Ambulance charges may dramatically increase

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RAA board, has advised the council that the contingency funds would be available, if needed, to offset inflationary pressures on RAA.

The contingent nature of the item, though, sends a clear message from the administration to RAA that a failure to follow the recommendation to generate more revenue could have financial consequences.

The higher cost for transport and the new charge for medical services are among the recommendations for RAA improvement that have emerged from a report a Washington-based consulting firm, the Robert Bobb Group, led by a former Richmond city manager.

The report was formally presented to the council at a meeting that followed the mayor’s budget presentation.

Mr. Bobb was involved in the creation of RAA as a public utility in 1991 during his tenure as the city’s top executive. He advocated for the RAA’s development as the antidote to rising public dissatisfaction with private ambulance companies’ responses to heart attacks, gunshot wounds and other emergencies.

The RAA through the years has secured recognition nationally and internationally for its work, garnered 95 to 99 percent approval ratings from residents it serves and become one of the few ambulance services accredited by the two major standard-setting agencies.

The city always has provided a subsidy to the RAA to fill the financial gap between the cost of service and the revenue collected, but now appears determined to either hold the amount steady or to reduce it.

Since the 2021-22 fiscal year, the subsidy has been set at $4 million, even as RAA has argued it needs a higher amount to fully cover costs.

During budget deliberations in 2022, the Stoney administration cut a deal with the RAA to enable the city to cut its subsidy from a previous $5 million a year to $4 million.

Under the deal, the city agreed to buy 14 replacement ambulances over two years for $3.5 million. In exchange, the RAA agreed to shift $3.5 million it had saved to buy ambulances to support operations.

In the 2023-2024 budget proposal, the administration has proposed to keep the subsidy at $4 million, but did not offer to continue to buy ambulances for RAA. Instead, the administration is looking to RAA to generate more revenue by increasing the charge for transport and adding a new charge for medical services. Even if the RAA complies, it remains unclear how much new money might be collected.

RAA receives about 56,000 calls a year for service, but only 70 percent or 39,000 result in billable transports.

Payments often fall below the RAA’s full charge, according to the Bobb Group’s report.

The report found that 63 percent of the revenue RAA received from transports in 2021 came from government insurance programs, Medicare and Medicaid, which pay less than RAA’s retail rate of $600. Medicare pays $300 to $500 per trip, depending on the level of service, while Medicare, a federal-state program, pays $175 per transport, a report shows.

Private insurers generate only about 14 percent of RAA’s report. Most insurers set a certain amount in their policies to cover ambulance service, leaving policy holders to make up any difference between the coverage amount and the billed charge.

It is unknown whether insurance companies would agree to increase their coverage amount and how much higher they might go if RAA raises its rate.

The annual financial reports that RAA submits to the city reflect the reality that billable amounts are not the same as collected revenue.

In 2021, RAA billed $28.1 million for transport services, but collected $14.9 million after contractual adjustments and writeoffs of uncollectable charges, the financial report states.

In 2022, RAA billed $25 million, but collected $13.5 million after adjustments, the report states. Council members did not object or express any dismay about the increase in charges the Bobb Group recommended and that the administration supports, including 8th District Councilwoman Reva M. Trammell, chair of council’s Public Safety Committee. For now, there is only a question mark as to whether the rate changes will go into effect.

Helen Harris, a leading voice, remembered

Continued from A1 lawsuit in the late 1980s. That suit led to the county’s division into districts and the 1995 election of Mr. Thornton as the first Black member of the county’s governing body, the board of supervisors, of which he continues to be a member and currently is board chairman.

Mrs. Harris’ push to get the county to “address the lack of diversity in Henrico’s workforce in the late 1980s also left a profound and lasting impact,” the two men noted. “As a result, the percentage of minority employees has nearly doubled and the number of minorities holding leadership positions has grown exponentially.”

In later years, Mrs. Harris served on the county’s Board of Real Estate Review and Equalization, and on the county’s Board of Zoning Appeals, which she twice chaired.

“No matter in what position she held or in which area she served, Ms. Harris was ready to uplift her community,” the letter continued.

The daughter of the Rev. Andrew Clay and Helen Virginia Christian-Epps, Mrs. Harris grew up in Richmond. Along with being cheerleader at Armstrong High School and a member of Ebenezer Baptist Church’s

Girl Scout troop, Mrs. Harris became, at 16, the youngest person to pass the state’s real estate exam and become a licensed agent in her father’s real estate firm.

After graduation, she began her education career after graduating from Virginia Union University in 1961, later taking graduate courses at Virginia Commonwealth University.

After brief stints of teaching in Atlanta and at the Smith-Madden Business College in Richmond, she joined the Armstrong faculty where she taught for 31 years before her retirement in 1994.

Her family said she was known for her tenacious and passionate teaching style and the high expectations she set for students. “Do it right or don’t do it at all” was among her favorite sayings. She was recognized with Teacher of the Year and Vocational Teacher of the Year awards during her tenure. She later became the organizer and facilitator of the Save Our Public Schools organization in Henrico.

Mrs. Harris also founded Girl Scout troops at an Atlanta church and at Cedar Street Baptist Church of God, to which she belonged before she moved to Henrico and became a member of St. Peter Baptist.

She taught in St. Peter’s Vacation Bible

School, led classes for new members and also served as a deacon.

Her family said she created a ministry of “love taps” through which she called, sent cards, emailed and took other steps in seeking to maintain connections with members.

She also served for two years as director of healing for Great Commission Outreach Ministries in Richmond and also daily offered prayers for those she listed in her prayer book.

Mrs. Harris was a member of Delta Sigma Theta Sorority and Women of Wisdom Pinochle Club.

On any given night she could be found watching her favorite NBA team, college basketball team or NFL teams and comparing and reviewing plays with her grandsons.

She was a regular at VUU football and basketball games, as well.

Mrs. Harris earned family renown for her home cooking, scratch biscuits and fried chicken.

Her husband, Charles E. Harris, predeceased her.

Survivors include her two children, Alaine H. Jackson and Dr. Emanuel C. Harris; her brother, Andrew C. Epps III; five grandchildren and a great-grandson.