EMS Review Committee: Cost to start Elyria EMS program likely higher than study estimated

As Elyria gets deeper into conversations about the prospect of bringing ambulance services into the Elyria Fire Department, it appears that the cost may be higher than initially anticipated. Following a study last year that said the city could potentially profit from bringing the service in-house, Elyria City Council formed the EMS Review Committee, an advisory panel made up of city officials and residents, to review the concept and make a recommendation to Council. Elyria's emergency medical services are currently provided by LifeCare Ambulance. The company does not charge the city for transporting residents to the hospital, but it does charge $126 for each medical call it goes on wherein it does not transport a patient, because there is no way for it to collect payment for such calls. Per the city's contract with LifeCare, its payments to the company are capped at $400,000 and in the first two years of the contract Elyria paid just over $300,000 and just over $350,000. The contract runs through 2028 and will be extended by an additional year if it is not terminated by either party. At its second-ever meeting last week, members of the EMS Review Committee expressed concerns about the potential cost of the proposal to end that contract and move EMS service to the fire department. In 2025, Fitch and Associates of Chagrin Falls performed an EMS feasibility study for the city, reporting that Elyria could add emergency medical service to its fire department for roughly $3 million and expect to generate about $1.2 million of revenue a year. At the committee meeting last Thursday, Safety Service Director Chris Pyanowski said that cost estimate probably was too low, as it did not account for architectural work that would need to be performed on city facilities to make the EMS program possible. Fire Chief Joe Vargo estimated that purchasing and outfitting five ambulances alone would cost around $2.5 million, not accounting for any new personnel or architectural work. City officials are still working to nail down a more precise estimate of the total investment that would be required. In response to questions posed by the committee in its inaugural meeting last month, Vargo said he spoke with chiefs of other departments across Ohio that had added EMS service. In a letter sent to the committee, Vargo said that the closest comparison was Steubenville, which added EMS service in 2021 after the private company that had previously provided the service left. Vargo said that though Steubenville is significantly smaller geographically — 11 square miles as opposed to Elyria's more than 20 square miles — it had a similar enough population and call volume to be informative. Steubenville does not require a levy to operate its EMS service, but Vargo said that the city was only able to start the program in the first place due to the use of $10 million of COVID-era American Rescue Plan Act funding. Both Vargo and Pyanowski said that the fire department does not currently have the money in its budget to launch the EMS program, and that the city has no intention of seeking a levy or tax increase to generate that money. Difficulty in collecting payment for services is common across the EMS industry, and Vargo said that Steubenville collects payment on only 35 percent of the ambulance bills it sends out. This means that for every $100 the city bills a resident or their insurance, it receives just $35. "From a business standpoint, how can you make money when you are only getting $35 on every $100 you invest," asked committee Vice Chair Larry Klipstein, a resident. "That doesn't make sense to me, that seems like you are always losing money every time you go pick someone up." Vargo said he would seek further clarification from Steubenville, but emphasized that the money it collects is enough to cover the operation of its EMS program. He added that LifeCare told the city it collects on only about 25 percent of its bills, and it is able to operate as a for-profit company, so the Elyria would clearly not need to collect on all its billed costs to run a program. "It sounds to me that we could expect, give or take, that our likelihood of success in collections would be more or less what a private entity would be doing," Law Director Amanda Deery, who is on the committee, said. "That is what Steubenville has found since they went from private to doing it in-house… The money left on the table is about the same as what the private entity is doing there." Contact Owen MacMillan at (440) 329-7123 or omacmillan@chroniclet.com.