Idaho Agencies Are Divided on Ambulance District

Dec. 10--While the Latah County commissioners have sounded a "return to station" signal that stops any rush to create a countywide ambulance district this year, the concept is far from dead.

The commissioners have decided to take 2012 to work with the ambulance agencies in Moscow, Troy, Deary, Juliaetta-Kendrick, Potlatch and Genesee to gather data and opinions on a countywide taxing district.

Many of these providers already have taken a stance based on the effect they think such a district would have on their communities, with both skeptics and supporters.

Commissioners had initially looked at pushing formation of an ambulance district by a New Year deadline for the State Tax Commission to add it to its rolls for 2013. The earliest taxes could be collected if the district were formed in 2012 would be 2014.

Chief Dave Reynolds in the Moscow Volunteer Emergency Ambulance Company, one of the district's more outspoken backers, said, "This is far earlier in the planning stages than most people realize."

Through an advisory board planned for formation in January, Reynolds said, representatives from each agency and community would be brought in to draft a budget and detail how service should be provided.

At the maximum allowable rate of $40 per $100,000 of assessed property value, about $745,000 in tax revenue could be generated, or $372,000 at $20 per $100,000 of assessed property value. What property would be open to taxation requires further study.

"The conversation has been pretty open-ended on that," said Reynolds of what the ultimate cost might be. "We don't want to put any extra burden on people."

Moscow is the only agency in Latah County that provides paramedic-level service, and frequently assists other agency responses.

But since Moscow's ambulance agency -- like the others -- consists of volunteers, many highly trained paramedics eventually move on to full-time, paid positions elsewhere, said Reynolds.

"That's one of the problems that we've tried to address," he said. "We've tried many different types of recruitment and retention models. And frankly, we're not doing very good with it. ... They were lured away by the good wages."

Reynolds has suggested using tax revenue from a countywide district to create five full-time, paid paramedic positions within the Moscow ambulance company, one of which would be deployed to every Charlie, Delta and Echo emergency call that came in around the county with one paramedic on backup standby.

Dispatchers decide the severity of an ambulance request based on a set of questions with an Alpha response being lowest and Echo being the highest.

So far, reactions by rural agencies to the proposal have been varied based on their current use of Moscow's services, balancing that with an increase in property taxes and whether the proposal will serve their communities for the better.

Troy Volunteer Ambulance

Several members of the Troy Volunteer Ambulance delivered a written opinion to county commissioners in mid-November opposing the formation of a county ambulance district.

"The paramedic program is an important component of the emergency medical system," said Robert Kwate, a Troy ambulance driver. "We don't agree with the taxing district. We're completely opposed to automatically sending paramedics to most calls when they're not requested. ... When you need (paramedics), they're valuable. When you don't need them, they're a waste of money."

Kwate said a majority of emergency calls coming out of Troy do not require paramedic-level assistance, and doesn't feel additional taxes should be put on community members if unnecessary responses are going to be automatic under the proposed system.

"We don't do it very often and when we do call them, we typically meet up with them somewhere around Joel ... maybe a little closer to Troy," he said. "We just have not had a call where they've made a difference. Part of that is because the EMTs do everything they are supposed to do."

Along with other rural ambulance agencies, Troy recently began charging a transport fee, but Kwate said billing has not yet been delivered to the first patient. The ambulance also receives some city tax support, grant funding and donations.

"We do not need anything else," said Kwate. "We do not need any tax money at this point. We did not ask for it."

He said another concern is that the ultimate cost for a county ambulance district would be higher than the current prediction, and how that increased cost of service will affect the ambulance company's relationship with the Troy community.

Mutual aid agreements exist between all county ambulance agencies, but Kwate said if they are all competing for a bigger share of the tax pot, it could affect those relationships as well.

"If we're going to be competing against each other it changes the dynamic, and we don't want that," he said. "We just want to be good neighbors and help people out."

