Chesterton Fire Chief Mike Orlich has made this pledge.
Should the Town Council act to create a municipal advanced life support (ALS)
ambulance service, and should that service be unable to pay for itself
through the fees charged to patients, then the service will be killed.
“That would be the unfortunate day we would have to discontinue the
service,” Orlich told a roomful of folks on Tuesday, who had come to the
town hall to hear his presentation on the ways and means of a municipal ALS
Orlich opened his presentation with a brief history of ambulance service in
Chesterton. As recently as the early 1980s, there were four ambulances
available in Chesterton to transport patients: two provided by the
county-funded service, two—one an ALS unit, the other a basic life support
unit—provided by a private service. Later in the decade, the private service
closed, leaving the two funded by the county. That county service was
contracted to Porter Memorial Hospital and its successor, Community Health
Orlich’s point: since 1980 the Town of Chesterton’s population has grown by
53 percent—and the CFD’s annual calls have increased by 237 percent,
two-thirds of which are EMS assists—but the number of ambulances serving
Chesterton has remained unchanged.
As it is, Orlich noted, the CFD around 90 percent of the time arrives at the
scene of an EMS assist before Porter Hospital EMS personnel do. That’s not a
slam against the EMS personnel, he said, but an indication of how thinly
stretched those EMS personnel are, tasked to cover the Tri-Towns, Beverly
Shores, and unincorporated Westchester, Liberty, Jackson, and Pine
townships. And when the two ambulances at the barn at East Porter Ave. and
Ind. 49 are both on a call, one of Porter Hospital’s other three units—in
Valparaiso, Union Township, and Hebron—must respond, or else a unit from the
Portage or Valparaiso FD.
The CFD’s ALS service would work and look like this:
•It would be comprised of a single ALS unit staffed and operated 24/7/365.
•It would be a function of the CFD, not a separate municipal department.
•It would require the hiring of four new paramedics, which would bring the
CFD’s total number of paramedics to six. Two would be assigned to each of
the CFD’s three shifts, on 27 hours, off 48, bringing the total number of
CFD personnel on each shift to six: two paramedics, four firefighters.
•The ALS service would be funded not through property taxes but
through user fees based on the level of service provided each call. Basic
life support, $500 per call; ALS1, $700 per call; ALS2, $850 per call. Plus
a mileage fee of $10 per mile, with the average miles traveled per call at
•Based on last year’s calls for service, Orlich calculated that with 40
percent BLS calls and 60 percent ALS—and adding mileage—the CFD would bill
•A 60-percent collection rate would create a revenue of $314,100 (less a
private billing service’s cut). A 67-percent collection rate, a revenue of
•Next, Orlich projected total operational expenses of $284,512, for wages
and benefits, a part-time clerk, fuel, equipment, and supplies.
•A 60-percent collection rate would yield a net revenue—less the private
billing service’s cut—of $29,588. A 67-percent rate, a net revenue of
•The ALS service would need a seed loan from the Town of Chesterton, made
probably in CEDIT funds. That loan would be re-paid over 36 to 48 months but
Orlich is hopeful that the ALS service would begin provide an actual revenue
stream within 60 to 90 days of start-up, tentatively scheduled for April 1.
•All revenues would be deposited into a non-reverting fund for exclusive use
by the ALS service.
•A separate expense would be the ambulances themselves. Orlich wants to
acquire two, a new one and a used one, the latter as a back-up. He estimated
the cost of two new ones—worst-case scenario—at $231,000. But Orlich
believes he can find a new one and used one for less and is exploring a
variety of funding options, including grants and private/public
Orlich then spent some time addressing the concerns voiced by some
•There would be no duplication of services, Orlich said. The CFD has been
responding to EMS assists for years. ALS would be an “enhancement” of a
service which the CFD already provides.
•Residents would not be double-taxed, because the current ambulance service
is not funded through taxes in the first place but—like the CFD’s proposed
service—through user fees. Orlich also noted that the cost of the current
contract which Porter County has with Porter Regional Hospital is not
technically tax-funded either. Rather, he said, it’s funded with proceeds
from the sale of Porter hospital.
•No new fire station or ambulance barn would need to be built. The ALS
service would operate out of the current CFD station, Orlich said.
•Patients would have their choice of where the CFD transports them, except
in the case of a life-threatening medical crisis, in which case the CFD
would be legally obligated to transport the patient to the closest
•Orlich emphasized, again, that the ALS service would be provided through
the CFD, not through another, new, department.
•And he said that the CFD is not “pushing this project as fast as we can.”
Rather, the CFD began exploring the feasibility of an ALS service in the
summer of 2010 and made a report to the Town Council in the summer of 2011.
The Chesterton Tribune covered that presentation.
Orlich also listed the advantages of a municipal ALS service.
•There would be a “quicker responses” to medical emergencies in town, given
the fact that the CFD typically already arrives at the scene before Porter
Hospital EMS personnel do.
•All paramedics would be cross-trained as firefighters, giving the CFD more
manpower at fire and other scenes not requiring an ALS response. That could
have a beneficial impact on the CFD’s ISO rating, which aids insurance
companies in setting home insurance premiums.
•Most important, Orlich said, a municipal ALS service would improve the
chances of a person’s surviving a medical crisis, because he or she would be
treated more quickly.
Orlich then took
questions from the audience.
If user fees
work, one person wanted to know, why is Porter County subsidizing Porter
Regional Hospital’s ambulance service?
“I can’t answer
that,” Orlich said but he did acknowledge that the county is subsidizing the
hospital’s service with the proceeds from the hospital sale.
What would the
CFD do in the event of two medical calls at the same time?
The CFD would do
what Porter Regional Hospital does now: call for back-up from one of the
other three units or from the Valparaiso or Portage FDs, Orlich said.
To what extent
would a private billing service cut into the CFD’s revenue stream?
unable to give an exact answer. Some firms take a cut off the top of what’s
collected, other a percentage, 3 to 5 percent. At this point Orlich noted
that, if the ALS service proves financially unfeasible, it will not be
continued. “We’re not going to do anything that doesn’t work,” he promised.
change in any way?
It will not,
Orlich said. All calls will be dispatched through the county 911 center.
If the current
system is working, why change it?
Hospital’s EMS personnel serve nearly all of North Porter County, with just
two ambulances. “They don’t serve just Chesterton,” Orlich said. “And
sometime the local units are tied up.”
The question was
raised again, what will happen if the CFD’s projections are wrong, if there
isn’t a sufficient revenue stream to support a municipal ALS service?
“I don’t feel
it’s a likely possibility,” Orlich said and noted that the CFD’s projected
collection rate—in any case, a conservative projection—is based on the rates
experienced by other regional fire departments.
“It’s all guess
work,” a man replied. “You can’t be sure. You can’t go by other departments.
You have to go by what you got here.”
by saying that the CFD is modeling other FDs’ collection rates but that all
other numbers are based on the CFD own calls, in the Town of Chesterton.
happen, though, the question was asked once more, at the end, if the money
just isn’t there.
Then the service
will be dissolved and the equipment put on the market, Orlich said.