Wilmington considering $3.5 million subsidy plan for EMS services

Wilmington is considering providing subsidies to St. Francis Hospital for EMS services.

The Wilmington City Council discussed a proposal Monday night to contract with St. Francis Hospital to subsidize emergency ambulance service through 2024.

The service mostly is used by the most vulnerable residents of the city, according to St. Francis. It had about 20,000 EMS runs in Wilmington in 2023. 

In the council’s Joint Finance & Economic Development and Public Safety Committee meeting Monday night, the details of the contract were explained.

Background of the problem

Under the deal, Wilmington would pay St. Francis, which is part of the Trinity Health Mid-Atlantic network, up to $3.5 million this year to subsidize the hospital’s costs for emergency transports.

This comes after Wilmington Mayor Mike Purzycki announced the city is faced with a potential crisis about emergency ambulance service, which had always been provided to the city without cost by St. Francis Hospital. 

Faced with severe financial difficulties, St. Francis told the city in late 2023 that it would not be able to provide ambulance services in 2024.

The St. Francis EMS program was available without cost to the city because people who were transported to the hospital were billed by St. Francis for employee and equipment costs through the health insurance program. 

St. Francis said the billing process was no longer covering the true cost of the service.

In recent weeks, the city administration and St. Francis explored alternative funding options to keep the ambulances running for at least another year. 

Purzycki said the city also considered having the Wilmington Fire Department add an EMS unit, which is still a possibility.

The city also issued a request for proposals to see if another ambulance service could take over from St. Francis, but the only bidder was St. Francis for $3.5 million. 

The most feasible solution, Purzycki has said, is to enable the city to spend up the $3.5 million. 

His office is asking the city council to approve a $3.5 million budget amendment that will be funded from the city’s budget reserve. 

Monday’s discussion

“One of the challenges that we have with providing the services is 56% of the folks that we pick up either are self pay, which do not end up paying for the service, or our Medicaid managed care recipients, which are very low paying insurance, less than $20 per run,” said Scott Bundek, EMS Chief at St. Francis Hospital.

He said the majority of residents that use their services are the most vulnerable in society.

“So we’ve tried to manage that the best we can through the last few years but no matter what we do, it just doesn’t seem like we’re able to not come to council or have a proposal that isn’t zero bid as we have in the past,” he said. 

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It’s critical the city ensures there is no interruption in service, so it has to move fast, said John Looney, chief of the Wilmington Fire Department. 

Bundek told the committee that St. Francis had a net loss of $9 million dollars for the entirety of its most-recent four-year contract.

“It represents just the direct cost of salaries, supplies, fuel, maintenance, the vehicles,” he said.

District 7 Councilman Chris Johnson, chair of the Finance Committee, said it would be helpful to know the price per ambulance run before the council adjusts its budget.

Johnson also wanted to know if the subsidies could be less than $3.5 million. The answer was no.

“It would have to be for a reduced term rather than for a year, if it’s any less than that,” Bundek said. 

St. Francis would not be open to a six-month contract, its chief of staff stated.

District 3 Councilwoman Zanthia Oliver, vice chair of the Public Safety Committee, suggested requesting funding from the governor or New Castle County in the future. 

“It seems like we’re in between a rock and a hard place, and that if we want EMS services to continue, we need to continue this contract with St. Francis,” said at-large councilman James Spadola. 

The ordinance is expected to be revisited and voted on in the full-body council meeting on Thursday, Jan. 18 at 6:30 p.m. Watch that meeting here.

Jarek Rutz

Raised in Doylestown, Pennsylvania, Jarek earned a B.A. in journalism and a B.A. in political science from Temple University in 2021. After running CNN’s Michael Smerconish’s YouTube channel, Jarek became a reporter for the Bucks County Herald before joining Delaware LIVE News.

Jarek can be reached by email at [email protected] or by phone at (215) 450-9982. Follow him on Twitter @jarekrutz