ELYRIA — If one City Council member has his way, the city will stop looking into the idea of starting an emergency medical service program as a revenue generator because he contends doing so will take the focus off more pressing issues and send the wrong message to a private company.
Councilman Mark Craig, I-4th Ward, on Thursday sent a referral to City Council President Mike Lotko urging him to place a resolution before Council stating that the city would not invest further time and resources into the idea of providing EMS service.
Craig wants to shut down a recent effort by Mayor Holly Brinda to pursue it.
“By reopening the investigation into EMS provided by the city of Elyria, we are taking a step backwards, ignoring the clear results of the McGrath audit and wasting resources in a time when resources should be carefully preserved,” Craig wrote in the referral dated May 16, exactly one week after the release of the state performance audit brought the prospect of EMS service back into the spotlight.
The performance audit went into great detail describing the needs of the city as well as the financial burdens of the Fire Department, but it stopped short of giving Council a clear directive as to whether the future of the department should also include EMS.
Instead, the audit left it up to the city to decide.
Brinda said she began fact-finding recently in hopes of doing just that, sending newly hired Assistant Safety Service Director Bruce Shade to meet with Herb and Pete de la Porte of LifeCare Ambulance Inc. At the meeting, the city made a formal request for information related to EMS calls in the city.
“Regardless to how Mr. Craig feels about this and it seems he has already made up his mind, this is a big decision and I don’t know what we are going to find yet,” she said. “I don’t have an agenda. But I do think we have an obligation to play it and examine it further. To the taxpayers, I would say that examination will be thorough, thoughtful and in their best interest.”
Craig contends the city already has done a thorough examination of the issue and came to a conclusion.
“I’m not trying to start trouble,” he said. “I am just trying to stop us from traveling too far down a path that will only lead to trouble. This topic has been resolved under the prior administration to the satisfaction of Council.”
In 2009, the city, under the leadership of then-Mayor Bill Grace, commissioned a $50,000 report from the McGrath Consulting Group that recommended keeping emergency response status quo with LifeCare because it was cost efficient and care wouldn’t improve if changed.
Craig said the McGrath report continues to be valid five years after the fact, and he wants Council members to formally tell Brinda they stand behind it so the administration can move on to more pressing city matters — in his opinion, economic development and the upcoming income tax renewal in November.
Tim McGrath, co-writer of the report, said Friday he could not recall any issues with LifeCare in regards to its performance or willingness to provide information for the audit.
“That was five years ago, but nothing sticks out to me and I thought everyone was OK with the service they provided,” he said. “They were a very good organization, if I recall correctly, very open and shared information with us. They seemed like a pretty well-run transparent organization and that tells me a lot right there.”
Before a city, that previously did not transport patients, looks at taking over EMS services, McGrath said it has to ask itself several questions — what is wrong with the service it is already getting, what changes can it suggest the private organization make to improve service and is it cost effective to duplicate the services of a private company.
Lotko, D-at large, said the referral will be placed on the agenda of the next Strategic Planning Committee meeting, which likely will the first Monday in June. The discussion will start with the referral, but Lotko said it will also included several matters that need to be hashed out even if the intent is not to wrap EMS service under the city umbrella.
“Both parties — the city and LifeCare — need to discuss some contractual issues,” he said. “The agreement between the city and LifeCare hasn’t been updated since 1997. I will make sure that will be done, but that does not mean I will be going down the EMS path.”
Brinda said beyond the 17-year-old contract, of which she doesn’t need Council’s approval to update, there are several issues that have to be vetted.
“One clear factor that cannot be ignored is the best used of manpower,” she said.
Currently, the city has 74 firefighters with 23 of whom are paid by a federal grant. When the grant expires in late 2014 or early 2015, the city will have to either cut the Fire Department down to a level it can afford or find a new revenue stream to support the department.
