Glasgow Daily Times, Glasgow, KY

Local News

March 4, 2014

What’s the best way to fund EMS?

Board mulls taxing district, privatization


If the director of Barren and Metcalfe counties’ ambulance service had his way, the service would be funded in Barren County as it is in Metcalfe – with a taxing district.

Barren County Judge-Executive Davie Greer agrees with him, but she is not optimistic that such a thing could happen here soon.

At a meeting last week of the board of directors for Ambulance Service Corp., doing business as Barren-Metcalfe County Emergency Medical Services, director Mike Swift requested the board consider funding another crew that would be primarily for daytime hours when there is generally more demand. Anywhere from three to 12 times a month for the past nine months, an ambulance has not been available when needed, he said.

A decision was postponed until at least the next regular meeting, which is in April, and board members asked Swift to gather additional information about what other ambulance services in the state do, but considerable discussion took place leading up to that temporary conclusion.

During that discussion, possibilities such as a taxing district in Barren County and placing the service in the hands of private company were mentioned.

In follow-up discussions this week, the Daily Times took a closer look at those options and how the service is funded.

The revenue generated by the operation of the ambulance service is right at 75 percent of the $3.06 million budget for the current fiscal year, according to financial reports provided at the board meeting.

The deficit created between the operations revenue and expenses – $760,054 this fiscal year – is contributed by three government entities and T.J. Samson Community Hospital according the following formula: City of Glasgow and Barren County, 30 percent each; Metcalfe County and the hospital, 20  percent each.

Metcalfe County pays for its portion through the collection of a tax in a special taxing district that was created in the late 1970s, when the question of whether to create the district was placed on the ballot both there and in Barren County. In Barren County, though, the idea was defeated.

The Metcalfe County rate is 5.8 cents for every $100 value of real property, 6 cents for every $100 value of personal property, and 3 cents for every $100 value of motor vehicles and watercraft.

For the fiscal year July 1, 2013, through June 30, 2014, Metcalfe County has more than $207,000 budgeted as expected revenue from that tax, said Metcalfe County Treasurer Vickie Stephens.

The county’s 20 percent of the budgeted deficit would be $152,010.

For the fiscal year ending in 2013, $225,000 was budgeted for that county’s portion of the deficit, but the claims only totaled $108,000, she said.

Over the years, the county has had a little left here and there and has built up a reserve. It has a $363,000 certificate of deposit, she said, and has approximately $586,000 in the bank, she said. As long as the agreement setting up those percentages toward the deficit is in effect, the county would continue to pay the 20 percent to meet its obligation, and anything additional would be held in reserve in case something changes.

“Metcalfe County decided to have this tax in place to make sure we have ambulance service,” Stephens said.

That is exactly why Metcalfe County has the taxing district and Barren County doesn’t, Swift believes. When the measure was put on ballots, Metcalfe County’s county judge at the time framed it as the only way Metcalfe would have ambulance service because the county would cease to pay for a portion of it out of its coffers. In Barren County, Swift said, it was a question of whether voters wanted another tax, and the county judge said the county would have the service either way.

“An ambulance taxing district would be the fairest means of providing financial stability for the ambulance service,” said Swift, who has been with the service since it started in January 1975. He doesn’t see any other option that would be a lasting or long-term solution for maintaining the level of service BMCEMS provides.

As it is, he said, the service “wouldn’t be able to provide the level of care we do without the fire departments,” who often act as first responders for at least basic life-saving measures until an ambulance can arrive.

He has forwarded the board’s request for information on the other services in the state to officials in Frankfort, because it would be so time consuming to call all 120 counties, but he said the only county in the immediate region that does not have a government-subsidized service is in Bowling Green, where The Medical Center runs it, but every county he could think of besides Barren has a taxing district, he said, naming at least eight counties.

“That’s pretty much the prevalent way,” Swift said.

Greer, who is a member of the ambulance board but was out of town during last week’s meeting, said Tuesday she thinks creating a taxing district is “the only way the people of Barren County are going to keep its ambulance service.”

“I’ve been for it all along. … I am for putting it on a taxing district,” she said. “This county is  not going to be able to fund it like it should be funded without any kind of raise in taxes.”

She believes the will is not there among a majority of magistrates to make the change. Even though it shouldn’t be looked at as raising taxes, that’s how it’s perceived, she said.

“We need the ambulance, and we have been so fortunate because our ambulance service is one of the tops in the state, I would say, but it’s not going to continue to be because we can’t afford to keep it up the way we’re headed, with expenses,” Greer said. “Everything’s going up.”

Greer said she had brought up the idea before, approximately three years ago, “but it was probably never seriously discussed.”

It didn’t get to the point of an actual vote, or even really looking into how much the tax rate would need to be for it to be enough to cover the deficit here, she said.

Asked about her opinion of whether it could get to a point where it would need to be privately run, she softly chuckled and said she tried to get the hospital to take it over around that same time, roughly three years ago, “and they wouldn’t take it.”

But the hospital, which also has a representative on the ambulance service’s board of directors, has been contributing a portion of the deficit since before she became judge-executive nearly 12 years ago, she said.

Laura Belcher, chief of planning and business development for T.J. Regional Health, the umbrella corporation for the hospital, provided the following comment via email Tuesday afternoon:

“Last year, T.J. Samson subsidized the ambulance board $138,495. This amount represents 20 percent of the annual deficit of the ambulance board. In today’s economic climate, many entities are struggling and need to bolster their revenues to cover their cost of operations. The ambulance board needs economic support from the communities that benefit from their service. Metcalfe County has a taxing district to ensure their community has ambulance coverage. A tax in Barren County makes sense to assist in keeping the service viable here as well.”

Swift said Edmonson County had a taxing district that was repealed and the county had a private business take over the service, but the service went out of business. After a serious traffic collision for which there was a significant wait for an ambulance from another county, Edmonson County went back to having a taxing district.

The prospect of a similar scenario would be a “con” regarding privatizing the service here, he said. The “pro” would be that the taxpayers would no longer have to fund it, as long as the private company kept it viable, Swift said.

“If it’s [supposed to be] such a profitable thing, why don’t all the hospitals run ambulance services,” he asked.

Regarding the taxing district option, Swift said it would provide a viable means of revenue and more stability to the operations of the service. On the down side, the governments, through taxpayers, would be contributing more.

Reflecting on the civics classes he’d had in the past, he said the No. 1 reason government exists is public safety, so it would stand to reason that providing this service should be a priority, especially when it only has to pay for a percentage of a quarter to a third of the budget.

“Without the tax, the level of service provided could be reduced,” Swift said.

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