City requests ambulance fee increase

The city of Ruston is prepared to stop providing ambulance service outside the city limits unless the Lincoln Parish Police Jury agrees to an increased contract fee.

Ruston has proposed going from the current $30,000 a year to $120,000 a year with a 5% annual increase after the first year. City officials say there’s no room for negotiation. The fee has not increased since it was set 28 years ago.

“The city of Ruston can’t continue to subsidize the police jury,” Mayor Ronny Walker said.

City and parish officials are scheduled to meet later this month to talk about the situation. That meeting was originally scheduled for Jan. 5 but was postponed at the parish’s request.

Parish Administrator Doug Postel said while he understands Ruston’s position, the parish needs time to explore all of its options, including private ambulance service.

“We will not leave (parish residents) high and dry,” he said.

Though both Walker and Ruston Fire Chief Chris Womack — the ambulance service is part of the fire department — said they believe the best care option for parish residents is for the city to provide emergency response, they also said that won’t happened without additional funds to hire more personnel.

There have been times when Ruston residents have been at risk when most — if not all — of the responders on duty have been on EMS calls outside the city.

“The honest truth is there are many times when there are only two or three people if we have a working fire,” Womack said.

“We’re at a critical staffing shortage,” he said.

In the beginning

Prior to 1967, ambulances were run by local funeral homes. From 1967 to 1973, the Ruston Police Department operated the service.

Then, in 1973, the EMS responsibilities were transferred to the fire department. Ruston was one of the first, if not the first, municipal fire department to also operate an ambulance service.

Firefighters cross train to handle both assignments. Most of the current firefighters are also emergency medical technicians, advanced EMTs or paramedics.

According to RFD records, the fire department made the first proposal to provide parishwide ambulance service in July 1988. In February 1990, an intergovernmental agreement was signed between the city and the police jury.

In 1992, the parish began paying the city $5,000 per month for ambulance coverage.

But in 1993, the cityparish Joint Ambulance Committee voted to reduce those payments to $2,500 per month. The rate has been the same ever since.

The committee has faded from view. Though it reportedly still exists, it hasn’t met in 28 years.

Crunching the numbers

Meantime, personnel and equipment costs have ballooned.

More than 80% of the RFD’s calls are for emergency medical service. And roughly 40% of those calls come from outside the city. In 2021, city EMS made 1,656 parish runs, according to RFD’s tally.

Walker figures Ruston has been supplementing the parish’s $30,000 payment to the tune of about $1 million a year. The proposed $120,000 fee won’t touch that, but it would enable Womack to begin to hire additional staff.

“If we continue to run in the parish, I need a minimum of six new people,” Womack said. “If we don’t run the parish, we don’t have to hire people.”

RFD has four frontline ambulances and one reserve ambulance. In 1995, the cost of an ambulance was $67,820. The newest ambulance in service now, a 2019 model, cost roughly $220,237.

“That’s just the ambulance. That’s not supplies,” Womack said.

The city also has a rescue truck that makes parish runs. The 2010 truck cost about $220,000 and carries about $100,000 worth of equipment. It’s the only rescue truck the city has.

Then there’s personnel. A new, young firefighter with limited experience costs the city about $50,000 with benefits.

Retirement costs alone have gone up 22% over the last two decades.

“Six (new) people are going to cost us $300,000. In a perfect world the parish would pay all of that because that’s why we have to hire them,” Womack said.

Spread thin

Every ambulance rolls with three people on board: a driver and two for patient care. At least one of those is a paramedic.

“If you have a wreck in the parish, there’s not just three on an ambulance, there’s two on the rescue truck,” Womack said.

The more units needed, the more personnel — and the less coverage for Ruston residents and businesses.

Ideally, RFD has a total of 16 people per shift to cover three stations.

“That’s the entire Ruston Fire Department on a given day,” Womack said.

The department is currently working with 15 on a shift because several of the firefighters are away in training. That doesn’t count others who may be out ill. Minimum staffing is 12 per shift.

If an incident occurs in the parish that requires multiple ambulances, a 15-person shift could be quickly cut down to three people, leaving the city of Ruston virtually uncovered by its own fire department.

That happened on Oct. 17, 2021, when all four of RFD’s ambulances responded to the mass shooting incident on Grambling State University’s campus that left one person dead and seven people injured, one critically.

To a lesser extent, Ruston was also in a bind during the February 2021 winter storm when one of the ambulances got stranded near the Corinth community and sat there for eight hours.

The situation both frightens and angers Walker. He fears what could happen if even two of Ruston’s four frontline ambulances were in the parish on a call and a major incident, or a fire, should happen inside the city.

“Is it fair to the citizens of Ruston to send an ambulance with three people and a rescue with two people and all of a sudden we have a fire in downtown Ruston and all our equipment is (out in the parish) for $2,500 a month?” Walker asks.

Womack said some people have suggested cutting back to two people on an ambulance.

“And jeopardize care?” he asks.

There’s still more involved.

“Liability greatly increases in the parish strictly because of the time frame,” Womack said.

Plus, the more miles driven, the greater chance of an accident. About 90% of ambulance verses deer crashes have occurred in the parish, Womack said.

What’s next?

Walker said the city simply wants to begin to recover its costs for serving the parish. To realistically do that, the cost per month should go to $25,000 or more, Womack said. But in lieu of that, and in deference to the police jury, they settled on the proposed $10,000 per month.

If the city gets the $120,000, that’s still less than some area public-run ambulances are getting.

Jackson Parish gets just over $1 million annually from a dedicated property tax; they have three ambulances. West Carroll Parish gets roughly $663,000 in sales tax revenue to run two ambulances. DeSoto Parish gets $5 million a year in tax dollars. They have six ambulances and are adding another.

Postel said he would not be proposing a tax to garner money for ambulance service. The parish has been talking with private companies.

“We will do everything within our power to make sure high quality ambulance service is provided to every citizen in the parish,” he said.

The police jury’s 2022 budget, approved in December, shows a $60,000 allocation for ambulance services — double the previous $30,000.

The money comes from the interest on the parish’s proceeds from the sale of the Lincoln General Hospital in 1996.

Postel said he expects a decision on whether to pay the city’s increase or opt for other service to come within the next few months.

If the parish refuses the city’s contract, the offer is off the table. Jeopardizing Ruston residents isn’t a choice, Walker said.

“The city of Ruston is responsible for the city of Ruston,” he said.