Highland News Leader

Highland ambulance rates increased by an average of 25 percent

File Photo

A ride in a Highland ambulance will cost you more.

The Highland City Council passed a resolution to increase Highland ambulance rates during its meeting on Jan 2, help cover equipment needs for the department, which are estimated to cost $200,000 annually.

Highland Emergency Medical Services Chief Brian Wilson said rates were raised an average of 25.1 percent.

“We have to find a way to make sure our equipment is up to date and it is in good shape when we need it,” Wilson said.

Last year, the council approved a  1/2 -cent retail sales tax increase in specific areas of the city. The tax was pursued to help raise money for the city’s Public Safety Department. Initially, the city pursued a full 1-cent sales tax, which was estimated to bring an extra $1 million to the city. The extra money would have been enough to help replace public safety equipment and remedy the police, fire and EMS facility needs.

But, with only half of the initial amount of extra funds coming in, city officials had to rework how those monies would be spent. City Manager Mark Latham said two priorities were outlined. The first was the equipment needs of the Highland Fire Department.

The fire department’s budget for the 2017-2018 fiscal year was about $262,000. In contrast, the department has an annual need of $202,500 to keep up with replacing/repairing other vehicles, rescue tools and complying with federally mandated purchases of bunker gear and self-contained breathing apparatuses. The department also needs to replace its almost 37-year-old fire engine, which can cost almost $1 million used.

“The fire department doesn’t have a revenue stream,” Latham said.

Secondly, Latham said funds need to go toward rebuilding public safety facilities. However, Latham said how much money will be needed to do that is not yet clear. Council members have yet to sign off on a plan.

Latham said that the city is considering a design-build of a bare-bones options for a new police station, and possibly a new, similarly constructed fire station. Originally, the city wanted to build a combined public safety facility for all three departments, but construction costs and lack of funding made that impossible.

Latham said building a new scaled-down facilities, at least for the police station, would likely be cheaper than remodeling the existing buildings.

Currently, the city is working on getting an idea of what the needs of the departments are and what square footage would be needed for each, according to Latham. He estimated that the city might go out for proposals sometime around March 1.

The new rates

Out of all of the public safety needs, Latham said EMS can fill its needs best, because it has an adequate, independent revenue stream.

“We don’t want to put anymore burden on the taxpayer with regard to capital equipment and to with the sales tax that was passed,” said City Manager Mark Latham.

Going back to the drawing board, Wilson decided to look at the department’s rate charges. After comparing rates from about 15 other services in the area, he said they found something interesting.

“We found out we were significantly under most others in our area,” Wilson said.

Wilson worked with the city’s Director of Finance Kelly Korte to come up with new rates that would cover the departments $200,000 annual need.

The new rates are:

▪ In-district basic life support (BLS) is $510, a 29.4 percent increase;

▪ Out-of-district BLS is $660, a 26.4 percent increase;

▪ In-district advanced life support one (ALS1) is $610, a 29.8 percent increase;

▪ Out-of-district ALS1 is $750, a 25.38 percent increase;

▪ In-district advanced life support two (ALS2) is $850, a 29.5 percent increase.

▪ Out-of-district ALS2 is $950, a 21.2 percent increase;

▪ In-district specialty care is $1,050, a 17.5 percent increase;

▪ Out-of-district specialty care is $1,200, a 17.5 percent increase;

▪ Disposable supplies went up to $50 a 11.1 percent increase;

▪ Mileage went up to $14 per mile, a 16.7 percent increase;

▪ Oxygen went up to $40 a 14.3 percent increase;

▪ Paramedic assist was the only rate not to change at $150;

▪ Refusal of services charge went up to $60, a 33.33 percent increase.

While he said the jumps in rates might seem drastic, Wilson said that the rates reflect what should have been adjusted in smaller increments over the past several years. When he went back to look at the rates, he realized they were being raised every five to eight years.

“Though it looks bad on a snap-shot level, if you average it over five years, it is not that bad,” Wilson said.

Wilson told council members he would like to review the rates on a annual basis going forward to avoid larger jumps like this. However, with the increases, Wilson said Highland is still “below the median point” of service costs.

“There are a lot of entities out there that are a lot higher than we are,” Wilson said.

By comparison

Comparing EMS services is difficult to do, because business models vary, Wilson said, making comparison not truly apples to apples.

Wholly municipal-owned and operated are generally covered entirely by tax revenues and most of them do not recover enough through patient billing to break even, and their rates tend to be lower.

