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Hospitals' ambulance tab too high, Pinellas says

The county says it hasn't been paid $1.28-million and may sue, yet it continues to transport patients from the hospitals to mental facilities.


© St. Petersburg Times, published June 1, 2001

The county says it hasn't been paid $1.28-million and may sue, yet it continues to transport patients from the hospitals to mental facilities.

CLEARWATER -- Five of the area's biggest hospitals owe Pinellas County $1.28-million for ambulance service charges that have gone unpaid since 1996, according to county officials.

To recoup the money, attorneys for the county will ask county commissioners Tuesday for permission to sue Bayfront Medical Center and St. Anthony's Hospital in St. Petersburg, along with Morton Plant Mease Health Care, which includes Morton Plant Hospital in Clearwater, Mease Dunedin Hospital in Dunedin and Mease Countryside Hospital in Safety Harbor.

"We've attempted to have discussions with them, meetings with them to get them to respond," said Julie Scales, senior assistant county attorney. "Because those have not been successful, that is why we've decided to file suit."

Despite non-payment, Pinellas County continues to transport patients from the hospitals to mental facilities. The patients have been involuntarily committed for psychiatric evaluation under Florida's Baker Act and are taken by a Sunstar ambulance from the hospital to the mental health facility, in most cases PEMHS, or Personal Enrichment through Mental Health Services, in Pinellas Park.

In 1996, state law required the hospitals to pay ambulances fees, which are $355.90 per trip, plus $8.60 per mile. Bills average between $400 and $425.

County officials say that, except for these five, the other hospitals that use the ambulances have paid their bills.

"We have made an enormous effort over an awfully long period of time trying to get this worked out," said Chuck Kearns, director of Pinellas County EMS and Fire Administration.

The county did not notify the hospitals of the bills until 1999, said Amy Lovett, a spokeswoman for BayCare Health Systems. Lovett, who spoke on behalf of St. Anthony's and the Morton Plant Mease hospitals, said they have been negotiating a solution ever since.

"We've been working with the county, trying to come up with a more appropriate and cost-effective way to provide the transportation," Lovett said. "What we've been trying to do is come up with a way that a transport could be in the $85 range, rather than the $350 range."

The hospitals declined to comment about whether they agree with the dollar amount that the county says is owed.

"I don't think anyone wants to speculate on that," said Stan Blakey, a spokesman for Morton Plant Mease Health Care, which belongs to BayCare. "Obviously, there is an issue here, and the parties are working on resolving the issue."

In September 2000, Morton Plant Mease Health Care paid $26,000 toward the bills owed by its three hospitals, county records show. But the hospitals still owe $195,000.

Bayfront Medical Center racked up much of what it owes the county while the hospital was part of the BayCare network. The hospital left BayCare in December. This week, Bayfront officials said they had not heard from the county about the bill.

"This appears to be something BayCare was handling," said hospital spokesman Bill Hervey. "We haven't had any direct contact with the county on this issue. We plan to follow up with the county to figure this out."

The problem was detected during a routine audit after Kearns joined the county in 1997. Kearns said he and his staff tried to work with the hospitals to get the back money. When that didn't work, Kearns put them on notice with a letter that went out Sept. 23, 1999. At that point, the five hospitals owed $686,500.

"There has not been cooperation in paying anything since they got the notice," Scales said. "They have not paid either before or after getting the notice."

Earlier this year, it appeared the issue would be resolved. The county offered to settle the matter if the hospitals paid a total of $385,900. The county would have written off $815,000. In a February letter to the county, BayCare president Frank Murphy indicated someone on his staff would contact the county "to make sure that all past due bills are paid."

But nothing ever came of the settlement offer, Scales said.

"Communication has been difficult all along," Scales said. "It's hard not to see that as a pretty fair deal."

Every year, the county writes off about $12-million for ambulance services provided to the poor, those without insurance and Medicaid and Medicare recipients. There are no tax dollars earmarked for ambulance service; it pays for itself through user fees.

Kearns said using ambulances is not the most cost-effective way to transport Baker Act patients. The county is planning to bring online a transport van that will cost $85 per ride, significantly less than the average $400 charged now. Kearns said he hopes to have the van in operation this summer.

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