County to bid ambulance service

March 28--The Johnson County Commissioners Court on Monday accepted CareFlite's letter of intent to cease providing ground ambulance service for the county effective as of Sept. 30.

The termination, CareFlite officials said, will not impact emergency medical helicopter service to the county.

Commissioners declined CareFlite's request to renegotiate the current contract between the provider and the county. They instead elected to allow ambulance providers to submit requests for proposal and to ultimately put the matter out for bid. CareFlite, County Judge Roger Harmon said, is welcome to participate in the bidding process.

"I'm bringing this before the full court to decide," Harmon said. "I'm not in favor of renegotiating as I've already been contacted by several other ambulance companies and I think we owe it to our citizens to put it out for bid."

CareFlite, via a March 14 letter, alerted Harmon of their intention to terminate their contract with the county in six months.

The current contract allows CareFlite to terminate, upon 180 days written notice, if CareFlite has losses, or can demonstrate prospected losses, of $500,000 within the fiscal year.

CareFlite's losses in the first four months of fiscal year 2017 exceed that amount, according to the letter.

"Our losses on this service will exceed $1.2 million in the fiscal year that ends Sept. 30," CareFlite President and CEO Jim Swartz said. "Which is unsustainable. That is the reason for the notice."

Although CareFlite is a nonprofit, the reality is that they still have to cover costs, Swartz said.

The specs for the proposal requests should be ready to send out by next week, County Purchasing Department Director Ralph McBroom said.

Time is of the essence, Commissioner Larry Woolley said to allow a sufficient window to go through and accept a bid and to allow the next provider sufficient time to set up and be ready to go on Oct. 1.

"We may discuss this all day because we have to get this decided so we have time to get this done," Woolley said. "But let me assure our residents that we will get it done and the county will have ambulance service after September. But we need to take the time to find a company that's fiscally and functionally responsible enough to do business in this county and meet responses. So let's put it out in the market and see what happens."

Woolley and Commissioner Jerry Stringer questioned the future of CareFlite subscription services whereby residents can secure ambulance transportation for an annual fee of $49 or less.

"I've had frustration over the last week or so because I've seen large ads in the Times-Review for the CareFlite memberships, which I consider questionable knowing that you all may or may not be the county's provider after September and that that question is still up in the air," Stringer said.

CareFlite Vice President of Ground Operations Doug Filbert said that county customers will be able to seek a refund for the unexpired portion of their membership should the county not continue on with CareFlite. Filbert added that the subscription would continue to cover helicopter service as well though.

The county last year renegotiated CareFlite's contract, adding a $300,000 annual subsidy to the company, which the county had previously taken out.

Going out to bid, Bailey said, could cost the county far more than $300,000 in taxpayer funded subsidy.

"We don't know that," Stringer said. "Let the companies bid and see what they say."

Cleburne issues

At issue also is the question of non-emergency ambulance transports from Texas Health Harris Methodist Hospital Cleburne as well as nursing homes and medical clinics within Cleburne city limits.

A city-issued permit is required for a private ambulance provider to perform such services, Cleburne Fire Chief Clint Ishmael said.

Whether the city would provide such a permit to a new company, should CareFlite not be the county's choice after September, is a question that would have to be decided by the Cleburne City Council, Ishmael said.

Ambulance providers realize a substantial portion of their revenues providing such services.

"The new provider is going to want that to be part of their portfolio and I can't blame them," Commissioner Kenny Howell said.

Another challenge is the fact that the Cleburne Fire Department recently began operating full time ambulance service for the city, a development that seems to be a thorn in the side of at least several commissioners and one that has no doubt impacted CareFlite's revenues.

CareFlite still operates within Cleburne in a backup capacity but CFD operates as the primary ground ambulance provider.

This has raised concerns, Harmon said, given that CFD decided not to honor CareFlite's subscription program. Which means Cleburne residents who purchased such subscriptions will get charged the full rate should a Cleburne ambulance show up instead of a CareFlite one. Residents have little or no choice in the matter since dispatch sends whichever ambulance provider is closest and available at the time of the call.

"Cleburne residents are the losers here," Harmon said. "The city of Cleburne didn't pay any of [the $300,000 subsidy] when we renegotiated with CareFlite. But Cleburne residents pay both city and county taxes.

"When Cleburne makes a call they're not honoring the CareFlite memberships so the patient is stuck with the difference between what their insurance pays and what Cleburne bills. Of course all residents in the county, including Cleburne residents, paid for that $300,000 subsidy and Cleburne residents are paying for those new high dollar ambulances for the Cleburne Fire Department.

"We had good service with CareFlite but decisions were made that were never brought to this court by Cleburne when we were renegotiating that contract [with CareFlite]."

Another issue revolves around the Johnson County Jail, which is located in Cleburne.

CareFlite charges the county Medicaid rates for the transport of Johnson County inmates from the jail to the hospital or a doctor's office while CFD charges the higher regular rate.

The county owes the city about $90,000 in unpaid ambulance transport bills, Ishmael told commissioners.

Commissioners asked Ishmael to set up a meeting between county and Cleburne officials in attempt to work out the issues, including whether or not the city would be amenable to charging the county Medicaid or at least reduced rates for ambulance transport of inmates.

Commissioner Rick Bailey praised CareFlite for their service to the county and "charitable" efforts in several areas.

"I hope CareFlite decides to competitively bid and that they come back and continue to serve the county and that their subscription memberships continue on," Bailey said.

Bailey reiterated that, in his opinion, going with a new provider may result in a high cost and an increase to county taxpayers.

"And it may not," Stringer said. "Having worked as a first responder myself I have the utmost respect for the [CareFlite] people on the front lines. There's no better. But the ideology of the company I will never accept."

___

(c)2017 the Cleburne Times-Review (Cleburne, Texas)

Visit the Cleburne Times-Review (Cleburne, Texas) at www.cleburnetimesreview.com

Distributed by Tribune Content Agency, LLC.