Privately owned services are meant to make a profit and do a lot of non-emergency transfers, etc. “There are some communities, however, who contract with these agencies for their emergency EMS needs as well. Their rates tend to be at the higher end of the spectrum,” Wilson said.

Highland EMS is somewhat unique considering that while it is a municipally owned and operated service, it is more like an enterprise fund.

“Generally speaking, about one-third of the total operating costs are covered by tax levies based on property taxes. The other two-thirds of the operating costs are covered by user fees (patient billing),” Wilson said. “Therefore, we depend heavily on our billing rates to cover costs of vehicle and equipment replacement, which includes some highly technical and costly equipment…

“Although it is never pleasant to have to increase the costs of anything, I am pleased that Highland EMS remains well below the highest rates in the area charged for Advanced Life Support and Basic Life Support transports, which represent the majority of all of our calls for service.”

Edwardsville EMS rates are:

▪ City resident BLS services cost $425, which is 16.7 percent less than Highland;

▪ Non-city resident BLS cost $525, which is 20.5 percent less than Highland;

▪ Citizen resident ALS services cost $475, which is 22.1 percent less than Highland;

▪ Non-city resident ALS cost $575, which is 23.3 percent less than Highland;

▪ City resident ALS2 cost $700, which is 17.6 percent less than Highland;

▪ Non-city resident ALS2 cost $750, which is 21.1 percent less than Highland;

▪ Mileage costs $15 per mile, which is 7.1 more than Highland;

▪ Refusal of services cost $75, which is 25 percent more than Highland.

Troy EMS rates are:

▪ Resident BLS services cost $580, which is percent 13.7 more than Highland;

▪ Non-resident BLS cost $625, which is 5.3 percent less than Highland;

▪ Resident ALS services cost $800, which is 31.1 percent more than Highland;

▪ Non-resident ALS cost $1,000, which is 33.3 percent more than Highland;

▪ Resident ALS2 cost $875, which is 2.9 percent more than Highland;

▪ Non-resident ALS2 cost $1,200, which is 26.3 percent more than Highland;

▪ Mileage costs $15 per mile, which is 7.1 more than Highland;

▪ Refusal of services assessment only and treatment both cost $150 which is 150 percent more than Highland.

Alhambra-Hamel EMS rates are:

▪ Resident ALS cost $500, which is 18 less than Highland;

▪ Non-resident ALS cost $600, which is 20 percent less than Highland.;

▪ Resident ALS2 cost $600, which is 29 percent less than Highland;

▪ Non-resident ALS2 cost $700, which is 26 percent less than Highland;

▪ Mileage cost $15 per mile, which is 7 more than Highland;

▪ Non-transport or refusal charge cost $75, which is 25 percent more than Highland;

▪ Alhambra-Hamel currently has no standard BLS rates but is working on a charge, according to Paul Stroud, the EMS manager.

Staunton EMS rates are:

▪ Non-emergency, resident BLS cost $350, which is 31.4 less than Highland;

▪ Non-emergency, non-resident BLS cost $550, which is 7.8 percent more than Highland;

▪ Emergency, resident BLS cost $450,which is 11.7 less than Highland;

▪ Emergency, non-resident BLS cost $700, which is 6.1 percent more than Highland;

▪ Resident ALS1 cost $650, 6.6 percent more than Highland;

▪ Non-resident ALS1 cost $850, 13.3 percent more than Highland;

▪ Resident ALS2 cost $800, 5.9 percent less than Highland;

▪ Non-resident ALS2 cost $1,000, 5.3 percent more than Highland;

▪ Resident refusals cost $175, 191.7 percent more than Highland;

▪ Non-resident refusals cost $350, 400 percent more than Highland;

▪ Mileage cost $15 per mile, 7.1 more than Highland.

Pocahontas-Old Ripley Fire, Rescue & EMS could not be reached for its rates.

Other business

Fair housing ordinance approved

In other business at its Jan. 3 meeting, the council approved a resolution to support fair housing. Latham said that this is something the city has to do every year. The resolution prohibits discriminatory and unlawful housing practices, which promote segregated neighborhoods and interfere with the achievement of stable, integrated and balanced living patterns.

The resolution also states discriminatory and unlawful housing practices outlined by the Housing and Urban Development pursuant to the Community Block Grant Regulations are against the policy and practices of the city, to participate in or allow the expenditure of government funds for housing projects which are not consistent with HUD rules and regulations.

