately 20 minutes to each call. A unit is considered back in service as soon as a patient is left at the hospital.

If the change is approved, the department will monitor the effects on services on the Island looking forward. “If we find that we need to make adjustments, we will,” he said.

Conrad expects that the city will collect most of the cost from insurance companies.

“We believe that Mercer Islanders would mostly have insurance,” said Conrad.

Tubbs said if the proposal goes through, transporting patients isn’t expected to change staffing levels at the stations, except in rare cases, such as bad weather, when call traffic is already higher. Medically, he said, training won’t change, but responders would have to get specific information from patients in order to bill insurance, something he said would be contracted out.

“We believe it’s relatively easy to do,” he said of the changes in procedure. “We can absorb it into our current budget.”

Most importantly to the department is that if they do start transporting patients off Island, it will not effect their regular level of service.

“The fire department continues to be committed to service,” said Tubbs. “We expect that’s not going to be diminished.” He said should issues come up after the proposal goes into effect, they would make necessary adjustments to continue doing what they’ve always done.

If the Council approves the measure, it would go into effect in February 2011.

Learn more

To learn more about the specifics of the program, see the proposal online on the city’s Web site at www.mercergov.org.

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