July 30, 2008

La Crosse to Go Ahead With Plan to Get into Ambulance Business

By Samantha Marcus, La Crosse Tribune, Wis.

Jul. 30--The ambulance business in La Crosse may soon get more competitive, bringing to a head a public-private battle over who should provide emergency services in the region.

Top elected city and county officials said Tuesday they will simultaneously introduce legislation to create a municipally-run emergency medical service. But "it has a long way to go," La Crosse County Board Chairman Steve Doyle said. "What it really means is that the negotiators for the city and county appear to have a meeting of the minds at this point," he said. "Neither the City Council or County Board has actually agreed on anything."

A deal by the city and county likely would create a tug-of-war for business with Tri-State Ambulance, which is owned by Gundersen Lutheran Medical Center and has vowed not to cede any ground to the city.

"Tri-State will not exit the ambulance business in the city of La Crosse, even if the city enters it," Tri-State officials said in a written comment. "We will compete in a manner that does not compromise the quality of Tri-State's service."

More than a year of mediation has resulted in a proposal that both city and county representatives have agreed on but that Tri-State "still has shown reluctance" to sign on to, La Crosse Mayor Mark Johnsrud said.

Tri-State Director Matt Zavadsky said his compamy was not made aware an agreement was reached.

"Quite frankly, we don't know what the tentative agreement is," he said. "We only know what we've talked about with the county. We don't know what the county has talked about with the city."

Zavadsky said Tri-State hasn't sat at the table with the city for at least six months.

Madison Attorney Howard Bellman, who was brought on more than a year ago to mediate the dispute, said Tuesday he hasn't been a part of the talks for several months.

Johnsrud acknowledged city negotiators haven't had any direct conversations with Tri-State officials in months and instead the county has acted as a go-between.

"Mediation is, I believe, suspended at least -- if not over," Doyle said, adding that in the next couple days the city and county will decide how to go public with details of the proposal.

Johnsrud described it as "enhanced emergency medical services" but declined further comment, except to say "it's more than ambulance service."

Doyle called it a "positive development, not just just for city residents, but countywide."

Tri-State has argued all along that the existing system functions exceptionally well and fragmentation would threaten the quality and affordability of service.

The average charge to a patient for care is about $462, Zavadsky said.

"If something changes in that regional services delivery model, and if, for example, the center is taken out of the donut, the clinical, operational and financial performance of the system will suffer," Zavadsky said.

In 2007, Tri-State's net income was $77,000 on $4.2 million in operating revenues, according to its Web site. Zavadsky said less than 50 percent of what Tri-State bills its customers ever gets collected.

"There's a huge difference between what you actually bill and what you bring in the door," Zavadsky said. "This is a very difficult business."

Samantha Marcus can be reached at (608) 791-8220 or [email protected]


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