Originally created 10/11/00

Ambulance service faces lack of funds



Rural/Metro Ambulance is asking for $625,000 a year or it might not be able to continue as the county's ambulance provider after its contract expires in June.

Outgoing Augusta Administrator Randy Oliver suggested looking at a number of options, including letting the new fire chief - finalists for which might be announced next week - look at creating a county emergency medical services system.

Rural/Metro subcontracted with University Hospital in 1996 to provide ambulance service for five years, a contract that will expire June 30. The ambulance company had banked on nonemergency runs, paid for by Medicare or Medicaid, to help subsidize the emergency calls, said Doug Hooten, division general manager for Rural/Metro. For the first two years, it worked, with a ratio of about 65 percent nonemergency to 35 percent emergency calls.

Then, Georgia Medicaid contracted nonemergency calls to regional brokers, who offered rates below Rural/Metro's costs, Mr. Hooten said. And Medicare restricted what rides it would pay for, reversing the nonemergency to emergency ratio. The changes have cost Rural/Metro about $2 million in revenue in two years, Mr. Hooten said.

A county subsidy of about $600,000 a year also was phased out after the third year of the contract. Now, Rural/Metro is operating at a loss, although Mr. Hooten would not say by how much. And as it begins negotiations with University, which technically is the county's provider and had passed through the county subsidy, Rural/Metro is asking for help.

"It's not our company's responsibility to subsidize this," Mr. Hooten said. "The system itself is going to have to have some sort of funding to progress and move forward."

Rural/Metro is not threatening to leave and has had a good experience in Augusta, Mr. Hooten said.

Augusta could contract directly with Rural/Metro and pay the subsidy, but the budget is tight, Mr. Oliver said.

"It's clearly going to take some budgeting to do it," he said. "The commission is going to have to decide what other areas of service they want to cut or whether they want to look at trying to generate revenue in any other way."

Augusta is down to seven candidates for the new fire chief and is asking them about experience with ambulance service, Mr. Oliver said. The three finalists should be named next week, he said.

"I think that's one of the things they're going to have to address fairly quickly as to the best way to provide that service," Mr. Oliver said. Just equipping an ambulance could cost $100,000 each, although paying for them with sales tax money is allowed, he said.

It could cost the county $2 million to operate its own service, Mr. Hooten said.

Augusta also could bid out the service, and another ambulance service in Augusta, Gold Cross EMS, is interested, said Gold Cross chief executive officer Tom Schneider. Rural/Metro also would bid, Mr. Hooten said.

J. Larry Read, chief executive officer of University Health Services, said negotiations on extending the contract had just begun but he had not heard of any money demands from Rural/Metro. Running an ambulance service is "not one of our core businesses," Mr. Read said.

The state actually oversees providing emergency services and the Region VI EMS Council would have to review any new provider to see if it was adequate, council president Rich Bias said.

Whatever the option chosen, the discussion should begin now, Mr. Oliver said.

"Now is the time to start looking at it and addressing it, not when you get down to June, when your options are very limited," Mr. Oliver said.

Reach Tom Corwin at (706) 823-3213.