Life Squad Billing

Last month, the Lucas County Commissioners voted to begin billing for the use of Life Squads, the advanced life support ambulances that are paid for through sales tax revenue. The Sylvania Township Fire Department mans a Life Squad, and we respond to Life Squad calls dispatched throughout Lucas County, though the majority of time it remains in the Sylvania area with occasional runs in outlying areas to the west, Springfield Township, Toledo and Ottawa Hills. I adamantly oppose soft-billing of Life Squad services for several reasons.

The decision to begin billing is based in part on a supposed need for increased revenue for the EMS system. The EMS system is supported by a sales tax that was passed specifically for this purpose a couple of decades ago. Officials say this is not enough to continue to support the system as it currently exists, and that soft-billing is just a band-aid. But this 'band-aid' has been 6 years in the making - yes they have slowly been working up to nailing the taxpayers with soft-billing for 6 years, and yet it is only a temporary fix. Instead of taking 6 years to provide a temporary fix, why didn't they seek a permanent solution?

Let's talk about what soft-billing is and how it negatively affects you. Soft-billing is the practice of billing insurance companies for use of the Life Squad by county residents. Any billed amount not paid by the insurance company is not pursued. For those who end up utilizing the Life Squad who do not live in Lucas County, the insurance company is also billed, but if they don't pay the entire bill, the user will be pursued for the remainder, up to and including collection action. For those who work or shop in Lucas County and directly or indirectly pay income, sales and real estate tax, that doesn't matter, they will still be hard billed for services. One excuse for doing soft-billing is that it 'doesn't cost' anyone anything. Wrong. It costs your insurance company, and your insurance company sets your rates based on how much is paid out on behalf of your group. So soft-billing will negatively affect insurance rates, though admittedly it may only be a minor amount (because the cost is spread out among so many insureds).

Sylvania Township receives approximately $660,000 from the county for manning Life Squad 6. Unfortunately, it costs closer to $1 million to operate it 24/7. We have happily subsidized this cost, as have the other four jurisdiction that operate Life Squads, because it provides a valued service to our community, not just Sylvania but the county as a whole. But in deciding to begin soft-billing, there is no agreement or firm intention to increase the amount of money the township will receive. So, while the County will be profiting off of the efforts of our firefighters, we continue to subsidize this service at great expense.

Another problem that I have with the soft-billing is the reasons they give for soft-billing, such as increased run volumes and more complex medical protocols which strain the system. Yet there is no data to support these claims. And the guestimate of $2-3 million in revenue from soft-billing is literally just that - a guestimate. There has been no study or review of run data done to arrive at that figure. They could be off by millions, they have no idea.

Finally, Lucas County EMS implements and directs new medical protocols be used in the treatment of patients without any follow-up study or review of medical data to determine if the new/added medical treatments being used are successful in preserving life. These new protocols take added personnel to implement and therefore are very expensive to the township to support and implement. If they are successful - GREAT! It is well worth the added cost. But we don't know if they are successful because there is no follow-up study being done. And again, we are being compensated at a rate that does not even cover manning the Life Squad with two Paramedics. These protocols can take three or more personnel to successfully implement.

For four years we have been reimbursed at the same rate for the Life Squad, approximately $660,000. Yet our costs are increasing (wages, benefits, insurance, fuel, etc.) every year. Add on top of that the increase demand on our personnel. Sylvania Township is being asked to provide more and more, while we are paid the same. Meanwhile, Lucas County will now begin to profit from the work of our employees (as well as the other jurisdictions' employees) with no guarantee on where that soft-billing revenue will go. There is some intent that a portion of it will go to purchase new Life Squad units, but that is not in writing. There has been some talk apparently that revenue will be shared with other jurisdictions that do not staff Life Squads, in order to supplement their fire and rescue services. But no guarantees, no promises, no commitments, just a decision to begin soft-billing.

I am opposed to the county implementing a plan to soft-bill for Life Squad services until a study has been completed which reviews all options for funding and providing emergency medical services and advanced life support transportation to those in both our community and throughout the township.