Saturday, February 28, 2004

Cost of service strains cities

Kenton wants paramedics

By Travis Gettys
The Cincinnati Enquirer

Covington's decision to enter the paramedic business and not participate in a countywide system has left some Kenton County cities scrambling because they cannot afford advanced life support without contributions from the area's largest city.

Now it's up to officials from cities throughout the county to persuade their communities to help pay for the service, which dispatches paramedics to the most serious calls.

If cities are unable to foot the bill to continue uniform paramedic services throughout the county, a property tax increase could go before voters in November.

"The fiscal court needs some commitment from cities before putting the tax issue on the ballot," said Roger Rolfes, Edgewood city administrator.

The advanced life support committee of the Kenton County Mayors Group will meet next month to determine what increase would be needed to pay for services provided by TransCare, a nonprofit organization owned by St. Elizabeth and St. Luke hospitals. Covington opted out of the TransCare setup.

The tax increase "would be a rate that could be adjusted each year, but one that would never exceed what the voters approve," said Larry Klein, committee chairman and Fort Wright city administrator.

TransCare for years has provided paramedics to county fire districts for free, depending instead on yearly subscription drives and insurance payments.

"The money they're bringing in is not enough," Klein said. "They can't subsidize the service to the communities anymore."

Despite staffing cuts proposed Friday by Sam Grippa, president and CEO of TransCare, municipal governments would still owe more than $500,000 for services provided this year.

The county is expected to contribute about 25 percent of the total cost to cover unincorporated areas, said Fort Mitchell City Administrator Bill Goetz.

Grippa said TransCare would consider both "hard" billing, which holds customers responsible for fees not covered by their insurance provider, and "soft" billing, which does not.

Requiring hard billing with available subscriptions would cost cities $593,150 - $5.49 per person - annually for the first two years, Grippa said, and soft billing without subscriptions would cost $717,298, or $6.64 per person.

Committee members reached a consensus that all municipalities must be involved for the service to operate properly.

"It has to be a project that we do together or there's going to be huge holes," said Erlanger Fire/EMS Chief Bill Martin.

Grippa cited Boone County as an example of what can happen when advanced life support, which dispatches paramedics, is managed on a city-by-city basis.

Some larger communities can afford paramedics, who can prescribe medication and use a manual defibrillator. Smaller cities and rural areas that cannot rely on help from other municipalities cannot afford it, Grippa said.

Bill Scheyer, Erlanger city administrator, said he opposes creating a similar situation in Kenton County.

Advanced life support is a vital service, Scheyer said, and if funds cannot be found to pay for it, something else would be cut from the budget.

"If we're going to have services that are consistent across the county, we have to find a way to pay for it," he said.


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