Elyria, LifeCare face a turning point

Elyria appears to have little choice but to start subsidizing LifeCare Ambulance to keep the company responding to medical emergencies in the city. Facing financial pressure, LifeCare has asked the city to start paying it $126 each time it goes on a call but doesn't transport a patient, which happened roughly 3,900 times last year. That would have worked out to a little more than $490,000 had the city been responsible for paying LifeCare last year. Yet the city doesn't seem to have any other good options to provide its residents and visitors ambulance service, at least in the short term. LifeCare was the only company to respond to a request for proposals the city put out in 2022. We doubt the city could find another company to replace it before the Jan. 31 deadline LifeCare has set for a new contract to be approved. (The company's contract with Elyria expired at the end of 2023. It has been negotiating with the city since the summer.) And it's not as if the Fire Department could quickly spin up an ambulance service to replace LifeCare, which has been handling that function in Elyria for decades. Although the Fire Department responds to medical calls, it doesn't have the vehicles or the manpower to run an ambulance service right now. Fire Chief Joe Pronesti told us Wednesday that the Fire Department went on about 46 percent of the 8,631 EMS calls that came into Lorain County 911 last year. Firefighters are only sent to certain kinds of medical emergencies, and they don't transport patients. Yes, University Hospitals has said that it could scrounge up some ambulances for firefighters to operate if LifeCare were to cease operating in Elyria. That's a backup plan, we suppose, although it doesn't appear to be a fully formed one. We asked Pronesti what it would take for the Fire Department to take over ambulance service in Elyria. His reply made clear that it wouldn't be easy. "We can't do it with the staffing, and it's a costly venture," he said, adding that the city would need more firefighters than the 71 it has. If the Fire Department did start operating ambulances, Pronesti said, it would be able to recoup the cost of its operations by charging for transporting patients, just as LifeCare does. However, if LifeCare is facing financial difficulties because it gets compensated only when it transports patients, it's fair to wonder if the city would run into the same problem. Even if the city were able to recoup its full costs, it couldn't do so until after EFD started transporting patients. There would be start-up costs associated with taking on ambulance service, including buying ambulances, which can take years to arrive once ordered. Pronesti also told us that the Fire Department and LifeCare had a good working relationship, and he wasn't advocating for EFD to take over ambulance service. That idea was batted around years ago when Holly Brinda was mayor, but it was abandoned once City Council members made clear their opposition. However, Councilwoman Mary Siwierka, D-3rd Ward, told us that LifeCare's push to be paid by the city should prompt another look at EFD taking over ambulance service. (Siwierka was Brinda's safety-service director and is Pronesti's sister, although they said they spoke only for themselves, not each other.) Siwierka said creating a city-run ambulance service wasn't what led her to be the sole vote against the LifeCare contract during a Finance Committee meeting Monday. Rather, she said, her opposition was grounded in the length of the contract. LifeCare pushed for five years, while Siwierka said three years, with extensions if necessary, would be better because the shorter term would give the city a chance to look at other options and reevaluate the contract. (City officials also should keep a close eye on LifeCare to make sure the company is hitting metrics such as proper response times.) When the idea of EFD running ambulances last came up we opposed it, in part because we didn't think it was necessary, given that LifeCare wasn't costing the city anything. However, if the full Council approves the new five-year contract next week, as seems likely, that would no longer be the case. The change in circumstances means the city should explore other options, including investigating whether another company could provide ambulance service more cheaply or even whether the city could take on the responsibility itself. The latter would only make sense, however, if the city could do it less expensively than the roughly $500,000 it would be committing itself to spend propping up LifeCare each year. That's a significant amount of money when city officials have acknowledged the possibility of budget shortfalls in the coming years. The city is running out of time to spend what's left of the approximately $18 million it received under the American Rescue Plan Act, and it still hasn't fully closed the hole the departure of Bendix Commercial Vehicle Systems blew in its revenue stream when the company moved to Avon. The deal with LifeCare might be necessary now, but it will complicate the city's financial outlook for years to come.