STOW -- City officials say they believe that EMS ambulance transport fees that have not risen in 16 years need to be increased due to rising costs.

But city officials also say that residents should not be impacted by an increase.

City Council gave first reading March 23 to an ordinance that would raise the fees. The ordinance would also update what medical facilities that EMS can take patients to.

The fee increases include:

Basic life support with transport will increase from $450 to $550.

For advance life support 1 with transport, the fee would increase from $600 to $650.

For advance life support 2 with transport, the fee would remain at $725. An additional cost-per-mile fee for all categories would increase from $10 to $12.

There is no fee for basic or advance life support if there is no transport and that would not change.

According to city ordinances, basic life support is defined as including only procedures that can be performed by an emergency medical technician with just basic training, while advanced life support includes procedures that require an EMT intermediate or paramedic to do, with ALS 2 certain specific procedures.

During Council's March 23 roads and safety committee meeting, Fire Chief Mark Stone said Stow residents are only billed what their insurance pays.

"If our residents have insurance and their insurance pays a certain portion, we write off the balance of it because they are taxpayers," said Stone. "We consider their taxes as being their deductible, if you will. So going to this new fee schedule would not affect our residents. I don't think that they would even notice it at all."

Finance Director John Baranek said residents are sent a bill to provide to their insurance companies and that there are also policies in place to protect Stow residents without insurance.

"We do not bill...a resident. If they prove that they do not have insurance, we waive (the fee)," he said.

Baranek told the Stow Sentry April 6 that non-residents are typically billed for any portion that is not paid by insurance, but exceptions can be made.

"If a non-resident is invoiced and the city receives payment, the non-resident is billed for their unpaid portion of the services rendered unless they can prove that they are indigent, then the remaining portion is waived," he said.

Stone told Council that the current fees date back to 2001, when the city's EMS began transporting patients rather than contracting with a private ambulance service.

"The cost of doing business was much cheaper then due to obvious reasons," said Stone, adding that EMS uses its ambulances more than it used to and EMS also uses a digital records keeping system, which comes with hardware and software costs.

He said that the proposed fees were developed after the city looked at other area fire departments to see what they charge.

Budget and Management Director John Earle told Council that $663,000 in ambulance fees were taken in in 2016 and he estimated the fee increases could add $50,000 to $60,000 annually, while Stone said he estimated $70,000 to $80,000.

Change would update transport policy

Stone said that the proposed ordinance would also remove the names of specific hospitals that Stow EMS can transport patients to, making a less specific requirement that EMS refer to its protocols, or procedural rules, when deciding where to transport patients.

He said this is because the EMS transport ordinance, which Council also approved in 2001, has become outdated.

"We didn't foresee when this was set up, hospitals change names a lot these days," said Stone. "They merge with other hospitals and new ones are being built on a regular basis and the policy, if we were to look at it strictly, would kind of require us to stay with only those hospitals. We want to move on to other hospitals as they are built and we also want to be able to transport to hospitals when they change their names."

As an example, said Stone, a new hospital affiliated with University Hospitals is being built in Kent and Stow EMS would like to offer that as an option for patients.

Stone said that in addition, EMS cannot legally take a patient to a medical facility that he or she does not want to go to.

The proposed ordinance would also add a provision allowing Stow EMS to transport patients with a life-threatening condition from one hospital to another where the condition can be better treated.

"We, in the past, and currently still do not, do inter-hospital transfers," said Stone. "However, we found ourselves in a couple of situations in very recent days where they had a life-threatening situation happen up at Stow ER and they called us because they couldn't get a [private] ambulance to transport this patient who was having a serious medical condition downtown to where they could get immediate treatment. Since then I have gotten phone calls late at night asking for permission to transport again from that facility."

Stone added that private ambulances now are "harder and harder to find" and that amending the ordinance would allow shift captains to approve such transports.


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