Whitefish accepts Baker Tilly cost‑of‑service report; consultants recommend large ambulance and fire fee increases

Whitefish — The City Council on May 20 accepted a cost‑of‑service study from Baker Tilly Municipal Advisors that finds the combined annual operating cost for the city’s fire and emergency medical services (EMS) substantially exceeds current service charges and recommends raising many ambulance and select fire fees to reduce general‑fund and levy subsidies.

The study, presented by Steve Scharf, director at Baker Tilly, and Matt Stark, manager for the project, recommended raising several ambulance charges — including advanced life support (ALS) transport rates — and adding new fees for some fire responses, such as gas‑line ruptures and “treat‑no‑transport” evaluations. Councilors accepted the report as presented; council members emphasized that accepting the report is not approval of new rates, which must be set later and require a public hearing.

The report matters because Whitefish’s population and payer mix fluctuate seasonally and the department is funded by a mix of a dedicated property tax levy, charges for service (almost entirely ambulance billing), and general‑fund transfers. Baker Tilly calculated fiscal 2025 operating expenses at roughly $1.5 million for fire and about $2.3 million for EMS. Annual ambulance billings ranged from about $1.5 million to $1.8 million, with net collections historically around 45 percent of billed charges; the consultant used a 35 percent collection target in its recommendations to set “retail” billing rates high enough to increase recovered revenue from private insurers and self‑pay patients.

Key findings and figures from the presentation: - Fiscal 2025 operating expense (excluding spikes for capital purchases): roughly $1.5 million (fire) and $2.3 million (EMS). (Matt Stark, Baker Tilly) - Annual ambulance billing: $1.5M–$1.8M; net collections historically ~45 percent of billed charges; consultant used a 35 percent collection assumption to set recommended rates. - Example per‑call cost calculated by the firm: an illustrative EMS call (two crew members, one hour active, plus standby cost allocation) produced a calculated total cost of about $850; after applying residential levy credits and a 35 percent collection target, the recommended “retail” charge for some transports was roughly $2,400 (nonresident) to make the math work under the consultant’s assumptions. (Matt Stark) - Specific recommended fee moves cited in the presentation: ALS resident transport from approximately $1,250 to about $1,800; nonresident ALS from about $15.50 to $24.30 (figures presented by Baker Tilly as illustrative recommendations); mileage increases (current near $25/road mile) recommended closer to $35/mile; treat‑without‑transport increases were also shown.

“The rates we’re recommending are quite a bit higher,” Matt Stark said during the presentation. “Part of that is to put you in a stronger position in terms of opening negotiations with insurers.” The consultants emphasized that Medicare and Medicaid payments are fixed and unaffected by local charge schedules, so higher retail charges are intended primarily to change the starting point for negotiations with private and out‑of‑area insurers and to raise recoverable revenue from nonfederal payers.

Councilors and some public commenters raised affordability and collection concerns. Resident Tran Seymour, speaking during public comment, said higher billable amounts will disproportionately affect lower‑income and uninsured residents and questioned whether raising retail charges will actually increase net collections from people who cannot pay. The consultants acknowledged those concerns and noted payment plans, itemized supply billing, and policy choices (for example, different handling of private‑pay patients) would be council decisions.

Council action and next steps Councillor (unnamed in transcript) moved to accept the Baker Tilly report as presented; another council member seconded the motion. The council voted to accept the report unanimously. The motion accepted the study for staff use and for future policy work; council members were explicit that accepting the study does not enact any new charges. Staff told the council that any future rate increases would require a separate agenda item and a public hearing before adoption.

What remains unresolved Baker Tilly recommended substantial rate increases based on its cost model and a 35 percent collection assumption; the consultants and councilors agreed the next steps are policy decisions for council — including whether to adopt the consultant’s collection target, how to treat residents vs. nonresidents, whether to itemize supplies on bills (the firm recommended doing so to improve recoveries from federal programs), and potential hardship or charity policies. The council directed staff to use the report to prepare proposals and to schedule public hearings before any rate changes.

Quotes “We’re recommending rates that will hopefully put the city in a stronger position in terms of opening negotiations with insurers,” Matt Stark, manager, Baker Tilly Municipal Advisors, said during the presentation.

The council accepted the report for record and staff use; no fee changes were adopted at the May 20 meeting. Staff and councilors said they will return with rate proposals, public‑hearing notices, and policy options for council consideration.