Administration and Leadership, Industry News, Industry News, News

Mass. town reviving the ambulance service?

Fitchburg, Mass. Leominster’s Finance Committee Chairman Dennis Rosa said he would caution cities who want to create a city-run ambulance service as a financial solution.

“If I was looking at another community that didn’t have (a city-run ambulance) service, I wouldn’t have such high hopes that I was going to put an ambulance service together and start getting positive revenue,” Rosa said this week. “I would be looking at it as a superior service to provide for our residents.”

City officials in both Leominster and Fitchburg said the approach to an ambulance service must be as a business, with proper financial costing and planning.

“If it gets political, forget it,” Rosa said.

Rosa, an at-large city councilor, said it was a six-month process when Leominster revamped its ambulance service’s billing system 15 years ago, and he estimated it would take at least that long to start an ambulance service from scratch.

Fitchburg Mayor Dan H. Mylott has given Fire Chief Kevin Roy permission to examine resurrecting the city-run ambulance service, and Roy said he expects to have a verbal report ready by next week.

Mylott said this week he does not believe a city-run ambulance is worth the financial risk, but that the city needs to examine any revenue-creating source it can find for the 2008 budget.

Private companies have handled the city’s ambulance services since 1983.

Roy estimates one ambulance in Fitchburg earning a revenue of $400,000 to $450,000 next year, with a profit of $75,000.

The additional revenue would be used to keep five firefighters from being laid off, which Roy insists is necessary for public safety.

Roy said revenue and profit would increase each year as the ambulance service got off the ground and he points to Leominster as an example.

“I don’t believe it’s a financial risk at all, I think it’s been proved in Leominster,” Roy said.

Barely breaking even

But Leominster’s service barely breaks even once all the costs are included, Rosa said.

Roy defended his estimates as extremely conservative.

“I’m not putting out a number for next June that I cannot meet, because my credibility would be shot,” Roy said.

Mylott’s proposed cuts will leave the fire department with 14 firefighters per shift, when Fitchburg should have at least 17, according to Roy.

The department will be able to field 15 firefighters per shift with the revenue from the ambulance service, Roy said.

“If we make more cuts now, and don’t find a revenue source, the public’s going to be in more danger,” Roy said.

Firefighters operating the ambulance as EMTs can also be sent out on firefighter calls, Roy said.

Fire Lt. Kenneth Desjean, president of Fitchburg’s firefighter union, said firefighters completely support a resurrected ambulance service.

“We’re looking at it as a funding source to prevent layoffs in the department, bring in some revenue,” Desjean said.

Desjean acknowledged firefighters in the early 1980s disliked the service, but he said that was because the city did not properly fund it.

“I was on it back in ’83 when (the ambulance) was taken out of service. It was subject to a lot of breakdowns,” Desjean said.

Desjean said firefighters would not be excited to work ambulance shifts, but they would be willing to do so.

Firefighters in the more junior positions would probably do most of the shifts, Desjean said.

“We do have a core group of people who are very interested in doing that work,” he said.

Ward 3 Councilor Joel Kaddy, who serves as the Public Safety Committee chairman, said he has heard rumors that some firefighters are not pleased about the possible return of the ambulance service.

He also raised the question of whether the city will have to pay firefighters additional stipends in the future.

“Even though I’m for it, Kevin Roy has to prove his figures,” Kaddy said. “This isn’t just to save his firemen’s jobs, this is a business. He has to prove to us he can make this work and we’re not going to lose money.”

Accurate numbers?

Ward 4 Councilor and mayoral candidate Ted DeSalvatore said he wants the figures to come from someone other than Roy or another city’s fire chief.

Roy may avoid some of the negative concerns behind creating an ambulance service, DeSalvatore said.

“Going by the say-so of a fire chief who wants the service is not a check in the balance,” DeSalvatore said.

The cost-and-benefit estimates must be right because the city has so little financial room to maneuver, he said.

“Because of our fiscal condition, we have to forgo the luxuries and stick to what our needs are,” DeSalvatore said.

DeSalvatore also raised the issue that Fitchburg would have a much higher payment default rate then Leominster because it has a higher rate of uninsured residents.

“Now if the state mandates that everyone has to be insured no matter what, that would take care of that problem and make this an absolutely doable deal,” he said.

Fellow mayoral candidate Lisa Wong said she would need to see a detailed business plan from Roy before deciding if an ambulance service could make money and help public safety.

The plan would have to properly examine market data, she said.

“I can’t say whether this is a business risk or not,” Wong said. “My feeling is it seems like a good fit, because the fire department, more often than not, is the first responder.”

She also suggested having ambulances bid on gaining a city-wide monopoly contract in the city as a no-risk way to raise revenues.

The Fitchburg Fire Department received more than 5,000 ambulance requests in 2006, which is about 67 percent of its call volume.

More than 35 percent of those ambulance calls require a fire engine to go with them.

Fire engines go on the more serious ambulance calls because firefighters can often get to outlying areas quicker with three fire stations in the city, and because a serious injury will often need up to four trained EMTs, according to Roy.

The Leominster ambulance service generated nearly $1.2 million in revenue from August 2006 to April 2007 with two ambulances, according to billing figures.

There is an 85 to a 90 percent collection rate on the revenue, Rosa said.

Revenue from Leominster’s ambulance service are put into the city’s general fund, and cash gets funded back into the fire department as needed, Rosa said.

Roy declined to speak in detail about what his start-up costs may be, but said he is in negotiations with private ambulance companies about obtaining the necessary equipment.

In a 2001 City Council committee report, Roy estimated it would cost $1.2 million for a two-ambulance operation the first year.

Leominster Fire Chief Ronald Pierce said he sees the ambulance service’s biggest gain as the goodwill generated among residents.

“When people go out and do a good job … it can’t help but increase your view of the local fire department,” Pierce said.

Pierce said that while there are a number of costs with running the department’s two-ambulance operation, the department makes money with it as well.

Pierce termed it a “win-win” for any city.

“I know the people, the quality of firefighters (in Fitchburg),” Pierce said. “They’d be as good as my people, I know they would.”

Leominster Mayor Dean Mazzarella said each community must make its own choice for what matters to them.

But he said residents often say they prefer to have their ambulance service run by the city.

He said he received an e-mail just recently in which a family praised the ambulance service’s response.

“That’s one of the advantages of having a real local fire department run their ambulances, run by, for the most part, local people,” he said.

Mark Brown, a vice president with municipal insurer USI New England, said there would not be any large increase in insurance liability if a fire department were to add an ambulance service.

Firefighters perform many EMT tasks already, he said.

“I don’t think it would be an eye-popping expenditures,” said Brown, who could not go into further detail.