Middlesex County defends high Land Ambulance costs in upcoming budget

Call volume and operational challenges are the two main factors driving the Land Ambulance budget increases.

So far in 2019, the call volume for the London area is up by 9.5 per cent and the municipality expects that number to increase by 10.3 per cent by the end of the year.

“The fact that call volumes are growing at so fast a rate this year has made it really difficult to predict what the call volume rate will be at the end of the year,” said Middlesex County CAO Bill Rayburn.

Sanctioned and unsanctioned events, increased substance abuse, mental health, and an aging population, are all leading to the higher call volume.

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During their meeting Tuesday, Middlesex County Council broke down the numbers for city councillors, as it’s a price set by the county and shared between the two.

Unlike other services included in the city’s preliminary budget, Land Ambulance is not a fixed cost, it’s a bill the city pays based on two factors.

Based on a 2013 and 2017 agreement between the city and county, 85 per cent of London’s portion is made of a weighted assessment rate, based on property value, and the remaining 15 per cent accounts for call volume.

At a committee meeting last week, London city councillors went over their plans for the city budget for the next four years, with the biggest increase coming from Land Ambulance (Middlesex-London Paramedic Service).

At the time the service projected an increase of 17.3 per cent, compared to the 1.5 the city set a benchmark for all organizations and services.

The jump was an issue for several at the meeting who found the increase to be hard to swallow because of the impact it would have on taxes.

“There are three different factors … impacting the cost for the city,” said Rayburn.

“The first is the allocation of municipal costs which is done by agreement, the second is the provincial contribution, and the third is the Land Ambulance budget.”

When comparing the Middlesex-London Paramedic Services budget to that of other municipalities of similar sizes, the county had the smallest budget, with 2019 being $37,909,354.

The closest county to this number is Essex-Windsor at $45,456,310 and the County of Simcoe coming in the highest at $73,000,000.

The other factors Rayburn singled out are equipment and maintenance. He said the city is experiencing more and more code zeros, when people call and no ambulance is available to help.

Right now, Rayburn is projecting an increase of 15.9 per cent which a drop from what they originally planned for.

“There is so much volatility with these numbers right now it’s impossible for me to tell them what their bill will be in 2019, let alone next year or for the four years after.”