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Hopewell chief proposes raising EMS fees, offers subscription and hardship relief
Summary
Chief Rupert proposed changing EMS billing to a percentage of Medicare allowable (options at 135% or 150%) to fund apparatus purchases, and outlined two relief measures: a household 'Ride Saver' subscription (proposed to rise from $59 to $69) and a hardship discount based on HHS poverty guidelines.
Chief Rupert presented a plan to adjust Hopewell’s emergency medical services (EMS) fee schedule to a percentage of Medicare’s allowable amount and to use the increase to help pay for expensive apparatus and maintenance. At a July council work session, Chief Rupert said the department currently charges below Medicare-allowable amounts and below surrounding jurisdictions, and proposed options tied to Medicare adjustments so fees could be updated automatically.
The proposal included two options: set fees at 135% of Medicare allowable (estimated to generate roughly $26,000 annually) or at 150% (roughly $45,000), with actual revenues to vary by call volume. Rupert said apparatus costs have risen sharply since 2020 — for example, a new ambulance lease payment is projected at about $88,000 annually and new engines about $228,000 each — creating a funding gap the fee change would help address.
Rupert described two citizen relief measures that would accompany the change. First, a household subscription program described in the presentation as 'Ride Saver' (currently $59 per household per year, proposed to increase to $69). Rupert said the subscription covers anyone living at the household address: “if you get a call...we're not gonna bill you for anything.” He added that the subscription lets staff maintain insurance information on file, which helps billing and collections.
Second, he proposed a hardship policy using the U.S. Department of Health and Human Services poverty guidelines. Under the plan, households at or below 100% of the poverty guideline would receive a 100% discount; households at 200% of the guideline would receive a 50% discount; discounts would taper with higher income bands and at 300% the household would be responsible for the full bill. Rupert said the city would still report the full charge to federal reporting systems while showing the discount on the resident account.
Council members asked for clarifications about how self-pay patients and those with insurance would be treated and about how the discount would be applied. Councilor Holloway warned of broader budget pressures, mentioning projected Medicaid cuts, and thanked staff for planning ahead. Councilors expressed support for the relief measures while weighing resident impacts.
The presentation was for council discussion; no ordinance vote occurred during the meeting. The next steps discussed were to refine the ordinance language, confirm program administration details, and return to council with formal ordinance language and implementation procedures.
