December 17, 2014

Elyria
Cloudy
28°F
test

Audit raises questions about LifeCare’s future in Elyria

The very first recommendation state auditors posed regarding Elyria safety forces in its comprehensive audit released Thursday was less of a recommendation and more of a statement: The city needs to decide how emergency medical services are to be provided in the city.

And so the future of the Elyria Fire Department is in the spotlight again.

The department has been the most-talked about city department in recent years as city officials grappled to find ways to staff it with dwindling revenue and debated its role when it comes to emergencies in relation to the work that LifeCare Ambulance Inc. provides.

And, despite a city-commissioned report in 2009 written by the McGrath Consulting Group that recommended keeping emergency response status quo with LifeCare because it was cost efficient and care wouldn’t improve if changed, Mayor Holly Brinda said addressing EMS in the city is a valid question that still needs to be answered.

She very pointedly asked the auditors to examine EMS in the city as a part of the scope of the audit.

“The whole situation with LifeCare at the very least needs to be revisited,” Brinda said Thursday shortly after the state Auditor’s Office released the 112-page document compiled over the better part of a year.

Brinda said many factors make the issue relevant, including that the Fire Department is poised to lose 23 firefighters next year when a federal grant expires, more than 70 percent of the calls for service the city responses to are EMS calls, and the contract the city has with LifeCare dates back to 1996 and has never been updated.

The contract was signed by former Mayor Michael B. Keys and his administrative assistant, Mary Siwierka, who now is Brinda’s safety-service director.

Brinda readily admits the final decision does not rest with her. Instead, City Council members will have to make the call after exploring the four possible options the audit lays out:

  • Continue with private EMS with a new contract.
  • Provide EMS through the Fire Department.
  • Create separate EMS and Fire departments.
  • Abandon EMS all together from a city standpoint, including serving as first responders.

But some Council members aren’t eager to dive into that debate again.

The depth of information concerning EMS in the audit, which cost the city $119,000, raised some eyebrows, particularly since the McGrath report wasn’t used as a resource by the auditors.

“I was definitely surprised to see the issue revitalized in the audit that was just released,” said Councilman Marcus Madison, D-5th Ward. “When the McGrath report came out, at that point I thought the conversation was over.”

Councilman Tom Callahan, D-at large, said he knew the matter was not dead when he went to a prerelease conference with auditors last month.

“When I had my meeting with the auditors, I asked some questions related to EMS, and they indicated to me that they spent more time on the EMS angle than any other topic or department they looked at,” he said.

The state audit offers some direction for the city, although it stops short of giving a direct recommendation.

First, if the city decides to renegotiate the EMS contract, the audit calls on city officials to add some cost-recovery caveats to the document.

Creating such a revenue stream would be a first for the city and is not being looked at favorably by LifeCare.

“They should check the fire trucks because a lot of the supplies they are using are our supplies,” said Herb de la Porte, vice president of LifeCare.

Additionally, de la Porte said Elyria could cut down on wear and tear on fire trucks if it stops responding to nearly 90 percent of all EMS calls.

“We need them on maybe 100 calls a year,” he said. “We need them when there is a risk of danger to our crew or when a patient needs to be rescued or extricated. We can handle everything else.”

In 2011, the Fire Department responded to a total of 267 fire calls and 2,190 EMS calls. The average response time according to the audit was 6 minutes and 33 seconds.

LifeCare records indicate its response time for EMS calls averages out at 6 minutes and 5 seconds from the time a call is made to 911 to the time an ambulance arrives at an emergency.

In Lorain, where LifeCare handles all EMS calls and the Fire Department does not serve as first responders, the average EMS response time is 6 minutes and 52 seconds.

While the McGrath report is four years old, many saw it as a very comprehensive look at the Fire Department and the city’s relationship with LifeCare.

The McGrath report said, “It is hard for the consultants to justify replacing a private ambulance company that appears to provide excellent service, and for the city to take on a significant expense when currently they are receiving these services for free. The consultants do not believe that service delivery to patients would improve if the Fire Department took over emergency transports.”

State Auditor Dave Yost said auditors did not reach the same conclusion because they could not accept the McGrath report as accurate.

The biggest piece of the data puzzle Yost said auditors could not verify was LifeCare data. As a private company, it is not subject to public records laws.

However, Pete de la Porte said no attempt was ever made to get the information.

“When McGrath was writing its report, we worked with them very well,” he said. “They spent the entire day here and we gave them all the information they wanted.”

LifeCare’s Chief Financial Officer David Richards said the notion that LifeCare would not provide information discounts how the company’s sees its role in the community.

“We are a private company that serves a public trust,” he said. “We gain nothing by hiding information. We are not going to hide things that could erode the public trust.”

Councilwoman Donna Mitchell, D-6th Ward, doesn’t think this is the time to revisit the issue.

“But ultimately it’s what the citizens of Elyria think of the audit when they read it for themselves,’’ she said.

Mitchell said she questions the state’s audit because it left LifeCare out but gave estimates on how much money the city could make if it took over the service. Based on comparisons with peer cities, the audit said Elyria could potentially generate $852,672 in revenue for EMS response and transport.

Contact Lisa Roberson at 329-7121 or lroberson@chroniclet.com.