Ambulance fight splits Wichita and Sedgwick County

Starting soon, you might have a choice of who to call when you need an ambulance: public or private.

And that’s causing a red-light political emergency between the Wichita City Council and Sedgwick County Commission.

The City Council is scheduled Tuesday to consider a plan aimed at allowing private companies to provide non-emergency ambulance transport. The county has been lobbying hard for them not to do that.

A typical non-emergency transport involves 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, County Emergency Medical Service Director Scott Hadley said.

Under an agreement last approved in 2004, the county has the exclusive right to transport all patients within city and county boundaries.

Private ambulances already operate in the county, but they can only provide a ride when the trip begins or ends outside the county. They’re mostly used to transport patients from other counties to hospitals in Wichita, or to take Wichita patients to distant sites when they need specialized care that’s not available locally.

City officials and a Kansas City ambulance company supporting the plan say they think partial privatization would improve safety by letting private-sector operators move the patients who don’t need lights and sirens, just a medically safe and secure ride to and from the hospital.

“It could free up EMS to provide service where they need to,” said City Council member Pete Meitzner.

But Sedgwick County officials say the Wichita proposal has the potential to undercut their EMS budget, wreck a system that has served Wichita’s citizenry well and put the brakes on expansion plans to add new stations and more paramedics.

If the city carries through with its plan, “It’s going to impact them (city residents) with reduced services, higher taxes or higher fees” to use ambulance service, said County Commission Chairman Jim Howell. “There are no other options.”

The city-county agreement automatically renews each year, and previous efforts to change it went nowhere.

“We try to do a really good job for our citizens at a reasonable cost,” said Commissioner David Unruh.

Hadley has been meeting with City Council members one by one all week, urging them to keep the service as is and outlining what he sees as the ramifications if they change it.

Opening the market to private providers would cut $2.5 million to $3 million from the county ambulance service’s revenue, he said. That would delay or halt plans to expand service next year and could force cutbacks in the number of ambulances, paramedics and stations serving the county, he said.

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

“Eighty-five percent of what we do is for the city of Wichita,” Hadley said.

Under the current system, all ambulance calls are screened by the county’s 911 emergency response system, Hadley said.

The dispatchers are trained to evaluate whether a medical situation is an emergency or not and at times will upgrade a response if the report from the scene implies a more urgent problem, Hadley said.

In addition, paramedics occasionally will discover a serious emergency requiring immediate medical action when they reply to what people on the scene had characterized as a non-emergency call, he said.

Meitzner, however, said he discovered a gap in ambulance service about six years ago when his father was terminally ill and wanted to go home from the hospital for his final days.

“He was bedridden,” Meitzner said. “We had to put him on a gurney to get him home.”

Using the county ambulance service would have cost the family hundreds of dollars, he said.

They found a van service that could accommodate the trip, but Meitzner said he thinks a private ambulance would have cost less than county EMS and been more comfortable for his father.

The costs for public and private ambulance rides would be about the same and are almost always mostly paid by insurance, Medicare or both, said Bill Noonan of APS Ambulance, a company lobbying to open the Wichita market.

The big advantage would be reduced waiting times, Noonan said. He said non-emergency patients can sometimes wait hours if the county ambulances are busy with emergency calls.

Meitzner said he finds it ironic that the county is arguing to keep a government monopoly on ambulance services.

“I thought the majority of the county (commission) was for free-market competition,” Meitzner said.

The conservative commission majority routinely criticizes government as bloated and wasteful, and has identified privatization of all but basic services as a guiding principle of its 2017 budget.

Mental health care, community development, planning, social services and health department services are all included in areas identified in county budget documents as ripe for privatization.

However, the county considers its ambulances a vital service.

Howell said commissioners are planning to add new stations, trucks and personnel as part of their budget process this year. But that would change if the city cancels the current agreement, he said.

The first step toward partial privatization, and the step the City Council will consider Tuesday, is to move to terminate the 2004 agreement that gives the county exclusivity. If the council doesn’t do that before July 1, it will renew automatically for another year.

If the council does vote to terminate, it basically starts the clock on six months’ notice to give both sides time to adjust.

At a meeting Friday, Mayor Jeff Longwell was careful to point out that the city wants to rework the pact, not destroy it.

The council will meet at 9 a.m. Tuesday at City Hall, 455 N. Main.

This story was originally published June 17, 2016 at 7:31 PM with the headline "Ambulance fight splits Wichita and Sedgwick County."