Friday, July 16, 2010

EMS Consolidation Won't Save A Dime

Yesterday, the Ballard administration announced a plan to consolidate the efforts of Wishard Health Services, the Indianapolis Fire Department and the townships in providing EMS efforts, a plan it says will save $1 to $3 million. A press release from the Mayor's office reads:

The City of Indianapolis will partner with Health and Hospital Corporation of Marion County (HHC) to provide EMS services. Wishard Memorial Hospital will serve as the sponsoring hospital. Through its strong and longstanding relationship with HHC, the Indiana University School of Medicine will provide medical leadership for the new division in the areas of quality, education, training and research.

Mayor Ballard directed the Department of Public Safety to study the overlapping EMS services of IFD and Wishard Health Services and determine opportunities to enhance quality and efficiencies. The first element in the unification plan involves the merger of EMS services provided by IFD and Wishard Health Services.
“Many health industry experts and community leaders have long advocated for EMS reform and consolidation of EMS services throughout Marion County, and today Indianapolis is taking a major step in that direction,” said Mayor Ballard. “Creating efficiencies like this is something we all recognize as a key component of good government. We will improve the quality of key services and reduce costs at the same time" . . .
Marion County neighborhoods affected by this unification are the areas currently served by the IFD (Warren and Washington townships) and Wishard EMS (inside the historic city limits, Franklin Township and the Town of Speedway) . . .
An EMS chief with equal stature with the Indianapolis fire and police chiefs will report to the director of Public Safety. The EMS chief will be a physician within the IU School of Medicine’s Department of Emergency Medicine. HHC will encumber the operational costs, liabilities and all organizational responsibilities for the unified service. A medical advisory committee representing area hospitals will remain in place for clinical oversight.
The news report in the video above by Fox 59 News' Kara Brooks notes that no current personnel will lose their jobs as a result of this merger, although she says some firefighters worry that they will lose out on some overtime pay benefits as a result of the merger.

Let me begin by saying that all fire department-related consolidations in Marion County to date have led to zero savings for the taxpayers. When township fire departments have been consolidated into IFD, the costs of delivering those save services has actually increased. In the recent case of Perry Township, for example, firefighters there got a big pay boost when their department was consolidated with IFD because Indianapolis firefighters are paid better than most township fire departments. Also, Perry Township's EMS services were provided by a private ambulance service, unlike IFD, which has either Wishard or IFD to make the ambulance runs.

As someone who recently experienced the use of Wishard's EMS services, I can tell you that their billing rate is not cheap. I was charged nearly a thousand dollars to be transported to the hospital. Although Wishard handled my ambulance run, two paramedics from IFD's station two blocks away arrived--after the ambulance arrived. The two paramedics sat in their truck while Wishard's EMS workers did all of the work. Why were these paramedics even needed to make this run? I'm told that thousands of such useless runs are made by IFD every year.

Someone who worked in the Goldsmith administration told me there was talk of privatizing all of the EMS services during his administration. At an earlier time in our city's history, fires used to be much more common than they are today. IFD established its paramedic services as a way of creating jobs for firefighters who were no longer needed to fight fires. Paramedics are more expensive to employ for IFD because of the training required for their jobs. When firefighters caught wind of the privatization move, they raised a big stink and Goldsmith's administration abandoned the discussions.

Township fire departments like Perry Township relied on the private ambulance service to provide both the paramedic and ambulance services. Yesterday's consolidation plan has no intention of eliminating any paramedic positions in IFD, and Public Safety Director Frank Straub made it abundantly clear there would be no privatization of EMS services. While I view some privatization moves by government skeptically, the EMS area is one area where government could achieve some real savings. The only thing this consolidation plan will mean is that only one taxpayer-funded ambulance service will operate under Wishard's direction. The ultimate cost to taxpayers will not decrease. And the charge to persons who use ambulance services will not decrease. The new plan will, however, create a new high-paid, high level chief under the Public Safety Director on par with the current IFD and IMPD chiefs.

Has anyone else noticed that you don't hear officials bragging about how much the law enforcement merger between the Sheriff's department and IMPD saved? That's because it hasn't saved a dime. In fact, those costs have gone up considerably post merger. Consolidation sounds good on paper, but unless the consolidation plans are actually implemented with an eye toward making those cost savings happen, they never occur. And that has been the case repeatedly in recent government consolidation efforts.


Southsider said...

Local state, and federal budgets are only a record of how much goverment over spends the taxpayer's money.

Downtown Indy said...

I would expect the additional units pad out the log records so that they can also pad out the budget.

In Perry Twp I see this routinely - ladders and engines being sent to medical runs. A neighbor has chronic respiratory issues and every time, there's an ambulance and 1 or 2 big red trucks that pull up.

I can understand the need to have adequate manpower and to err on the side of safety but I think the 911 operators could ferret out a better response, particularly for the 'repeat customer.'

M Theory said...

To the contrary, the tax activists CAN brag that our work in 2007 led to a $3.1 billion dollar decrease in spending in 2010 compared to 2009.

And the tax activists can brag that our work led to an overall spending decrease of more than $2 BILLION when you compare 2010 spending to 2006.

They need to put us in charge and do what we say. Oh yeah, that's right. We're supposed to be the ones in charge. Only our public servants don't normally do as we say.

Gary R. Welsh said...

Melyssa, You could not be more wrong. The only government spending reductions that have occurred to date is because of the severe downturn in the economy that forced reduced government spending at the state and local level. State and local governments can't simply print up money and issue a bunch of IOUs to run deficit spending like the federal government.

Gary R. Welsh said...

From the online Star today:

Indiana has brought in $957 million less in revenue for fiscal year 2010 than
lawmakers budgeted for, State Auditor Tim Berry announced this morning in
closing the state's books for the year.
To make ends meet, state officials made $669 million in spending cuts and
reduced reserves from $1.3 billion to $830 million.

M Theory said...

I think the estimates from property tax savings are probably in the $800 million range, although the DLGF so far can't give me exact data.

Gary R. Welsh said...

Are you calculating the additional state sales tax increase we are paying as a trade-off for the tax caps? Don't forget the Peterson income tax increase that Ballard made permanent either, even though the state picked up the costs intended to be used from that tax increase for public safety pension debt and county welfare costs.

Jon E. Easter said...

The only way to see savings is to eliminate jobs. My sources tell me that spinning off the EMS service might be a way to reduce fire runs and ultimately reduce the need for firefighters.

Stay tuned and keep your eye on this one!

Jon E. Easter said...
This comment has been removed by the author.
Marycatherine Barton said...

Caught Ballard gaming on the taxpayer dime again, AI. Great job!

wasmedic5 said...

How can you not see that this will save the tax payers money?! Everyone in Marion county that lives in a township that has fire-based or private ambulances as their primary EMS response are being jerked around and paying for 2 ambulance services. Health & Hospital who owns Wishard and Wishard EMS have always been required to provide EMS or send a Wishard Medic response anywhere in the county, But the townships decided years ago that they wanted to try and make a profit from EMS and provide it themselves. Therefore the townships were putting tax dollars into the fire departments ambulance services when all along they could have been using that money for fire apparatus, training, equipment... AND saving the tax payers from paying for two services of which they are only getting use of one. doesn't make very much sense to me.