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Folsom adopts higher ambulance transport fees as fire chief lays out staffing, recovery trade-offs
Summary
Council approved Resolution 11646 to raise ambulance transport fees and add an annual inflation factor after a presentation from the fire chief showing a widening funding gap; staff said changes to staffing models could reduce but not eliminate the shortfall.
The Folsom City Council on Tuesday adopted Resolution 11646 to update ambulance transport fees, a move city officials said is aimed at narrowing an ongoing funding gap in emergency medical services.
"Our blended cost recovery rate is 38 percent," Fire Chief Jason Solak told the council, explaining that the city currently recovers about $38 for every $100 billed because of Medicare and Medi‑Cal reimbursement caps and payer mixes. He said the department’s program costs average about $8.75 million a year while current fee revenue totals roughly $6.29 million.
Solak urged the council to approve a new Advanced Life Support base rate of $3,071 and an automatic annual ambulance inflation factor modeled on Medicare updates. He said the recommendation comes from a three‑year average of rising personnel, fuel and maintenance costs and from a fee study designed to reflect today’s service costs.
The chief also described two staffing options. Under the existing firefighter‑paramedic deployment, the city uses 18 firefighters across three ambulances and carries an estimated $2.46 million annual general‑fund gap. A suggested "single‑role" model — replacing firefighter‑paramedics on ambulances with EMTs and paramedics in a different crew mix — would lower personnel costs and reduce the projected gap to roughly $1.95 million, Solak said, noting that the change would not require layoffs if implemented carefully.
"If we implement and continue to make progress ... there’s absolutely zero change to our current employee structure," Solak said when asked whether the proposed model would displace firefighters.
Council members pressed staff on whether closing the gap depended on the staffing change. Solak replied that the staffing revision would allow a smaller fee increase — a projected $972 per transport under the single‑role model versus $1,224 under the current structure — but that fee changes and participation in public provider payment programs (PPG) are both needed.
Council approved the resolution after the public hearing. The measure includes authorization for an annual inflation adjustment and continued participation in state federal funding mechanisms to boost Medi‑Cal reimbursement to the city.
The chief’s presentation included detailed payer‑mix figures: private insurance yields the highest percent of billed charges, while Medicare and Medi‑Cal reimburse at much lower contract rates, a factor that staff said drives the city’s low net recovery.
The council’s action sets the amended fee schedule to take effect as recommended by staff; Solak said the change is projected to reduce the city’s annual subsidy but will not eliminate it entirely.
