Council postpones ambulance contract votes after heated debate over billing and bills to residents

Detroit City Council postponed votes on three ambulance-service contracts after a lengthy discussion about how ambulance providers bill for calls and whether residents — particularly seniors on fixed incomes — are unfairly pursued for unpaid balances.

Council members raised the issue during consideration of several procurement items from the Office of Contracting and Procurement (items 22.5–22.9). The items included extensions for transit and emergency medical services; council approved some items but moved to defer votes on three ambulance contracts (22.6–22.8) for one week to allow staff to supply more information and options.

The concern, voiced most strongly by Councilmember Angela Whitfield Callaway, centered on a practice she described as “triple-dipping”: the city pays ambulance companies to be on standby under multi-year contracts, the companies bill private insurers or Medicare/Medicaid for transports, and — when insurers do not fully pay — companies sometimes pursue residents directly or turn unpaid balances over to collections. “If we have a senior citizen…call an ambulance, we’re paying you to do this because you’re on standby. Then you’re collecting from the city, then you turn around billing the insurance company, and then you go after the seniors personally,” Callaway said, pressing the fire department for changes to the practice.

Deputy Fire Commissioner Derek Hillman acknowledged the council’s concerns and described the current practice as standard industry procedure. He said contractors are retained to guarantee response capacity and that the department bills insurers for services rendered. Hillman told the council that hardship policies exist for individual residents and said the department will assist residents who meet those criteria. “The current practice of billing is standard throughout the industry,” Hillman said. “They’re standing by and we’re paying for the dedication of those units.”

Council members said they want a data-driven review. They asked for a written memo explaining how the city set billing rates, which cities were used as comparables, whether fire-escrow or other local funds could be used to reduce or eliminate resident liability, and how hardship claims are handled. The motion to prepare that memo passed.

The council formally postponed votes on the three ambulance-service contract items (22.6–22.8) for one week to permit staff from the fire department, the Office of Contracting and Procurement and the budget office to provide answers. Council approved related line items where waivers were requested and where members determined immediate approval was appropriate.

Next steps: staff will prepare the requested memo and return to council before the postponed vote date so members can decide whether to require contract language changes or alternative payment arrangements before final approval.