Waukesha - In a trade-off likely echoed increasingly through the halls of government as next year's budgets are taking shape, the Waukesha Fire Department faced a choice: Come up with additional money or cut services.
So it has a plan to raise nearly $220,000 in additional annual revenue by boosting emergency ambulance fees to its residents and visitors - some by more than 50% - and by starting a new medical transport service beyond the city limits.
The city's Finance Committee recommended approval of the ambulance fee increases on Monday - even boosting some for non-residents higher than initially requested. Common Council approval will be sought Oct. 6.
Under current ambulance fees, a city resident is charged $375, $500 or $650, depending on the level of services needed. Non-residents are charged $510, $590 or $770. Both pay $8 per mile for trips, as well.
Effective as soon as possible upon Common Council approval, those fees would increase by $100 for residents and from $80 to $110 for non-residents. Mileage would jump to $12 per mile.
Beginning in July, the rates would go up $95 to $118 more for residents and $125 to $200 more for non-residents, with trip costs at $14 per mile.
The largest increase would be felt by residents needing the most basic service, such as a wound bandaged or a broken arm splinted, where the $375 fee would increase to $593 by next July - a 58% increase.
The Fire Department's billing consultant said that for 24% of the ambulance calls, private insurance could pay the bill. But 63% of the calls are covered by federal Medicare and Medicaid, which caps rates at $307 to $529, depending on level of service, Assistant Fire Chief Steve Howard said.
The consultant says the initial increase would add about $58,000 a year while the July 1 rate increase would raise $110,000 more.
Individuals who can't pay can seek waivers.
The Finance Committee on Monday also encouraged Fire Department managers to do more legwork on a proposal to offer scheduled transportation services for patients between health care facilities, such as hospitals and nursing homes. If approved, the plan would reverse a city policy dating to 1975 when Waukesha's paramedic service was first created and non-emergency transport services outside the city were prohibited.
Brookfield, Delafield and West Allis have provided transportation outside their boundaries for several years and see substantial revenue from the service, Waukesha fire officials said. Waukesha could raise $52,000 a year from the service, according to the consultant.
While the policy might temporarily take an ambulance out of city service, that must be weighed against permanent service cuts possible under tighter budget limits, Howard said.