The Haines Borough is moving forward with a plan for ambulance billing that promises to bring in more revenue for the fire department without imposing any new costs on Haines residents.
The idea of charging residents for ambulance calls at all marks a major shift. For as long as the volunteer fire department has existed, it has provided ambulance services at no charge. Instead, the cost of the service has been levied equally on everyone making purchases in the borough, with revenue from a half-percent borough-wide sales tax dedicated to ambulance services.
That was until last year, when an outside audit of the borough volunteer fire department recommended exploring “cost-recovery options” for ambulance services — instituting some sort of charge per ride.
According to the audit, the half-percent tax has brought in enough revenue to cover ambulance operations four out of five years, from 2019-2023. But the fire department budget stands to increase, particularly with the recent hire of a full-time chief making $100,000 per year — though plans to institute ambulance billing do predate the new chief position.
The idea of charging for ambulance services has been floated, including in 2021 and 2017, but has faced resistance. In the past, volunteer firefighters and EMTs, have said they don’t want residents avoiding or delaying necessary medical care due to worries about cost.
This year, when the topic has been discussed in the assembly, assembly members made it clear that they do not want an ambulance-billing program imposing costs on Haines residents, particularly residents without health insurance.
On its face, the idea of bringing in ambulance revenue without added cost to ambulance users seems difficult to square. But the proposed plan, as it has been described by borough officials, promises to do that.
“If we pick you up, you will receive the care you need,” outgoing fire chief Brian Clay said this week, of operations under the new proposal.
Borough staff have called the seemingly-silver bullet proposal a “zero-balance” billing policy: ambulance users would be charged up to the amount their insurance company would reimburse, and no further.
Borough manager Alekka Fullerton said insured users would not even be charged for co-pays or deductibles, and uninsured users would not be charged at all.
Clay echoed that assessment, saying his understanding of the program was that users “would see no bill.”
That kind of billing policy does exist elsewhere, including in Chugiak, where the department writes off non-insured costs, Anchorage fire department finance officer Mary Cohen said. Chugiak’s volunteer department partners with the Anchorage fire department.
Anchorage and Chugiak are two of a number of departments in the state that contract out their ambulance billing to a company called Wittman Enterprises. Wittman Enterprises is now a subsidiary of North Carolina-based EMS Management and Consulting (EMS MC), which the Haines Borough Assembly voted to contract with Tuesday night.
Under the proposed contract, EMS MC will provide the software, payment infrastructure, and staffing necessary to start up and operate the ambulance billing system. In return they’ll take 5% of the revenue that the new system collects.
Haines Borough assistant clerk Kiersten Rowley, who helped develop the ambulance billing plan, said even under the new system, ambulance crews would be submitting the same run reports as before, on the same software, and with no additional information inputs needed.
The company’s proposal to the borough says the onboarding process into the billing system will take “45-60 days.”