Mayor ready to ‘cut off’ ambulance runs to county|[6/28/06]

Published 12:00 am Wednesday, June 28, 2006

Two months from budget-setting time, governing bodies of the City of Vicksburg and Warren County were to approach a contentious issue between them Tuesday – deciding a fair-share formula for public ambulance and rescue services.

Vicksburg officials said they were ready to present figures amounting to a cost-benefit analysis of providing the city-owned services outside the city limits. However, the day ended with no movement on the issue, and today Mayor Laurence Leyens said he will not hesitate to end the service.

&#8220We’ve given them written notice we’re going to cut it off,” Leyens said.

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District 4 Supervisor Carl Flanders, this year’s board president, said he tried to set up a meeting between the supervisors and Paul Rogers, accountant and strategic planner for the city, appealing to his fellow supervisors to come to the table.

&#8220There is no way I can pass along data sheets and verbalize what needs to be communicated in an effective manner,” Flanders said last week.

Supervisors have balked at what they see as Leyens’ heavy-handed tactics – saying the city has failed to provide accurate or verifiable information, to bill as agreed last year or provide non-conflicting data for analysis before any discussion started.

&#8220What we had hoped for was having it in advance of a meeting,” District 5 Supervisor Richard George said this morning. &#8220It’s customary in business to be prepared.”

Ambulance and rescue service here was created as an early city-county venture in the late 1960s. Most other areas franchise private ambulance firms, but the belief here has been the public service is faster, better and less expensive for residents.

In May, the city board decided that the agreement needed to be reworked. That followed a near-breakdown in 2005 when supervisors said they had set their budget when the city broached the topic.

In a state-approved agreement, the county has been paying $350,000 each fiscal year to provide life support and rescue services to county residents. The county does not pay for trips made by ambulances for mostly non-emergency calls such as basic transfers of patients from their homes or nursing homes to medical appointments. Those are categorized as &#8220basic life support” and the vast majority are inside the city limits.

For weeks, supervisors have disputed long-awaited bills they received in May that totaled more than $400,000, expressing doubts about the way the city arrives at its total of ambulance runs. The billing was supposed to be quarterly under the agreement, but three bills arrived at once, containing different charges and time periods over multiple fiscal years.

Leyens said the city wants to put an end to the county’s practice of &#8220picking and choosing” the types of runs it pays for and, he said, he believes he has devised a verifiably fair method of apportioning costs, essentially subsidies, from city and county residents – given that city residents also pay county taxes.

&#8220We’ve got a system, a good system, but it has real costs and my responsibility will not allow me to impose those costs on city residents totally,” he said.

Ambulances and rescue units, with an annual budget of $3.1 million, are dispatched through the combined E-911 Dispatch Center from Vicksburg Fire Department stations.

Nearly 70 percent of ambulance costs are recouped through billing public and private insurance sources – a figure markedly increased in recent years. No bills are sent to individuals for rescue responses.

The county is being billed $533.41 per ALS ambulance run that was not paid for otherwise and $261.93 per rescue run. That’s another issue for George, who said he’s not clear on when or why rescue units are dispatched.

For the year starting Oct. 1, supervisors budgeted $350,000 for the expense. The three invoices sent to the county in May covered 368 runs outside city limits from July 2005 through March 2006. Its exact total was $401,303.15.

Many factors complicate negotiations. For example, many responses serve injured people who may not be residents of Warren County or even of Mississippi. Many also result in no services being needed. But the costs are still there.

&#8220If there’s a wreck and we send an ambulance out to Bovina and there are only minor injuries, we have to absorb that cost,” said South Ward Alderman Sid Beauman, who agrees that the county should be paying for basic life support responses, too. &#8220That doesn’t make any sense. We can’t operate that way.”

Vicksburg Fire Chief Keith Rogers has said the counting method and categorization of runs was changed in 2002 to adhere to fee schedules set forth by Medicare. The fire department began keeping computerized records of ambulance runs in the 2004-05 fiscal year.

Although contentious ambulance talks in the past have stretched well past the state of new budget years each Oct. 1, both boards have continued to work into the new fiscal year under the previous year’s agreement until a deal is reached. Beauman said he agrees with Leyens that if an accord isn’t reached, the city will consider the deal expired and end emergency response outside its boundaries.

Historically, some city-county agreements have worked well – such as one-stop voter registration and payments of taxes and car-tag fees. Others, ranging from recreation and animal control to fire projection have been more fractious. Until 20 years ago, the Vicksburg Fire Department also responded outside the city limits. Starting then, a network of county volunteer fire departments was established.