Budget relies on $163M in extra ambulance reimbursement money

Mayor Lori Lightfoot’s 2020 budget plan contained an eyeopening item when she unveiled it last week: $163 million in additional reimbursements from the state to cover the cost of city ambulance services.

Now, Gov. J.B. Pritzker’s office says federal authorities have yet to inform the state they’ve approved their portion of that payment, one of the largest parts of Lightfoot’s plan to close an $838 million shortfall without resorting to a massive property tax hike.

Following Lightfoot’s Wednesday

budget speech, Pritzker spokeswoman Jordan Abudayyeh released a statement saying the ambulance money is “federal funds that could be used to increase reimbursement rates for local ambulance services, based on cities’ actual spending.”

“We are waiting for confirmation from the federal government that they will authorize this reimbursement,” Abudayyeh said.

The ambulance payments represent an effort by the city and state to collect the correct amount of money from insurance providers and the federal government to cover the cost of the more than 100,000 ambulance runs the Chicago Fire

Department makes each year.

According to city Comptroller Reshma Soni, the state sent notice earlier this year to municipalities and other government units all over Illinois that operate ambulance fleets to update their numbers. Chicago has for years been billing only $900 per ambulance trip, when the actual cost to the city is around $2,500, Soni said.

“So this is an effort we undertook with the cooperation of the state to make sure we were getting reimbursed the correct amount,” Soni said.

The city expects to be able to collect at the higher rate from the time it turned in its request to the state in September, Soni said.

While it’s unlikely the city would get the full $2,500 per ride, Lightfoot is counting on the increased returns for the last few months of 2019, plus all of 2020 to equal an additional $163 million coming in to city coffers by the end of next year, Soni said. About two-thirds of that revenue would come from the federal Centers for Medicare & Medicaid Services. A spokeswoman for that agency was not immediately able to confirm the status of the city’s request.

Lightfoot last week said she’s not worried about counting on that much federal help for balancing the 2020 budget. “We’ve been working on this with the state, who’s really the partner in this, for quite a long time,” she said. “We feel confident, based upon the conversations that we’re already having, with what’s in place.”

“The money’s already there, the money’s always been there,” Lightfoot added. “This is about us getting our fair share to bring us closer to whole in getting reimbursement. This isn’t some new pot of money. This is a program that’s already in place and we have stepped up and asked for better reimbursement rates to cover the expense that the city itself has been shouldering the responsibility for.”