Springfield City Council members will consider spending $280,000 in the next fiscal year on what could be the first step toward a multimillion-dollar, city-operated ambulance service to supplement privately operated ambulances and shorten response times in medical emergencies.
The money to buy a single ambulance appears on page 165 of the city's 400-page budget proposal from the administration of Mayor Misty Buscher. But including that line item in the proposed $686 million city budget – which includes the operations of City Water, Light & Power – doesn't necessarily mean the administration is saying it supports such a purchase or believes a city-operated ambulance service would improve services to residents, according to Fire Chief Edward Canny.
"It's a starting point for discussion," he told Illinois Times on Jan. 2 in advance of City Council hearings to finalize the city's fiscal 2025 budget, which takes effect March 1, 2024. The fire department's proposed $56.2 million budget will be discussed by the council at 5:30 p.m. Jan. 18."We want to keep our options open," Canny said. "We don't want to run the private companies out of business. ... This is going to take some time and some studying."
Even if the council, which often tweaks the proposed budget before it is finalized, supports moving forward with an ambulance purchase, many other steps would need to be taken before a city ambulance service could begin, Canny said. The spending request in the budget doesn't include the cost of supplies and personnel costs for an ambulance service, which would potentially be staffed by firefighters who are advanced emergency medical technicians or paramedics.
Even limited ambulance service, including regulatory approval at the state and local level, would take at least 10 months to set up, Canny said.
Unionized members of the Springfield Fire Department and at least one of the three privately operated ambulance groups serving city residents already are making their case for either moving forward quickly or slowing down.
Springfield Fire Fighters Local 37 says the need for additional ambulances on the street to respond to medical emergencies is so great that the city should purchase at least one ambulance this coming year and begin formal negotiations with the union to supplement what the three ambulance providers offer to residents.
A draft SFD report outlining options that was sent to council members in November said wait times for private ambulances responding to emergencies have increased since 2010.
The SFD report, compiled in collaboration with the union, said a delay of more than 30 minutes before a private ambulance is available to be dispatched to an emergency is a "near-daily occurrence." Such delays occurred 350 times in 2022, the report said.
"While this represents the extreme, an ambulance was only on the scene in five or fewer minutes 8% of the time in 2022," the report said.
But Greg Chance, regional chief executive officer of nonprofit Medics First, one of the three private ambulance services, said City Council members shouldn't use public money to buy ambulances before studying the current need and considering changes in city ordinances to require private providers to make more ambulances available.
Such an analysis hasn't taken place yet, he said.
A supplemental ambulance service was one option in a 219-page analysis of fire department operations that was completed in January by the respected nonprofit Center for Public Safety Management in Washington, D.C.
"This is a workforce issue, and this is a health care issue," Chance said. "Let's spend the time to fully discuss the issue."
Representatives of the two other private ambulance companies authorized by the city to transport city residents to the hospital, America Ambulance and LifeStar Ambulance, didn't respond to requests for comment.
LifeStar was fined $1,750 in the city's administrative court on Nov. 8 based on the fire chief's complaint Sept. 13 that the company failed to comply with city requirements to provide at least two ambulances staffed with paramedics 24 hours a day for potential advanced life support. The company failed to meet the requirements for at least six months in 2023, Canny said.
The $1,750 fine, which LifeStar hasn't paid yet, will be on top of $750-per-day fines for violating the requirements. The per-day fines are scheduled to be totaled and finalized in a Jan. 24 hearing.
Buscher, who received the firefighters union's endorsement in her successful campaign this spring, previously said a municipally operated ambulance service as a supplement to private ambulances "is something we should evaluate."
Buscher told Illinois Times on Dec. 4: "We've been in conversations with some of the ambulance companies that are here now, and my desire is not to put anyone out of business. I appreciate our businesses and our small businesses that are here, so I want to make sure that we're being a good friend to businesses, as well."
Ward 1 Ald. Chuck Redpath said he doesn't favor the city buying ambulances at this point.
"It's an expensive venture for the city," he said. "I'm willing to listen, but it's not got legs yet. ... We may need to look at shoring up the private ambulance companies."
Potential changes to improve the area's emergency medical services, or EMS, have gained momentum over the past year.
Factors include the suffocation death of Springfield resident Earl Moore Jr., allegedly related to improper treatment by a LifeStar Ambulance paramedic and a LifeStar emergency medical technician, and the city's August settlement of a labor dispute with the firefighters union.
The settlement was prompted by the union's 2021 unfair labor practice complaint that the city began requiring firefighters with training as paramedics or intermediate or advanced EMTs when the private services lacked enough of their own paramedics.
The settlement provided for a 1% pay raise for firefighters and a pledge from the city to work with the union and study a supplemental city-operated ambulance service.
Rinaberger said he believes Moore never would have died if a city-operated ambulance, staffed by firefighters, had been dispatched to Moore's east side home.
The two LifeStar workers were charged with murder in the death of Moore, 35, who suffocated – in a situation called compressional and positional asphyxia – after being strapped to a LifeStar gurney face-down during the trip to HSHS St. John's Hospital. The workers have pleaded not guilty in the case, which remains pending.
The Center for Public Safety Management said in its report that 11,500 of the fire department's almost 20,000 calls for service in 2019, or 58%, represented EMS services. As the population ages, EMS calls are exceeding calls to put out fires in Springfield and across the country.
The report said a city-operated ambulance service could cost $2 million to $2.8 million in startup expenses for ambulances and equipment, and between $3 million and $4.5 million per year in base personnel costs, not including pension liabilities.
Rinaberger said a city-operated ambulance service would serve only patients undergoing medical emergencies and eventually would pay for itself through billings to private insurers and enhanced reimbursements for Medicaid patients through federal dollars from the Ground Emergency Medical Transportation program.
The draft report from the fire department backed up Rinaberger's statement.
Dean Olsen is a senior staff writer at Illinois Times. He can be reached at [email protected], 217-679-7810 or twitter.com/DeanOlsenIT.
