Title
Resolution to Approve Fees for the Fire Department Ambulance Transport with Advanced Life Support (8 Votes Required)
Memorandum
At the July 6, 2026 City Council meeting, a two-year Advanced Life Support (ALS) ambulance services contract was approved with Huron Valley Ambulance (HVA) (R-26-264). The Ann Arbor Fire Department (AAFD) ambulances are licensed as Basic Life Support (BLS) ambulances and are staffed by Emergency Medical Technicians (EMTs). The contract between the City and HVA provides for Advanced Life Support ambulances staffed by paramedics.
Paramedics provide a higher level of pre-hospital medical care than EMTs and are authorized to perform advanced medical procedures, including starting intravenous (IV) lines, cardiac monitoring, advanced airway procedures, and administering medications beyond the scope of EMT licensure. For patients experiencing critical medical conditions, such as cardiac emergencies, paramedics are able to provide a higher level of care.
Often, an AAFD ambulance arrives on scene before the HVA ALS ambulance. Due to weather or other environmental factors, AAFD personnel may quickly load the patient into the AAFD ambulance. This provides the patient with privacy and creates a controlled environment for patient assessment and treatment. When the HVA paramedic arrives, they transfer their cardiac monitor and other necessary equipment to the AAFD ambulance. The AAFD ambulance then transports the patient and HVA paramedic to the hospital. This allows the HVA paramedic to provide advanced life support care during transport. This process is commonly referred to within the emergency medical services industry as an “ALS intercept.”
Due to insurance and ambulance billing requirements, only the agency that performs the patient transport can invoice the patient for the transport. Therefore, AAFD must invoice the patient for the ALS care provided by the HVA paramedic. This is a standard circumstance encountered in similar pre-hospital emergency medical service systems.
For calendar year 2027, HVA will charge the City $200.00 per ALS intercept, increasing to $210.00 per ALS intercept in calendar year 2028. The City must establish an ALS intercept rate in order for AAFD to invoice the patient for the higher level of care provided. The below rates include our approved BLS rates with the addition of this ALS service.
Proposed ALS rates - Medicare Fee Schedule
ALS emergent $1,106.33
ALS non-emergent $1,106.33
ALS 2 $1,106.33
Budget/Fiscal Impact: There are no budget impacts other than this fee adjustment.
Staff
Prepared by: Mike Kennedy, Fire Chief
Reviewed by: Kim Buselmeier, Financial Manager
Approved by: Milton Dohoney Jr., City Administrator
Body
Whereas, On July 6, 2026, the Ann Arbor City Council approved a two-year Advanced Life Support (ALS) ambulance services contract with Huron Valley Ambulance (HVA);
Whereas, The Ann Arbor Fire Department (AAFD) operates ambulances licensed at the Basic Life Support (BLS) level and staffed by Emergency Medical Technicians (EMTs);
Whereas, HVA provides ALS ambulance services staffed by paramedics, who are licensed to provide a higher level of pre-hospital medical care than EMTs, including intravenous therapy, cardiac monitoring, advanced airway management, and administration of medications;
Whereas, ALS care is necessary for patients experiencing certain critical medical conditions, including cardiac emergencies and other life-threatening medical conditions requiring advanced medical intervention;
Whereas, AAFD BLS ambulances frequently arrive at emergency medical incidents before an HVA ALS ambulance and may transport the patient into the AAFD ambulance to provide a controlled environment for patient assessment and treatment, including privacy and protection from weather or other environmental conditions;
Whereas, When an HVA paramedic arrives at the scene, the paramedic may transfer the necessary ALS equipment, including a cardiac monitor, to the AAFD ambulance and accompany the patient during transport to the hospital;
Whereas, This practice, commonly referred to within the emergency medical services industry as an ALS intercept, allows the HVA paramedic to provide ALS-level medical care while the AAFD BLS ambulance provides transportation to the hospital;
Whereas, Under applicable insurance and ambulance billing requirements, the agency that performs the patient transport is responsible for billing the patient for the ambulance transport and associated services;
Whereas, As a result, when an HVA paramedic provides ALS care during an AAFD ambulance transport, AAFD must establish and invoice the applicable ALS intercept charge to recover the cost of the ALS service provided by HVA;
Whereas, Under the City's ALS ambulance services contract with HVA, HVA will charge the City $200.00 per ALS intercept in calendar year 2027;
Whereas, The City must establish an ALS intercept rate in order for AAFD to appropriately bill for the higher level of medical care provided during an ALS intercept; and
Whereas, Establishing an ALS intercept rate will allow the City to recover the cost of ALS services provided by HVA without requiring the City to absorb the cost of those services when an AAFD BLS ambulance performs the patient transport;
RESOLVED, That City Council adopts the Medicare Fee Schedule of $1,106.33 for ALS transports by the Ann Arbor Fire Department;
RESOLVED, That all fees herein are effective January 1, 2027; and
RESOLVED, That City Council authorize the City Administrator to take necessary administrative actions to implement this resolution.