City Proposes Higher Ambulance Fees

Ambulance fees could increase for Wheaton residents if the city approves a city staff recommendation. 

City Council discussed the proposed rate increases, estimated to bring in an additional $168,000 in revenue, in a planning session Monday. The new rates would mean a collection rate of 72 percent of operating costs for the city's Medical Rescue Program. 

The city assesses a user charge for all resident and non-resident ambulance calls, plus mileage fees, at three service levels, including: Basic Life Support (BLS), Advance Life Support I (ALS I) and Advance Life Support II (ALS II).

The proposed rates would result in the following increases for Wheaton residents:

• 18 percent for BLS service,
• 24 percent for ALS I service and
• 24 percent for ALS II service and 37 percent for mileage.

For non-residents, increases would be:

• 30 percent for BLS fees,
• 37 percent for ALS I fees and
• 21 percent for ALS II fees and 57 percent for mileage.

City Manager Donald Rose explained Monday that the city looks at its ambulance fees every few years to check its collection percentages. When the city started its ambulance service in 1986, Rose said the city established the goal to recover 50 percent of the service’s operating costs through user fees.

He said that the city has consistently been “around” the 50 percent level in annual fee collections. According to the city’s memorandum on ambulance rates, the city has surpassed the 50 percent level in every fiscal year since FY 2004-05, with the exception of FY 2004-05 and FY 2007-08.

The annual collection amount has increased steadily since FY 2007-08 to approximately 60 percent in FY 2011-12. Susan Wallace, a special project administrator for the City of Wheaton, explained that a major reason for the increase in the collection percentage is that the Paramedic Services Contract with the city has remained the same since 2008. She added that the city’s decision not to replace a reserve ambulance resulted in a lower budget for the Medical Rescue Program in FY 2011-12.

Rose said the question of whether to raise rates is one of city policy. “The question is whether we want to increase that and recoup more (of the costs),” he said. “Our billing rates are at the bottom of the spectrum compared to other communities,” he added.

In a table of 20 comparable communities, Wheaton’s resident fees are in the lowest tier, with fees of $375 for BLS service, $425 for ALS I service, $625 for BLS II service and $6.25 for mileage.

Councilwoman Jeanne Ives said she had a problem with the fact that residents already pay for a high level of service. “I wonder why we should be charging them more,” she said.

Councilman Todd Scalzo said he would be “fine” with the staff’s proposed rates. While he agreed with Ives’ point that residents already pay for the services, the new rates would still keep Wheaton “below average” in comparison to other communities.

“The only concern I had was with (the) policy of 70 percent,” and the city’s willingness to meet that, he said.

Councilwoman Evelyn Pacino-Sanguinetti said that as the mother of young children, she wouldn’t want other mothers to be hesitant to call 911 in an emergency because of a higher fee. “I have three small kids and I’m 911 happy,” she said, “I don’t want mothers like me to think ‘I don’t want that fee.’”

Scalzo said he sees the 70 collection percentage as a “big jump” from the previous goal of 50 percent. “I’d rather set a low policy level and exceed it than set a higher rate (and not reach it),” he said.

Councilman Phil Suess said he thinks the city should consider its fees in the context of the city’s Medicare reimbursement rate. Nearly half of the funds the city collects from its ambulance services are from Medicare, according to the memorandum. Other pay sources include private insurance, private payments, Medicaid and facility contracts. “I think we can leave the policy question at 50 percent … What’s more important is maximizing recovery we can get from Medicare.”