Charles City, Floyd County look for EMS options as ambulance contract enters final year

By Bob Steenson, bsteenson@charlescitypress.com

With Charles City’s and Floyd County’s current contract with AMR ambulance service nearing the start of its last year, the Floyd County Ambulance Commission is looking for options.

Earlier this month the commission agreed to send out a request for information (RFI) to potentially interested parties, providing statistics about the current service being offered and asking for potential costs to provide similar or increased services in the future.

Charles City Administrator Steve Diers said the RFI was sent to three potential service providers, including AMR.

The city and county currently have a three-year contract with AMR to provide one advanced life support-level ambulance on a 24/7 basis, and an on-call basic life support ambulance.

In the first fiscal year of that contract, July 1, 2020, to June 30, 2021, the fee paid to AMR was $150,000, or $75,000 each by the city and the county. In the current fiscal year that ends June 30, the fee is $175,000, or $87,500 each. In the next fiscal year, beginning July 1 and running to June 30, 2023, the fee will be $200,000, or $100,000 each.

Diers points out that up until a few years ago, AMR paid the city a fee to house the ambulances at the fire station, for firefighters to drive the ambulances, and for dispatching services.

Now, he said, as part of the three-year contract with AMR, in addition to the yearly subsidy, the city paid about $170,000 to remodel a part of the fire station to provide office space, sleeping quarters, storage space and added equipment area to house three ambulances, with no charge to AMR, and dispatching is provided by Floyd County dispatching service for no charge.

“We are requesting information from EMS service providers to help us determine if this current structure is the best approach to meet our community needs,” the RFI that Diers sent out says.

“The Floyd County Ambulance Commission is interested in researching opportunities to amend/modify the current operation structure which may include provision of ambulances and equipment for entity use,” it says.

The commission will use information it receives from the responses to the RFI to put together a request for proposals (RFP) from companies or organizations interested in providing emergency medical services to the city and the county.

“Our current contract with AMR ends June 30, 2023. We would like to have a new service agreement in place by Jan. 1, 2023. We hope to develop a long-term partnership moving forward,” the RFI says.

Among the statistics provided in the RFI are the mix of current payers for service – 39.9% Medicare, 18.7% Medicaid HMO, 15.3% private pay, 11.4% Medicare HMO, 8.7% non-contract insurance and HMOs, and the remaining almost 6% a variety of other payers.

In 2021 there were about 1,300 dispatched 911 calls for ambulance service, with about 1,100 of those resulting in transport, the RFI says.

The RFI also emphasizes the need for transport services by the Floyd County Medical Center, which had more than 280 patients that required transfer to another facility in 2021.

Most of those – 150 – were to MercyOne North Iowa Medical Center in Mason City, 52 were to Mayo Clinic facilities in Rochester, 31 were to Iowa City and 22 were to Waterloo. The remaining 29 were scattered among 11 different facilities in Iowa, Minnesota and Wisconsin.

Not all of those transfers were made by AMR. Some were made by other ambulance services, some were by medical helicopter, some by sheriff’s vehicle and others by personal vehicle.

Another option on the table for Charles City and Floyd County is the possibility of starting their own ambulance service, possibly under the direction of the Charles City Fire Department.

The Ambulance Commission has discussed the possibility of using American Rescue Plan Act (ARPA) funds that the city and county are receiving toward starting a new public ambulance service.

It has also begun the process of declaring emergency medical services as an essential service, just as law enforcement and fire protection currently are, and then asking voters permission to levy either property taxes or an income tax surcharge or both, to support EMS.