Carson City is planning to send between $150,000 and $175,000 to the city's ambulance service.
The ambulance service is supposed to be self-funded but has relied on a taxpayer subsidy since it became a city-operated service in the 1980s.
"This is a battle we go through every year, but that's the nature of the beast," Ambulance Battalion Chief Vincent Pirozzi said. "An ambulance system does not make money. Private business has the ability to choose its business. We have to take every call. We have to recoup as much of the cost as possible. But we don't recoup it all."
This year the city subsidized the ambulance's $1.88 million budget by $175,000, which was used to buy two new ambulances for the aging fleet.
But a decrease in the number of rides and Medicare reimbursement will require an extra $100,000 this year and a labor contract settlement and other items will cost up to $75,000 extra.
The ambulance service predicted a 3 percent increase in business. Instead, rides went down 2 percent, city Finance Director David Heath said.
The unexpected costs will come from the city's contingency fund, Heath said.
"We budgeted $300,000 for contingency expenditures. We will be well over that," Heath said.
He didn't have numbers prepared on how much the city has overspent its contingency fund but said the ambulance subsidy would be covered by about $200,000 in unexpected revenue from motor vehicle privilege and real estate property transfer taxes.
Any money spent now, though, takes money away from the city's 2002 budget.
The numbers were presented last Thursday to city supervisors, who reacted with dismay.
Supervisor Robin Williamson said, "$325,000 is a pretty heafty chunk of change.
"Someone needs to do a review of this," Williamson said. "It's troubling that we subsidize them and say we knew we were going to have to give more. If there's a way to meet the needs of our community and let someone else fight with Medicare, we should look at other options.
"We pay three quarters of a million dollars to provide $50 rides. If that's what the community wants, fine, but somebody has to pay for it and it's the taxpayers."
Supervisors Pete Livermore and Kay Bennett both said while the additional money wasn't desirable, it was probably necessary.
"As much as I don't enjoy paying the subsidy for this, we may have to," Livermore said.
Pirozzi said there was nothing that could be done about unexpected costs and loss of revenue. He said about 75 percent of the ambulance's revenue is fixed by the federal government through Medicare reimbursements.
"We're at the mercy of the what we can collect," Pirozzi said. "We're caught behind the eight ball because our revenues are fixed by the government. We can't raise our prices like the businesses do. We do raise rates every year, but that only affects a small portion of our business. No matter who runs the ambulance they're not going to make money.
"Right now we're doing the best we can do."
Supervisors said perhaps it was time to take another look at how the ambulance is operated and how much city subsidy is too much. Looking at privatizing the ambulance service was a suggestion.
Pirozzi said the city's ambulance department offers the highest level of service possible by keeping an ambulance and its crew in every fire department station. Private business couldn't keep that level of service and make a necessary profit.
He also said it wasn't necessarily fair to say that the city had to subsidize the ambulance service by over $300,000 since the ambulance budget supports about $100,000 of the dispatch center budgets, for example.