Emergency purchase approved

The council waived customary bidding procedure and allowed a $62,790 emergency expenditure for the electric department.

The purchase was for a re-manufactured load tapchanger (LTC) and its installation at the Westside substation, according to Director of Light and Power Dan Cook. Cook said a tapchanger is a device that is attached to a large transformer in a substation. It automatically adjusts the output of the transformer to meet the demands of the load ensuring that voltage remains at an acceptable level.

An annual oil test on all of the city’s substation transformers, which was preformed on Oct. 5 last year, indicated trouble in the tapchanger. The oil analysis showed the total combustibles gasses in the oil increased from 62 parts per million to 12,975 ppm. To confirm the test, the department conducted another analysis on Oct. 26.

“The retest confirmed initial testing and we solicited quotes to service the tapchanger,” Cook said in a memo to the city.

When the tap changer was opened on Dec. 12, Cook said it was found that one of the main terminal connections burned up, which was causing arcing. That increased the explosive gasses found in the oil analysis. That arcing burned up the lug and bolts and burned a hole through an insulator panel and commutator ring, according to Cook.

“Had this not been caught early, it would have at least have ended in an unexpected power outage for a major part of the town. But we caught it,” Cook said.

Currently, he said the Westside substation is inoperable and the town load is being carried by the Northtown and Eastside substations. Cook estimated that power at the Westside substation would be back online during the first week of January. Latham said crews were on site installing the piece on Jan. 3.

The tapchanger was provided by Normandy in St. Louis and installed by Solomon, assisted by city staff. Cook said the initial quote for the tapchanger servicing was less than half the price of Solomon’s competitors.

Surplus property sold

The council approved the selling of 0.281 acres of surplus land to Don Rommerskirchen for $1,700.

Latham said that during a survey last year for the new emergency access to Silver Lake, Rommerskirchen discovered his well house and storage shed was on city property. Rommerskirchen desired to purchase the property from the city. The $1,700 was the appraised value of the land, and the city sees no use for the property, according to Latham.

Latham said the property was declared at surplus property before the sale and advertised in the Highland News Leader.

Nuisances ordinance changed

The council approved repealing and replacing the city’s nuisance ordinance.

During the meeting, Assistant City Manager Lisa Peck said the ordinance was replaced to help define the terminology and content better. Peck said not much was changed in the ordinance, it was just simpler to repeal the whole ordinance and replace it with the changes.

“The entire ordinance section is being adopted as this is a cleaner way to ensure the most current and correct version of the document is maintained,” Peck said in a memo.

However, Peck did mention one change to the ordinance, which had to do with grass cutting. Now, Highland residents cannot grow any weeds, grass, or plants, other than trees, bushes, flowers or other ornamental plants, over 8 inches without being considered a nuisance.

Blind fee approved

The council approved an ordinance to create one $200 annual fee for waterfowl blinds.

During the meeting, Ryan Hummert, the city’s natural resource manager, said the city has always provided a year-round blind option for an annual cost of $200. The city also offered options for yearly fees of $50 for residents and $75 for non-residents. However, paying the lesser cost meant that, at the end of the season, blind holders would have to remove their blinds.

Hummert said currently the city is at 100 percent capacity for the year-round program, making the other fee prices obsolete. Director of Parks and Recreation Mark Rosen also said in a memo the program provides a variety of benefits for the city, including helping to reduce shoreline erosion, drawing guests to Highland and better upkeep of the blind areas.

“Its kind of a win-win for everybody,” Hummert said.

Inflatables prohibited on lake

The using an inflatable watercraft on Silver Lake is now prohibited.

Hummert said during the meeting that inflatables never really were allowed on the lake, and the city discouraged their use. But he said an increasing number of calls inquiring about the use of inflatables made the department revisit this issue.

Rosen said there are two reasons why no inflatables are allowed, the first of which is liability. Rosen said there have been more and more requests for inflatable kayaks, as well as inflatable paddle boards.

The total ban was made so city staff would not have to be in position to determine whether an inflatable is deemed as “puncture-proof.”

“We felt that it would save any confusion to simply state that no inflatables are allowed,” Rosen said.

Rosen said prohibiting inflatables helps to keep swimmers out of the lake.

“The paddle boards are just too tempting for people to decide to use that as an excuse to swim,” Rosen said.

Megan Braa: 618-654-2366, ext 23, @MeganBraa_