Published: March 24, 2008 11:05 pm            

Ambulance franchising not needed, study says

Commissioners drop proposed ordinance

TERRE HAUTE — The Vigo County Board of Commissioners, after reviewing a study by two Terre Haute hospitals, are dropping a proposed county ordinance that would have established franchising requirements for ambulance service.

Carolyn Hamilton, a registered nurse and director of case management and educational services at Terre Haute Regional Hospital and Lori Horral, a registered nurse and manager of utilization at Union Hospital, met with commissioners Tuesday.

The two said a franchise ordinance that would limit the ability of both hospitals, as well as nursing homes, “to use other providers will severely limit our ability to provide timely and appropriate care.”

Hamilton provided data collected from Feb. 1 to Feb. 29 from both hospitals as well as five nursing homes (Meadows Manor East; Meadows Manor North; Harborside Healthcare; Royal Oaks; and Westridge) on total transports, which include ambulances, wheelchair vans and Medicaid-paid cabs.

During that time, 535 total emergency medical runs were recorded.

Of those, 303 runs, or 57 percent, originated from the five nursing homes, and 232 runs, or 43 percent, by hospitals. Another 9 percent were made by other hospitals, such as in Clay, Sullivan or in Indianapolis. Another 2 percent included runs to other sources, such as veterans hospitals.

“Ninety percent of the runs arranged by nursing homes and hospitals are for basic life support or lower level of care,” Hamilton said. “The largest percentage of runs — 64 percent — are handled by TransCare. Other providers are utilized 36 percent of the time when patients request or as needed.”

“Union and Regional both have dozens of patients awaiting acute care on any given day … that need to be in a hospital bed that are being seen in a doctor’s office. A lot of times we are waiting for beds to open to get transport back. To limit the hospitals’ and nursing homes’ ability to use other providers will severely limit our ability to provide timely and appropriate care,” Hamilton said.

TransCare provided 64 percent of the runs; Care Ambulance, 25 percent; Med Life Inc., 3 percent; and others, such as nursing homes with their own transportation, 8 percent.

TransCare owner Russ Ferrell said he initially sought the ordinance last October because of the expense to provide 911 support for the county.

Ferrell said Tuesday that the data from the hospitals is misleading, as it includes more than just basic life support and advanced life support runs by ambulances, but also cabs and vans. Ferrell said only 98 ambulance runs were made for basic life support and 16 for advanced life support, according to the EMS data results by the hospitals.

“It is not 535 runs, but far less. It is not a huge demand and when 48 percent of the [911 business] never gets paid, we are talking small peanuts to divide,” he said. “The hospitals did not show the times, which concerns me, because they were talking about how long they had to wait. We have statistics that go back 10 years.”

Ferrell said his company has spent $350,000 to communicate and respond to 911 calls in Vigo County. The county pays TransCare a $60,000 annual subsidy to respond to 911 calls in the county, a subsidy needed to cover costs, Ferrell said.

Commissioner Judith Anderson said the study by the hospital shows that people are getting transportation service.

“It is here in black and white that the people are getting service,” Anderson said. “There is no need for an ordinance. We wanted data to determine that the people are getting the service. Both hospitals and nursing homes that we have contacted and talked to are so much happier with the service they are getting.”

“I think we got someone’s attention to get the services better for Vigo County and it is there in black and white, the services are better,” Commissioner Paul Mason said.

Commissioner David Decker, board president, said competition makes better service.

“Competition, the free enterprise system,… improves services. I think everyone is happy with the service they were getting, but are even happier now,” Decker said.

“An ordinance doesn’t seem necessary. In most instances, when there is a need for a [countywide] ordinance, it is when the services are not adequate, but the services are adequate. We don’t want to limit free trade, because this country was founded on the premise of free trade,” he said.

Ferrell questions that services are being met.

“What does it mean the services are being met? If I bring four newspapers to town, granted everybody gets a newspaper, but ultimately there is not enough advertising to support four newspapers. That is my point. The services are being met, but it was also being met before [other ambulance services] showed up,” Ferrell said. He referred to Care Ambulance, owned by the Kentucky-based Louisville Transportation Co., a division of Interlock Industries in Kentucky.

Care Ambulance officials in January had objected to the proposed ordinance, saying it would have the negative effect of limiting competition.

“I lose 40 percent of the business, we don’t keep operating the way we had been operating, I have got to find a way to reduce my overhead to support that 40 percent reduction,” Ferrell said. “We have already done so. I have laid about six people off, more than a $100,000 in payroll a year. It is Terre Haute payroll, it is not Indianapolis and Louisville [Ky.] payroll. It is homegrown versus not homegrown, bottom line.”

Howard Greninger can be reached at (812) 231-4204 or howard.greninger@tribstar.com.

        

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