Fairfield City Council agrees to extra money for CARE Ambulance

FAIRFIELD — The Fairfield City Council held a special meeting Tuesday and approved giving more money to CARE Ambulance in light of its staffing and financial crisis.

The council normally holds only one meeting in December, but called a second one in response to CARE Ambulance announcing earlier this month it could no longer meet its contract requirement to provide two full-time Advanced Life Services ambulances in the county. Instead, it could only provide one full-time ambulance and another that operated from 8 a.m. to 8 p.m.

The council members voted unanimously to approve up to $30,000 extra in city funds toward CARE. City council member Elizabeth Estey, who represents the city on the Jefferson County Ambulance Service Agency, said the other two entities that comprise the service agency, the Jefferson County Board of Supervisors and Jefferson County Health Center, are following suit by providing $30,000 each for a total of $90,000 more to CARE. This would be paid to CARE in installments of $10,000 per month for the remaining nine months of CARE’s three-year contract to provide ambulance service to Jefferson County.

CARE representatives have told the ambulance service agency that it has to cut back its ambulance services in the county because of a shortage of paramedics, a shortage that will get worse in about a week when CARE loses a team of three traveling paramedics. That will leave it with only two paramedics. In order for an ambulance to qualify as ALS, which means medicine can be administered on board, it must have at least one paramedic.

Estey said CARE had earlier asked for an additional $90,000 per month for the rest of the contract, which the members of the ambulance service agency felt was impossible given their own budget constraints. CARE subsequently lowered its request to $60,000 per month.

Estey said the ambulance board feels that’s still too much, but it also wants to show CARE it will negotiate in good faith, and understands that its labor and insurance costs are much higher than expected. For instance, Estey said that the cost of insurance has risen 30 percent in the last couple of years.

To staff its ambulances, CARE has had to enlist traveling paramedics, but the company says they cost four times as much as a non-traveling paramedic, so relying on them is not financially sustainable.

“We recognize that they have increased costs, but we’re not conceding to everything they’re asking for,” Estey said. “CARE indicated that $10,000 more per month would make them break even. It’s not our responsibility to make sure they’re earning a profit, but this would help continue our negotiations with them. It’s not going to look favorably on us if we [counter-offer] with nothing.”

While the ambulance service agency and CARE are in negotiations over the current contract, the agency’s legal team has filed a petition for injunction against CARE to force the company to uphold its contract. Fairfield City Attorney John Morrissey told the council Tuesday that the ambulance board was not aware of CARE’s financial problems until October, and didn’t realize how severe they were until earlier this month when CARE requested an additional $90,000 a month.

“Back in September, we were happy and were talking about renewing the contract,” Morrissey said. “We had no idea they were losing so much money until October.”

Morrissey said he had received no communication from any attorney representing CARE as of Tuesday’s meeting. He said that, if the two sides cannot resolve the problem through arbitration, it would go to a trial, which might not be until after the contract expires on Oct. 1, 2023.

Council member Paul Gandy asked if CARE’s financial records have been audited. Morrissey said they have not, and that such an audit might only happen through the civil litigation the ambulance board is now undertaking.

Fairfield Mayor Connie Boyer asked Morrissey if there was anything in the contract that required the ambulance board to make up for CARE’s losses.

“Not a thing,” Morrissey responded.

Morrissey said the county doesn’t have a backup plan for ambulance service if CARE were to exit. The county has mutual aid agreements with all neighboring counties, but those neighboring counties can’t guarantee they will respond to every call.

“I don’t think we can turn our firefighters into paramedics overnight,” Morrissey added.

Lee Dimmitt, who will resume his role as Jefferson County Supervisor in January, addressed the council and urged them to consider a publically-run ambulance service. He said Jefferson County is the only county in the area that relies on a privately-run ambulance, and that all neighboring counties’ ambulances are run by their county or hospital. He added that he was confident paramedics would be willing to work in Jefferson County if its ambulance was county-run.

Gandy asked Dimmitt why he was confident a county-run service would avoid the staffing problems CARE is experiencing.

“Because local paramedics don’t want to work for CARE,” Dimmitt said.

Estey said the next ambulance board meeting is scheduled for Jan. 17, but she expects it will meet sooner if there are developments to discuss regarding the current court filing with CARE. The hearing on the petition for injunctive relief the ambulance board filed is scheduled for Jan. 3.

Call Andy Hallman at 641-575-0135 or email him at andy.hallman@southeastiowaunion.com