Subsidy, response times key in ambulance decision

Published 3:00 am Wednesday, December 10, 2014

The City of Troy is recommending Haynes Ambulance be the county’s contracted service provider for the next three years.

The council members on Tuesday approved a resolution endorsing Haynes, based on the bid responses provided by both Haynes and Care Ambulance, whose service contract expires Dec. 13, 2014. The Pike County Commission, which is the lead agency in the contract process, meets at noon today to finalize the contract.

In making the recommendation, council members considered several factors, including patient costs; response times; and subsidy expenses.

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Care Ambulance, which has been the contracted ambulance service since 2005, sought a sole-provider guarantee from the county or a $394,092 annual subsidy to continue operating.

“Over the years, our revenue has been eroded by the County allowing competition to come in and skim the non-emergency work that helped subsidize the low payer mix associated with 911 transports,” Care officials wrote in their bid proposal. “Any additional cost of doing business for this contract will have to be charged back to the County in the form of a subsidy … The only way for this delivery model to work in Pike County is to allow one provider access to all available revenue.”

Haynes Ambulance asked only for a $15,000 subsidy if a $500,000 performance bond were to be required by the county. Haynes offered to provide a $100,000 bond with no subsidy.

“We haven’t provided a subsidy in the past six years,” Council President Johnny Witherington said during the group’s work session. “A big issue relative to care would be the $32,000 a month subsidy if the city and county could not guarantee (sole-provider status).”

He added that the city could not require Troy Regional Hospital to exclusively use one ambulance provider.

The subsidy cost would be divided among the three partnering government agencies: 40 percent by the Pike County Commission; 40 percent by the Troy City Council; and 20 percent by the Brundidge City Council.

The bid process also asked both Care and Haynes to detail responses to several significant items outlined by the committee, varying from guaranteed response times to providing information on how charges will be collected from patients.

“Haynes did offer better response times across the board; will have a mobile cath unit in all the trucks; and will take our E911 map data and use it in their vehicles, which should increase response time,” E911 Director Chris Dozier told council members during Tuesday’s work session. “And, of course, if you’re comparing charges for patients, there’s a significant difference.”

Haynes outlined its response times as eight minutes for emergency calls within the city limits of Troy; 8 minutes, 59 seconds for all calls within the Troy Fire jurisdiction; 14 minutes for emergency calls inside Troy Police jurisdiction; and 21 minutes for any Pike County areas outside those areas.

For non-emergency calls, Haynes’ response times were 15 minutes inside Troy Fire jurisdiction; 25 minutes inside Troy Police jurisdiction; and 40 minutes for all other areas.

By comparison, Care cited its emergency response times as 10 minutes within Troy Fire jurisdiction, 20 minutes in police jurisdiction; and 30 minutes outside of those areas.

The contract requires the provider to meet those response times on at least 90 percent of calls.

As for patient costs, Haynes said its standard run is $700; Care is $850 for non-invasive treatment, $1,320 for any invasive procedures. Haynes’ mileage is $12 per mile; Care, $15.75.

Dozier said the willingness of Haynes to utilize the E911’s mobile CAD/Map and update the data every six months was significant. Both ambulance providers use the same CAD/Map system and both could access and use local maps if they wanted to do so. Troy Police and Fire, as well as Pike County Sheriff’s Department, all have purchased the CAD/Map system and coordinate address through the E911 maps.

Dozier also said the contract proposal includes in an option to renew for two additional years, if both parties agree.

In other business on Tuesday, the council:

• Agreed to grant the Alabama State Climatologist access to weather data being collected at a station at the end of Hudson Street. “We’ve had a contract with the National Oceanic and Atmospheric Administration and the federal agency is vacated this and turning it over to the state climatologist,” Mayor Jason Reeves said. “They’ve asked that we enter into the same agreement we had with the federal agency so they can continue to collect what he calls ‘very accurate data.’” The 20-year agreement incurs no expense to the city.

• Signed an agreement allowing the city to receive $51,620.62 for the senior nutrition program from the South Central Alabama Development Commission. “They’re feeding about 50 people a day in-house at the center, as well as delivering meals,” Reeves told council members. “The program is growing.”