Milford takes over ambulance service: Change could net city $1 million

The city stands to bring in another $1 million or more in revenue each year thanks to a hard-won change in legislation that allows Milford to provide ambulance transportation for residents to area hospitals.

In the past, American Medical Response (AMR) held the license for transporting Milford residents to the hospital. After about three years of lobbying for state legislative change and working with the state Department of Health, Milford secured the right to transport patients and therefore bill insurance companies and/or the patients for that service.

“While the Milford Fire Department has long held the first responder designation and provided advanced life support services within the city, Connecticut’s Department of Public Health just recently assigned Milford the transport designation for basic life support ambulance service,” city officials said in a press release issued Tuesday. “This will now allow the fire department to transport patients to area hospitals and bill insurance companies for each level of service, thus creating a sufficient revenue stream to return to the general fund while helping to offset tax increases.”

Securing the ambulance transport license took a lot of lobbying and testimony over about a three-year period, something Blake started pushing for years ago when he was an alderman.

This is the second change in the way the city handles ambulance service.

In 2013, emergency officials here predicted the city could bring in $400,000 each year by billing for paramedic services the city provides when an ambulance responds to a resident’s 911 call.

Prior to 2013, AMR provided and billed for emergency medical services. Since Milford’s fire department provided paramedics, and usually arrived before AMR to a call to begin life support, local officials thought it was only logical that the city should bill for the service. Instead of contracting for an AMR ambulance with paramedic service, the city decided to use AMR just for ambulance transportation and basic life support services.

Now with this latest move the city has taken over the transportation aspect of the ambulance service as well, effectively taking over ambulance service within the city.

At the same time, Milford has contracted with Nelson Ambulance Service of Stratford to assist the city by responding when Milford cannot handle all the calls. Milford has three ambulances, according to Battalion Chief Dan Wassmer, and Nelson Ambulance Service will respond if the need exceeds what Milford can handle. The city reviewed qualified applicants and chose Nelson for its quality of service and flexibility, Wassmer said.

The new arrangement “comes with a host of benefits to the city and its residents, including improved patient care, quicker response times, additional ambulances in the city and the region, an enhanced system of quality management, and new non-taxpayer revenue streams to help sustain operations,” Blake said in a press release.

Of the 113 firefighters in Milford, 112 are EMTs, and 27 are licensed paramedics: Officials say they are more than equipped to handle the city’s emergency calls requiring an ambulance and life support.    

Milford residents requiring ambulance service are taken to one of the surrounding hospitals, depending on the care needed. These include Milford Hospital, Bridgeport Hospital, Yale, St. Vincents and St. Raphael’s/Yale.

A basic ambulance ride to the hospital, one that does not require advanced life support, could cost about $500. Advanced life support services cost more. Medicare covers about 90% of the bill, Wassmer said. Some insurance companies pay the entire amount and some don’t, leaving the rest the responsibility of the patient.

Since city tax dollars pay for the ambulance, the equipment, the responders and the training, some people may wonder why residents are billed at all. Wassmer said residents are charged for the service for several reasons: Some residents never call an ambulance while others use the service frequently; and once on the scene of an emergency, the city uses medical supplies and other services that otherwise wouldn’t be used.

The mayor added that the bills for ambulance service are largely paid by the insurance carrier, not the resident. And he said if there are extenuating circumstances where a resident could not pay the balance, the city will be more flexible in dealing with the amount due than another company might be.

“It is a big change,” Blake said, noting the revenues to offset taxes and the quick response times.

“Our first responders show up in four to six minutes, always. Sometimes faster than that. In a cardiac situation, those seconds and minutes matter,” Blake said.