Wallingford ambulance service in need of revenue to survive

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WALLINGFORD — The Fire Department’s emergency transport system is second to none, according to Deputy Fire Chief Stephen Alsup, who spoke with pride while discussing the town’s self-sustaining enterprise ambulance service.

The service is operated by the Fire Department but is run as a separate business entity.

“It’s really a model system,” he said, adding that he considers ambulance service “one of the fundamental services of government.”

But revenue is necessary to sustain and grow that service. According to the ambulance enterprise fund ordinance, the ambulance budget can be funded up to 10 percent by the town. Revenue from the service must be able to cover 90 percent of its expenses. If revenues can’t cover the ambulance budget, the program must be terminated, according to ordinance.

The service is being maintained, but if the revenue stream were to diminish there could be problems, Alsup said.

“I do worry about making it,” Alsup said. “If we don’t make it, what do we do? What if revenue falls off? How do we provide a necessary service to the community?”

Last spring, the service was budgeted to bring in $2.1 million. In this year’s proposed budget, the revenue estimate was reduced to $1.9 million. Operating expenses were reduced by about $27,000 from this year to last, but remain at $2.1 million. Last year, the service was budgeted to lose $71,211. This year, it is budgeted to lose $148,708. The town offsets the budgeted losses.

Comptroller Jim Bowes said the ambulance service has retained earnings of about $350,000. The fund also had an income of $431,793 in 2012-13, but lost $315,000 in unpaid debt in the same year. It is budgeted to lose $486,000 in 2013-14 and $393,542 in 2014-15. Alsup said bills are recovered at an 80 percent rate, which is normal for the industry.

The ambulance service has already proven successful by shortening response times. Prior to 2012, the Fire Department operated a single ambulance running 24 hours. A second ambulance operating during peak hours — 8 a.m. to 8 p.m. — went into service when the enterprise service was established. The Fire Department now handles 85 percent of the town’s medical calls, only relying on private ambulances 15 percent of the time. Previously, the town relied on private ambulances for half it’s emergency medical calls.

In 2013, the Fire Department responded to 6,373 total calls. Alsup said 78 percent, or about 5,000 of those calls, were emergency medical situations. Paramedics responded to 99 percent of medical emergency calls in 2013.

The town’s emergency transportation service isn’t biased to the fact that some people don’t have insurance.

“We extend credit to anyone who dials 911,” Alsup said.

But people without insurance usually can’t afford to pay their ambulance bills. The greatest portion of the ambulance fund’s uncollected debt can be attributed to the uninsured, Alsup said.

The billing process takes between 120 and 180 days. If a customer doesn’t pay in that time, the billing company turns the case over to a collection agency. The collection agency has only collected a few thousand dollars so far, Alsup said. The agency has 458 accounts to date, and each account owes about $700. In total, the agency is working to collect about $321,000.

Concern over the collection rate was discussed during a Town Council budget workshop on Tuesday. Dickinson said he would ask the Law Department to review cases and determine if further action is appropriate.

“We owe it to the program that we take it very seriously and look to collect what is owed,” Dickinson said.

Councilor Craig Fishbein suggested placing liens on property owners who do not pay their ambulance bills.

“We have to treat this like a business,” he said.

With an aging population, the department expects higher call volumes at night in the near future. Alsup said the department is considering the purchase of another ambulance in the next few months to work the overnight shift from 8 p.m. until 8 a.m.

The Fire Department has four ambulances in service. Two are used as backups.

Leo Pon was strictly a paramedic prior to working in Wallingford. Now he rotates working on the 24-hour ambulance for one week and a fire engine for two weeks.

“They want everybody to do both,” he said.

Tommy Chirico was hired as an EMT about a year ago to work the daytime ambulance.

If he isn’t out at a call, Chirico said, he is training, cleaning or preparing equipment.

“But usually we’re always out on calls,” he said.

Mike Martino, a paramedic hired to staff the daytime ambulance, always wanted to be a firefighter when he was growing up. Helping people is one of the best feelings, he said. On a recent call, a man had a dangerously high heart rate. Martino said he administered medication that lowered his heart rate to a safe level.

“It’s the coolest feeling helping someone like that,” he said.

Chirico and Martino both said one of the toughest parts of the job is the long hours. Another sobering aspect of the job, Martino said, is when you do everything you can but a person still can’t be saved.

“You have to hold your head high and say ‘we did what we could,’” Martino said. “Some days we feel like heroes, and some days we feel defeated.”

aragali@record-journal.com (203) 317-2224 Twitter: @Andyragz



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