Commission OKs EMS Rate Hike

BROOKSVILLE - Ambulance rides and on-scene medical care provided by Hernando County Fire Rescue are about to get costlier.

After a nearly hourlong debate, a divided county commission on Monday approved an across-the-board rate hike for basic and advanced life support services in the fire rescue district.

Chairman Chris Kingsley and Commissioners Diane Rowden and Jeff Stabins voted in favor of the increase. Commissioners Dave Russell and Rose Rocco voted no.

The changes:

- Basic life support or BLS service will rise from $300 to $355.

- Advanced life support will increase from $430 to $450.

- There will be a new category of advanced life support for critical care patients, who will pay $575.

- Vehicle extraction and stabilization will increase from $100 to $150.

- On scene care without transport will rise from $50 to $75.

- And the per-mile fee for transport will go from $7 to $9. Chief Mike Nickerson told the board that the increases are needed because of the rising cost of caring for patients and shuttling them to hospitals. The rates have not been changed in 10 years.

"In the industry, that's probably unheard of, and we're very proud of that fact," he said.

Pulling from underneath the podium a box of props, Nickerson noted that a single intravenous injection kit for a critical care patient can cost $99; single doses of drugs for diabetic and cardiac patients can cost as much as $110.

The cost of diesel fuel has climbed some 400 percent in the last decade, he said.

"This is an expensive business to be in," Nickerson said. "It's not a matter of the government trying to run the cost up, it's the cost of doing business."

The new rates take effect June 1. The increase will mean an additional $138,000 in the department's coffers next year. Nickerson emphasized that his 2009 budget reflects no increases in the ad valorem rate.

"The EMS rates are set to prevent that from happening," he said, adding that he would work to prevent future increases for "as long as humanly possible."

The commission's approval came with the stipulation that officials look for ways to further cut the millage rate in the Hernando Fire Rescue taxing district this year.

That wasn't enough for Russell and Rocco, who wanted attached to the approval a specific tax cut for the district to account for the rate hike.

"I still feel we can be more aggressive," Russell said after the meeting.

Nickerson said his 2009 budget is some $401,000 less than in 2007 due to millage rate reductions mandated by the state and another reduction passed by the commission last year.

According to the budget office, revenue from property taxes and EMS service fees for Nickerson's department helped increase his budget by $2 million from 2006 to 2007, from $4.9 million in 2006 to $6.9 million in 2007. Property tax revenues jumped from $2.7 million in 2006 to $3.5 million in 2007 and revenues from fees climbed from $2 million in 2006 to $3 million in 2007.

Nickerson also defended his department's $1.08 million in reserves set aside for 2009, noting that it is 15 percent of his total budget. The Clerk of Court and the county budget office recommend 25 percent for the department, which is a roughly three-month "cushion" to tap in the case of a lag in tax collections or a disaster.

Hamilton and Jennings agreed that they do, with Jennings calling them "a realistic figure."

"We think it's the right thing to do," he said.

Commissioners once again voiced displeasure with the 75 percent collection rate for EMS patients and told Nickerson to invite representatives from the billing agency and the collection company to speak before the board at an upcoming meeting.

At least two commissioners said they were willing to place liens on property of people who don't pay the medical bills. Nickerson advised against it, voicing a concern that the threat of a lien might prevent poorer residents from calling for medical help when they need it.

"If one person reads in the paper that we're filing liens and doesn't call an ambulance and dies, it's not worth it," he said.

Rowden agreed, saying she would need much more information before considering liens.

"It's not always about the bottom line," she said, "it's the lives that are saved out there."