October 14, 2001 11:00 pm

By Alice Perry Linker

Observer Staff Writer

If a city fire department operated in terms of profit and loss, adding ambulance service to firefighting could be a profitable venture.

La Grande Fire Chief Bruce Weimer estimates that if the city takes over ambulance service for Union County, the service will earn $628,130 the first year and will spend $426,222, leaving a surplus of $201,908.

The proposed budget and other issues surrounding ambulance service will be discussed during a public meeting beginning at 7 p.m. Thursday at the National Guard Armory-Blue Mountain Conference Center on 12th Street.

Grande Ronde Hospital now provides countywide ambulance service, but since spring, the hospital and the city have been discussing the possibility of transferring the service to the citys fire department.

The hospital has also been looking at ways to increase revenue should the board decide to retain ambulance service. Janet Wright, vice president for patient care, said that if the hospital increases the number of patient trips from Grande Ronde to other hospitals, including Boise and Portland, it could generate up to $20,500 a year.

We think thats a realistic number if we got everything in line, she said.

Wright said that adding ground transportation is not expected to be the major factor in any decision.

Before any change can be made, the hospital board must vote to give up ambulance service and must formally announce the decision to Union County, which has the final say about any ambulance provider. After the hospital relinquishes service, the city would apply to provide service.

The hospital board will discuss the possibility of transferring ambulance service during its November meeting, but it is not known if a decision will be made then. The hospital is a private not-for-profit corporation and its board meetings are not open to the public. Some board members, however, are expected to attend Thursdays public forum.

The citys budget projects a somewhat higher income from ambulance service than the hospital projected earlier this year. Several factors, including the billing practices of major insurance companies and Medicare, are different for hospitals than for agencies that provide ambulance service separately from overall patient care. Last spring the hospital projected revenues of $537,422 for the current fiscal year, which began May 1.

The hospital bills ambulance patients a base rate of about $1,113 per run, and Weimer said the city would continue that rate. Medicare and Medicaid pay a specific amount for each ambulance trip, no matter what the agency bills. Medicare rates are calculated on a complex formula that varies according to the additional services, such as oxygen, provided during the trip.

Weimer has said that the city already responds to medical calls and has two paramedics on staff. To run an ambulance, the fire department would hire four additional paramedics, giving each fire shift five professionals. One firefighter and one hospital paramedic could be laid off under the plan.

Eventually, the fire department will be completely staffed with firefighter-paramedics, Weimer said.

The fire department has indicated that it will hire the first round of paramedics from the hospital staff. The average paramedic income is expected to decline somewhat should the city assume the service. The average salary paid by the hospital is $43,248, including overtime, and the city proposes an annual salary of about $40,772, also including overtime.

Service to the outlying areas will not change should the city take over ambulances. Under state law, the city must provide service to all areas of Union County now served by the hospital, but the rural first responder and ambulance services will not be called on to stand by as often, Weimer said.

The fire department has budgeted $44,487 for small-city services during the first year, and Weimer said the department will develop ways to continue to contract services from the rural agencies.

A major expense expected by the city is the billing service. Weimer said the city will contract to pay $35,000 during the first year to a billing service from Springfield that deals primarily with ambulance services.

The hospital board is expected to look at the long-term financial picture as it wrestles with a decision about ambulance service. Wright said the overall future revenue picture is not good for small hospitals.

One piece is the pressure on health care, she said. Weve looked at upcoming finances, and were going to have to make hard decisions about our operations and finances. The horizon is not positive in terms of reimbursement and things like that.