Carmel committee approves amendment to ambulance capital fund, supports lift‑assist fee and billing change

The Carmel Finance, Utilities, Rules & Safety Committee on May 28 voted to send ordinance D‑2767‑25, an amendment to the ambulance capital fund, to the full City Council with a positive recommendation after hearing the fire chief describe changes to billing and a proposed lift‑assist fee for congregate care facilities.

Fire Chief Joel Thacker told the committee the ordinance corrects language and renames the fund to reflect that EMS revenue supports capital costs for both fire and EMS equipment. Chief Thacker said a 2024 state law change allows the city to bill up to 400% of Medicare and Medicaid rates for ambulance services; that change affects commercial insurance reimbursement and could increase fund revenue from commercial payers.

Chief Thacker said the department proposes a $500 lift‑assist fee to be charged when crews respond to extended‑care, supportive living, nursing home or similar congregate facilities for non‑injury “lift assists” — incidents in which a resident has fallen but requires no transport. He said Carmel averages about 10 such facility lift assists per month and that private‑dwelling lift assists, by contrast, are handled differently: the department responds to roughly 1,000 fall‑related calls in private dwellings annually and would not bill residents for those responses when care or transport is required.

To limit resident exposure, Chief Thacker said Carmel residents would be capped at $800 out‑of‑pocket for any difference passed through by commercial insurance. He acknowledged the city could not guarantee facilities would not pass fees on to residents but said the intent is to incentivize facilities to provide better fall‑prevention training and resident assistance.

Committee members asked whether facilities could be required to participate in fall‑prevention programs if violations recur; Chief Thacker said the department could explore requiring program enrollment for repeat offenders. Councilor Royal said he had investigated with providers and insurance and said he supported the proposal; Councilor Lott asked legal staff about the legal validity of differential fees for in‑city and out‑of‑city residents, and City Attorney Benjamin Lake said such resident/nonresident distinctions have been used elsewhere in Indiana and rest on the logic that city taxpayers subsidize operations.

The committee voted to approve the ordinance and its amendments and to forward it to the full council with a positive recommendation.

Ending note: Chief Thacker said the fee structure and continued fall‑prevention outreach to facilities aim to reduce calls for non‑emergency lift assists and grow a sustainable capital fund for ambulance equipment.