Okla. Councilor Wants Transparency With EMS Payments
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Sept. 20-- A city councilor wants to bring more transparency to how the city's ambulance fees are paid to the Emergency Medical Services Authority.
"My concern is that I don't want the citizens of Tulsa paying more than the actual cost of the service," Councilor Bill Christiansen said.
Tulsa and Oklahoma City collect their respective monthly ambulance fees the same way, but their ordinances differ on how the money is paid to EMSA.
"While Oklahoma City and Tulsa's processes are slightly different, the end result for EMSA is essentially the same," EMSA CEO Steve Williamson said in a prepared statement.
The council is set to discuss the city's ambulance service and monthly fee at a Tuesday committee meeting.
But the council has been told that neither Williamson nor staff from the Mayor's Office who are knowledgeable on the issue will be present for the discussion.
Williamson is in Washington, D.C., to testify to Congress on Medicare and ambulance-related issues, said Kelli Bruer, EMSA spokeswoman.
Christiansen said he still plans to discuss the issue among councilors and any officials who do attend.
"I think the elected officials of the city, whether it is the mayor or council, should have more oversight on what is given to EMSA and what it is spent for," Christiansen said.
"It's about accountability and transparency," he said about the $3.64 fee that is included on the city's monthly utility bills for residents who want to pay for coverage by the ambulance service. The city gives residents the ability to opt out of the program.
Christiansen said he'd like to see the city operate as Oklahoma City does.
Oklahoma City collects its $3.65 fee and by ordinance only remits to EMSA the amount in EMSA's approved budget request, said Assistant City Manager Laura Johnson.
Oklahoma City began its program halfway through the 2010 fiscal year.
Johnson said any surplus realized from the collections after EMSA is paid is retained by Oklahoma City and used only to offset any future deficit in the collections.
"The goal is to keep the fee for the user as stable as we can for as long as possible," Johnson said.
She said the Oklahoma City council drafted its ordinance to ensure the city had more control over the funding.
"Our big thing was that we didn't want to have an unexpected amount to go to EMSA and EMSA hold on to our money. That didn't seem to make sense to us," Johnson said. "We just wanted more control over the funds."
She said Oklahoma City officials also wanted to provide transparency to users so that "we could say this is how much we collected and what we did with it."
Tulsa's ordinance states that all the money collected through the fee will go to EMSA.
Budget Director Pat Connelly said that during the first two years of the program that began in fiscal year 2008, the city did send all of the funds to EMSA.
But starting in fiscal year 2010, under former Mayor Kathy Taylor and during the city's economic crisis, EMSA agreed to let the city keep $1.6 million to supplement the Fire Department's first-responder program.
It's not mandated that EMSA supplement the Fire Department's program.
This fiscal year, EMSA decreased by $1 million the amount to the Fire Department. Connelly said the agreement was to reduce the amount as the economy improved. He said that since 2010, EMSA received only the amount in its budget request, which is approved by the council.
Williamson said, "It is up to each city how it would like to design and administer its emergency medical services funding."
He said EMSA will work with whatever process Tulsa chooses, noting that both Tulsa's and Oklahoma City's processes are highly transparent and accountable.
The fee issue has surfaced in the wake of Mayor Dewey Bartlett's announcement that he will renew EMSA's contract over a bid by the Fire Department to provide ambulance service.
Every five years, Oklahoma City and Tulsa review EMSA'sperformance and consider whether to continue using it to run emergency medical services. The deadline to make changes is Oct. 31.
Oklahoma City has a consultant still reviewing the bids by EMSA and its Fire Department. Its council is expected to make a decision on which provider to choose once it receives the consultant's recommendations, Johnson said.
Mayoral Chief of Staff Terry Simonson said that although it was determined in Tulsa that EMSA's bid was better than the Fire Department's, "we still believe that there was room for improvement with EMSA both financially and under efficiencies."
He said Williamson has agreed to have EMSA participate in the city's KPMG efficiency review to identify opportunities to use competition and benchmarking to drive further savings.
Simonson said the city and EMSA estimate that efficiencies will be found that exceed at a minimum $1 million yearly.
EMSA costs, Tulsa vs. Oklahoma City
Tulsa --391,906 population --Monthly EMSA fee $3.64
Fiscal year: 2010 2011 2012 (budget)
Revenue $5.2 million $5 million $5 million*
Administrative cost*-- $162,000 $193,000 $135,000
Fire Dept. 1st responder*-- $1.6 million $1.6 million $600,000
EMSA $3.1 million $3.2 million $4.2 million
*106,000 residents have opted in for 2012.
**Not mandated. It is an arbitrary amount decided by EMSA board.
Source: City of Tulsa
Oklahoma City --579,999 population --Monthly EMSA fee $3.65
Fiscal year: 2010 (partial) 2011 2012 (budget)
Revenue $5 million $7.2 million $7 million^
EMSA^^ $3.5 million $6.9 million $7.6 million
Difference^^^ $1.6 million $284,652 -$593,730
^185,443 residents have opted in for 2012.
^^Includes administrative costs.
^^^ Surplus is retained by city to o?set deficits and to keep rate stable.
Source: City of Oklahoma City
P.J. Lassek 918-581-8382
pj.lassek@tulsaworld.com
