City of Amsterdam firefighters are already doing most of the work required to run an ambulance service, according to Fire Chief Michael Whitty. The only thing missing in order for the city to realize revenue from that work is an ambulance vehicle to transport patients to the hospital. Whitty discussed the idea and presented revenue and expense estimates at a common council public safety committee meeting on Monday.
According to Whitty, city firefighters responded to approximately 1800 emergency medical calls between July 2015 and June 2016. Often, firefighters accompanied patients to the hospital in the ambulance. Out of that number, 1620 were “billable” calls. However, because the city does not transport the patients, it cannot bill the patient’s insurance company for the services. Currently, GAVAC is the primary provider of ambulance services in the city and receives the revenue from patients and their insurance companies for the transportation service.
Whitty shared with council members quotes from three different medical billing companies. Revenue estimates ranged from $439,000 to $634,000 based on a range of 1500 to 1700 “billable calls” per year. Whitty asked each company to be “conservative” with their estimates and to factor in 30% of the calls being billed to either Medicaid or Medicare. Out of those yearly gross revenues, the fees for the billing companies would range from approximately $33,000 to $63,000 per year.
Whitty estimated approximately $250,000 in start-up costs for the service, which would include the cost of one new ambulance and related equipment such as stretcher, and a “stair chair” for moving patients down stairways. He said the city could potentially lease the ambulance and equipment for approximately $55,000 per year for five years.
However, with only one ambulance, Whitty said the city may not be able to transport patients in all cases and would still need to work alongside GAVAC until a second vehicle could be purchased. He added that with only one ambulance, there would be no additional staffing charges and that almost all the city’s firefighters are already certified as paramedics.
GAVAC currently contributes approximately $100,000 per year to the city. Neither Whitty or common council members would say how that number would change if the city started its own ambulance service.
According to Whitty, the city already carries the required liability and malpractice insurance required to respond to emergency medical services, and there would be no additional costs for that insurance.
“This clearly shows we have a huge chunk of money staring us right in the face,” said Alderman Chad Majewski. “We have the training, we have the staffing, and we’re responding to the calls now.”
Majewski said that he had worked with Whitty in compiling the figures and felt confident that the numbers were accurate. However, he said he was still open to an independent third party consultant looking at the plan.
“We’re looking for outside revenue to offset a budget that could be totally out of control next year unless we take preventative measures,” said Alderman Jim Martuscello. “That’s what this council is looking at – preventative measures for next year – where new revenues are going to come in.”
Alderman Paul Ochal thanked Whitty for his work and said he was “impressed” by the numbers.
Whitty said the issue was not about whether either the city or GAVAC was “doing a bad job or a good job”. But rather it was using the revenue to “stabilize” the city’s general fund out of which the public safety departments are funded.
In April 2015, former mayor Ann Thane and Whitty presented the idea of of a city-run ambulance service. Thane included revenues from the service in her proposed 2015-2016 budget. The council at the time rejected the idea and removed the lines associated with the service from the final budget.
Council members last year who were opposed to the idea cited a referendum held in 2004 which approved a change to the city’s charter which specifically prohibits the city from running an ambulance service. Both former corporation counsel Gerard DeCusatis and current Corporation Counsel William Lorman have issued opinions that another referendum is not required to remove the restriction.