Deary Ambulance

With state requirements always changing and the demand for higher levels of training, keeping a solid group of ambulance volunteers in Deary has been difficult, said Jason Johnson, vice president for the Deary Ambulance.

"It gets harder and harder to retain these members," he said. "We think it's 100-percent positive to start an ambulance district."

He said that's because if state requirements continue going up, funding remains slim and volunteers are unwilling to continue additional education -- often at their own expense -- a privatized ambulance company could be in Deary's future. Johnson said he doubted a private ambulance would have the same relationship with the community as the local volunteers do now.

"We're trying to create this ambulance district to protect Latah County," he said. "That district will allow us to try to recruit and retain members because it will give us a budget to work off every year where as now we rely on our billing."

Deary relies on Moscow assistance about 75 percent of the time, Johnson said, and its paramedics provide a level of service some patients require well before they reach the hospital.

"If you can't do that, that's where the paramedics come in," he said. "With that new ambulance district, we'll be able to have a paramedic available 24/7.

"I hate to see a new tax, but this is something that will benefit all of these communities more than a tax for a sole entity. I am a little nervous about how it will be received. I just hope with these town hall meetings it will help to clarify some questions."

Potlatch Ambulance

For Potlatch Ambulance Chief Debi Swinney, a county ambulance district is a great concept, but just not affordable in the current economic climate of her city.

"We consider it kind of a luxury," she said of Moscow's paramedic service. "They can provide another level of care for patients. Unfortunately, the economy just isn't good here. People here really can't afford another tax."

Swinney said Potlatch Ambulance receives a large amount of donations annually, and an additional tax burden could hinder that.

"We get thousands of dollars a year donated," she said. "If people were taxed ... they wouldn't be able to do that anymore."

She said the automatic response of a Moscow ambulance with one paramedic on board for Charlie, Delta and Echo calls could be a waste of resources, but her crew always has the option of turning them around if the call turns out to be a lower priority than initially believed. She said there were three Delta calls dispatched last week that ended up not requiring a paramedic.

Retaining volunteers in Potlatch might also become more difficult if an ambulance district is formed, said Swinney.

"We have fantastic employers over here that do allow our EMTs to leave in the daytime and they do allow them to stay on the clock," she said. "I don't think that we have any EMTs that don't work. If (employers) were to have to pay for an ambulance district, that could change the way they feel about that."

Genesee Ambulance

Genesee provides a well-attended annual crab feed, but even that plus a recently established ambulance billing system, donations and grants won't alleviate funding needs forever, said Fire Chief Becky Pickard.

That's why Pickard says she favors an ambulance district.

"We're all for it," she said. "It's going to be a good revenue boost for our department. ... I pay taxes as well. I think its such a beneficial thing for our area, and it's really what the future needs. We have to be forward thinking."

Pickard said Genesee also faces volunteer retention problems, and those numbers are dwindling.

"We have a hard time keeping volunteers that are willing to sacrifice the time it takes for training and to give up their jobs to rush out to a scene."

Moscow's level of assistance also surpasses what Genesee volunteers can offer, she said, including administering pain medication and dealing with cardiac emergencies.

The proposed response protocol also doesn't concern Pickard.

"We always have the option of calling (Moscow) off, and it really doesn't require much effort on our part," she said. "It will save a huge amount of time by it being automatically dispatched rather than us calling out for it."

Pickard said it was unfortunate all of the players in this endeavour were not aware of the time restrictions, and formation of an ambulance will be further delayed.

But, she added, "It's good to do it right the first time instead of having to revisit it... I just hope that everybody will keep an open mind and really look at the benefits before they make a decision. "

--A representative in the Juliaetta-Kendrick area could not be reached for comment for this article.

Brandon Macz can be reached at (208) 882-5561, ext. 238, or by email to bmacz@dnews.com.

Copyright 2011 - Moscow-Pullman Daily News, Moscow, Idaho