City Council can’t scrap county ambulance pact

Divided and shorthanded, the Wichita City Council failed Tuesday to muster the votes needed to scrap its longtime ambulance service agreement with Sedgwick County.

That means the county’s Emergency Medical Services Department will continue to provide all ambulance services in the city for at least the next 18 months.

The city did send a strong signal that it wants to spend the next year renegotiating the 13-year-old pact with the county, with an eye toward allowing private-sector companies to compete for non-emergency ambulance transport business.

But after nearly two hours of testimony and debate, the vote to send the termination notice failed 3-2 with two absences.

The majority – council members Pete Meitzner, Bryan Frye and Jeff Blubaugh – initially thought they’d won, until City Attorney Jennifer Magana told them they needed a majority of the full council, or four votes, to approve sending the termination notice.

Vice Mayor Lavonta Williams and council member Janet Miller voted against the motion, just enough to head it off, with Mayor Jeff Longwell and council member James Clendenin absent.

County officials oppose splitting the ambulance business, saying it could cost the county-run service $2.5 million to $3 million of its approximately $14 million budget. That, they say, would lead to service cuts, tax increases and/or fee increases for patients using the service. It would also put the brakes on expansion plans for next year.

“All of that are not good options and subject our citizens to risk,” said Scott Hadley, county EMS director. “There is no need or rush or urgency to do that. There is no risk in continuing that agreement and allowing us to provide the quality service we’ve provided for the last 13 years.”

The county transports about 43,000 patients by ambulance each year. Of those, about 7,000 are non-emergency transports, Hadley said.

A typical non-emergency call would involve taking a patient from a nursing home to a hospital for medical tests because the nursing staff noticed a health problem that needs attention but doesn’t appear to be immediately life-threatening.

Competition

Both the Via Christi and Wesley hospital systems urged the city not to scrap the county ambulance contract at Tuesday’s meeting.

Council members supporting the change and executives of private ambulance companies that want to do business in Wichita contended that competition would make the county service more efficient and free it from handling routine transports.

“If this is only for non-emergency (calls), it should free up assets where they can actually be out there where they need to be in emergency situations,” Blubaugh said.

Nick Porto, a lawyer representing Kansas City-based APS Ambulance, said the company doesn’t want an exclusive agreement or to handle emergency calls, just the right to compete with the county for local non-emergency transport. APS already transports patients into and out of the county.

“At its most fundamental level, if you think about what competition does, it makes the competitors better and that’s all it is,” Porto said. “Who is the beneficiary of the competition? It’s the patient.”

A ‘natural monopoly’

However, Paul Misasi, the clinical manager of the county EMS department, said ambulance service is a “natural monopoly” and competition only works when it is for the entire service, not parts of it.

He said the private companies just want to skim off the comparatively easy and profitable non-emergency business.

“The revenue generated from non-emergency services subsidizes the ability to do the emergency service,” Misasi said. “There’s a reason nobody’s in the room asking for emergency services. It’s because they won’t make money.”

In a competition scenario, “who they would not include would be the people who are hard to serve, the people out in Goddard, the people out in Cheney, the people out in Valley Center,” Masasi said.

He said the taxpayers in Sedgwick County pay about $5 per person per year in taxes for EMS, while it’s more than $20 in Johnson County, which has a system open to competition.

The council doesn’t have another meeting scheduled between now and the end of the month, the deadline for the city to give the county notice to end the agreement.

If that deadline passes, the city-county contract renews, as is, for a full year.

If the council had approved the termination notice, it would have triggered a six-month period during which the city and county could have renegotiated the pact before a Dec. 31 expiration date.

Miller said that would give the Sedgwick County Commission too short a time to address a $2.5 million to $3 million cut.

“We’re asking our partner agency across the street to redo their 2017 budget with a three-week notice,” Miller said. If the city did that to a private company, “the outcry would just be enormous,” she said.

This story was originally published June 21, 2016 at 1:53 PM with the headline "City Council can’t scrap county ambulance pact."