Mayor Annise Parker’s administration is weighing a plan to more than double the cost of ambulance transport in the city, a move that already has met with a chilly reception from City Council members.
City officials contend that Houston’s ambulance fees are far lower than those of other major U.S. cities, but critics questioned whether such emergency medical care should be considered part of the “core services” citizens fund with their taxes.
The debate brewing over ambulance fees and water rate hikes has emerged as an early barometer of whether council members have the appetite to initiate the major spending cuts or fee and tax hikes that may be required to balance the budget this year.
With little money left in reserve at the end of this fiscal year, according to projections, city leaders may have to make some hard choices to avoid some of the most severe cuts that have become de rigueur in other major municipalities, city officials said.
Alfred Moran, director of the city’s Department of Administration and Regulatory Affairs, which proposed the ambulance fee increase, even invoked the specter of furloughs — unpaid days off for some of the more than 20,000 municipal employees — if the city cannot consider other options.
“I think it’s pretty clear that the city is going to be dealing in 2011 with decreased revenues from its tax base, and we have to do a number of things that are going to be difficult,” Moran said. “It could go to something the mayor has not wanted to do, which is furloughs or personnel cuts, or it can be a lot of different small ways that we can ask the citizenry to pay fair shares of certain services.”
Payment not pursued
The last time the city raised ambulance fees was in 2002. Currently, ambulance transport costs $415, plus $7.50 per mile, with an average distance traveled of about 5 miles for a total of $452.50.
Under the proposal, that would go up to $800 and $16 a mile, or $880, which city officials said was more in line with other major cities, including Dallas and New York.
But the city only collects about 53 percent of the fees for the more than 140,000 transports the Houston Fire Department completes each year, and has no real mechanism for forcing people to pay. The city does not report non-payment to credit bureaus.
Although the existing ambulance fee brings in $31 million a year, doubling the cost only will bring in an additional $5.5 million because Medicare and Medicaid would continue to reimburse at the same rate they do now.
That would leave the burden for the increase to insurance companies and the uninsured, a fact some council members found objectionable at a City Council committee meeting Monday where the proposal was presented. Others questioned why additional fees were necessary when taxes should be considered sufficient.
“I’ve talked to a lot of people in the community about this and they’re not feeling it,” said Councilwoman Jolanda Jones. “Comparing us in a vacuum to other cities doesn’t prove anything.”
Jones questioned why fire trucks are dispatched to emergency events in which a person complains of chest pains, something she said happened recently at a fire station she was visiting.
Dr. David Persse, medical director of Houston’s Emergency Management Services, said many other cities send far more trucks on a more frequent basis to emergency situations in which they are not required.
He also cited research showing that those who call 911 do not always accurately report what assistance is needed.