Tulsa, Oklahoma Fire Department Seeks to Replace EMSA

The Tulsa Fire Department will submit a proposal Wednesday that claims it can provide ambulance service to the city cheaper than EMSA can, Deputy Fire Chief David Dayringer said.

Tina Wells, a spokeswoman for the Emergency Medical Services Authority, responded that no service provider can match EMSA for cost and quality.

This is the first year that the city has been asked to subsidize EMSA because of reductions in Medicare and Medicaid reimbursement.

The cuts, which started in 2002, are scheduled to lower the reimbursements to 27 percent less than the cost of service by 2010, Wells said.

EMSA was able to absorb the reduction-fed deficit through its cash reserve, but that is now depleted.

The subsidy for EMSA this year is $2,745,000. Tulsa is paying $1,873,000; Bixby, Jenks, and Sand Springs are paying a total of $192,000; and EMSA is paying $680,000 from its cash reserve.

The City Council has until Oct. 31 to decide whether to renew the EMSA Trust for five more years.

The renewal will be automatic if the council does nothing. If the council dissolves the trust, there will be a two-year transition period.

Dayringer said the department was asked during the budget process last spring to submit its costs for providing ambulance service after it became apparent that EMSA would seek a direct city subsidy.

Dayringer said he could not release specifics until after Mayor Kathy Taylor reviews the proposal, "but we think we can provide at least the same quality of service at a savings to the city."

He said the Fire Department already had an emergency system and available staff.

Firefighters Local No. 176 President Dennis Moseby said this was not the first time the department has suggested taking over the ambulance service. The department is already the city's first-responder to medical emergencies, he said.

The department also has cross-trained firefighters as paramedics or emergency medical technicians, he said.

EMSA provides a good service, but it is run for profit, Moseby said. The Fire Department "can take the profit nature out of it and return the profit back to the general fund," he said.

The Oklahoma City Fire Department also is trying to determine whether to take over ambulance service, Moseby said.

Wells said EMSA was included in the Oklahoma City Fire Department's cost analysis and was able to review its figures for providing service.

"We don't know what Tulsa is doing," she said.

The situation is not isolated to Tulsa, she said. No matter who provides ambulance service, she said, the cuts in federal reimbursement are an issue.

Wells said 49 percent of EMSA patients are covered by Medicare or Medicaid; 30 percent are uninsured; and 21 percent pay billed charges.

A rate increase would cover only about 9 percent of costs because the uninsured can't pay and the federal government reimburses according to its own schedule, she said.

"How high can you raise the rates?" Wells asked. "They have to be an amount that the officials can stand behind politically."

Wells said EMSA had been "highly successful in limiting costs for cities it serves and providing excellent value for patients."

She noted that EMSA has the second-lowest subsidy per response among 10 other comparable cities.

P.J. Lassek 581-8382

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