“Because fires and other such emergencies do not occur with great frequency (but the threat is always there), the firefighters are available to respond to medical emergencies in addition to the fire calls,” Brinda wrote on a blog she recently started on the city’s website. “Employing the Fire Department staffing for both functions could potentially allow us to achieve better utilization of our needed manpower.”
In addition, Brinda said the city is losing money by paying for supplies firefighters use when they arrive first on an emergency scene and handle patient care before LifeCare transports patients to the hospital.
“What are people afraid of? All we are doing is looking at the truth,” Brinda said. “I have no agenda. I really don’t. I’m trying to balance the budget and provide the best possible care and services.”
Brinda said Craig is sticking his head in the sand, believing the lingering questions will just go away.
Craig believes Brinda is chasing fool’s gold on a dead issue and misled Council by downplaying how much attention auditors would give to EMS service.
Both have expressed their opinions in the conversation forum of LorainCounty.com.
There, Brinda and Craig spar over the audit and EMS service with Brinda saying Craig is not a team player and waits until its time to vote on a matter before voicing a concern.
“It can’t be said that I waited until the last minute to voice my concern over this,” Craig said Friday afternoon, the day after making the referral. “I am starting this conversation and I want to say she has other things to do.”
Craig worries about alienating residents by wasting time revisiting old issues, which could cost the city the support of the income tax renewal.
Is there money
It is hard to determine if the city could make enough money to fully subsidize an EMS program. Based on comparisons with peer cities, the performance audit said Elyria could potentially generate $852,672 in revenue for EMS response and transport.
However, Pete de la Porte, president of LifeCare, using figures he found in the audit, said the city would spend more money than it would make by transporting emergency patients and then billing insurance companies for revenue.
The way de la Porte looks at it — with decreases to Medicare reimbursement, additional expenses for medical billing and collections and staffing requirements to operate two ambulances 24 hours a day, seven days a week — the city would loss well over a million dollars a year.
“For the three ambulances, you need 26 full-time employees,” he said. “Using a number in the audit, the starting firefighter cost is $71,000 each for a total cost of $1,846,000 in salaries every year. This does not include the $532,500 in equipment, any overhead, any overtime, nor does it include 7 to 10 percent billing expenses, gas, repairs, computer expenses and other supplies.”
McGrath said he has yet to have a municipal client that has made money on EMS.
“If the decision is just fiscally driven, you are going to recoup some money, but I don’t see it as a revenue generator. It will offset 30, 40 or maybe even 50 percent of what you will have to put in.”
Lotko said he just doesn’t think the city is in a position to entertain such a costly venture as EMS.
“How are we going to compete with free?” he said. “I haven’t heard from anyone that has an issue with EMS service and I can’t believe we can compete with what LifeCare does. From a dollar and cents standpoint, you would need a tough argument to convince me to go down that road.”
The Strategic Planning Committee is made up of all Council members and typically services as the forum for where far-reaching city issues are debated. For the resolution to pass, Craig would need the support of a majority of Council members.
Several members are already leaning in that direction.
“I don’t think we need to be venturing into EMS service,” Councilman Vic Stewart, D-at large, said. “When we are getting the service we are getting for free and based on the McGrath study getting exceptional service, there is no need to revisit this issue.”
Stewart said he expects Brinda to continue fact-finding although he says her time should be spent elsewhere.
“No, the focus should be guided toward the 0.5 percent renewal,” he said. “I know it’s just May, but if that fails nothing else will matter.”
Council members who were not around when the McGrath report was commissioned said they still know enough about the issue to know the city cannot afford to start EMS service.
“I understand what Mark Craig is saying and I generally agree with that,” said Councilman Jack Baird, R-at large. “If we have the conversation, that’s fine with me. But where would we get the money to do EMS? We don’t have that kind of money.”
Councilwoman Brenda Kay Davis, D-2nd Ward, agreed on the standpoint the city would need to invest a lot into the program to get it started from buying several ambulances and medical supplies to hiring an outside company to tackle the arduous billing process.
Contact Lisa Roberson at 329-7121 or firstname.lastname@example.org.