Councilor G.T. Bynum: With EMSA, "there is no way for me to know that you are guaranteeing the best possible rate to the citizens of Tulsa."
City councilors voted 7-2 on Thursday to maintain a $200 rate increase for emergency ambulance service provided by EMSA.
The increase - from $1,100 to $1,300 - is paid by private insurers only and will not affect customers covered by Medicaid, Medicare or the city's TotalCare program, according to EMSA officials.
Whether to maintain the rate increase has been the subject of much council discussion since it was approved last summer amid reports of extravagant spending by the organization and a subsequent audit.
The council's vote Thursday was on whether to maintain the rate or to let it revert to $1,100 on April 22.
It came just hours after Rural/Metro Corp. announced it was withdrawing its bid to become EMSA's next ambulance service provider.
The EMSA board voted last month to disqualify the Scottsdale, Ariz.-based company from seeking EMSA's five-year ambulance contract. The action leaves AMR, the nation's largest ambulance operator, and Paramedics Plus - EMSA's current service provider - as the contenders for the new five-year contract, which begins Nov. 1.
"When 80 percent of your user cost is tied to your vendor cost and you reduce the pool of competition among your vendors, there is no way for me to know that you are guaranteeing the best possible rate to the citizens of Tulsa," Councilor G.T. Bynum, who along with Councilor Karen Gilbert opposed the measure, said after the meeting.
Councilor Phil Lakin, who sits on the EMSA board, said it was important that the rate hike remain in place.
"If we would have allowed the rate to be decreased, that would have cost every Tulsa citizen more money for EMSA, and I don't want the Tulsa citizens to be charged a penny more for EMSA services," Lakin said. "Those funds would have been taken from the general fund, and then we would not have been able to use them for police and fire protection or parks or anything else, and that's just not right."
During a Thursday afternoon council committee meeting, EMSA CEO Steve Williamson told councilors that the cost of an emergency transport is $433 but that EMSA must charge much more to make up for the loss it takes on 88 percent of transports.
The 88 percent is made up of individuals who are either uninsured or who are covered by Medicare or Medicaid. That puts the burden on the 12 percent of transports covered by private insurance, Williamson said.
The EMSA CEO compared the billing practice to the practices used by hospitals.
"That charge on that item in the hospital is paying for all the charges that aren't being paid for at cost," Williamson said. "So they are cost-shifting also."
In June, councilors approved the $200 rate increase effective July 1. But because an investigative audit of EMSA was forthcoming, they agreed to the increase only after attaching a sunset clause that was to make the fee revert to $1,100 after Dec. 31.
Councilors later extended the sunset date to March 31 or three months after delivery of the audit, which is April 22.
The state audit, issued in January, found that EMSA spent lavishly on "unwarranted and extravagant" items, including spa treatments and an anniversary party for employees, and took EMSA's board to task for failing to stop "abusive expenditure patterns."
The audit by the state Auditor and Inspector's Office covers activity from Jan. 1, 2009, through June 30, 2012.
Phil Forgione, vice president of marketing for Rural/Metro, explained the company's decision to withdraw from the bidding process in a press release Thursday.
"The initial action by the EMSA board to leave Rural/Metro out of the bidding process without considering facts has left us greatly concerned about overall fairness and our ability to participate in an open and transparent competitive bidding process," Forgione said.
Williamson told councilors last week that it was important to have a pre-qualifying process to ensure the ambulance provider that gets the contract can do the work it is obligated to perform.
"There were parts of the request for credentials that were missing, and there were concerns about their financial strength ongoing," Williamson said of Rural/Metro's proposal.
Find continuing coverage
Read past stories and view documents related to the World's investigation of EMSA.
tulsaworld.com/emsa
Kevin Canfield 918-581-8313
kevin.canfield@tulsaworld.com
Original Print Headline: Council votes to keep EMSA rate hike
