Jun 30, 2014 - By Eric Blom, Staff WriterThe Fremont County Ambulance Department's new director says his agency's finances are unsustainable.
Joe Zillmer's statement during a June 24 meeting represented the second time in as many years, and under as many directors, that the Fremont County Commission has heard essentially the same message.
Charges for services are not enough to pay for the emergency medical agency, Zillmer said.
He recommended the department either cut services or receive more funding from the county board.
Last year, former ambulance director Laurie Wempen also proposed a large increase to the ambulance budget, from $2.1 million the year before to $4.1 million.
Under her recommendation, the department would have drained its $1.3 million reserve and used $833,000 from the county's general fund to bring many medics to full-time status from part-time, cover increased health insurance costs and provide a 24-hour ambulance crew in Dubois.
Those changes were largely accomplished with a smaller budget that did not require a general fund subsidy, but the solution only came after Wempen resigned citing financial frustrations.
By Zillmer's calculations, the ambulance department's current shortfall will amount to $1.6 million to $1.9 million a year for the next several years.
The first budget he presented for the coming fiscal year had his agency keeping services at current levels by using all of the $1 million left in its cash reserve.
Under that scenario, the department still would have to draw about $500,000 from the county's general fund, which pays for much of the local government's operations.
Zillmer presented another plan for the coming year that did not use any general fund money but that slashed services.
The county board had asked him to develop a budget that did not use any general fund money.
The centerpiece of the money-saving budget was a reduction in Lander-area services, from two 24-7 ambulance crews to one-and-a-half.
The second ambulance would be staff four days a week for 14 hours a day during peak hours.
"That will result in increased response times, especially to the reservation," Zillmer said.
His plan also eliminates nearly all purchases of new equipment. Zillmer said new purchases already have been put off for several years, and updated equipment is sorely needed.
Another large component of the second budget called for the removal of Dubois' full-time ambulance crew.
Zillmer said the team would be replaced with a first responder who would go on emergency medical calls alone in a sport-utility vehicle.
The medic would have some resources but would call for an ambulance if patient transport was necessary.
The ambulance would come from Dubois if a volunteer driver was available, or Lander or Riverton if one was not.
"That will delay transport time a little bit," Zillmer said.
The second budget also would result in the layoff of 19 percent of the department's medics, he added.
With fewer emergency medical technicians, Zillmer said the department would not be able to provide stand-by ambulances for as many community events and competitions.
However, the proposed cuts would eliminate the need for the $500,000 general fund subsidy and would leave more than $200,000 in his department's reserve account.
Dubois Mayor Twila Blakeman was not happy with the prospect of reduced ambulance service.
"We're devastated by the fact that we're going to be left with so little attention up there," she told commissioners.
The county board did not express support for or against the plan but asked for clarification on some points and showed interest in more money saving ideas.
"You've gone far beyond what we asked, and I want to ask, why?" Commissioner Stephanie Kessler said.
Zillmer responded that he did not mean to go "beyond anything."
"I was trying to make this as solvent as possible," he said.
Most ambulance agencies depend on public money, according to Zillmer.
"The county or the hospital board, they make up the budget shortfall," he said. "They subsidize."
Commissioners have not embraced that view: The commission finalized its draft budget June 24, including cuts to the ambulance budget.
"Obviously we want the best for our loved ones that are sick or may need an ambulance," Commissioner Keja Whiteman said.
"But I think we're setting it up to fail, because we don't have the revenue, and (the ambulance department) can't generate the revenue from their paid sources to maintain that level of service."
In the past, Zillmer said his agency has only been able to collect payments from a fraction of the patients it serves. Commissioner Travis Becker asked whether the ambulance department is working to improve collections.
Zillmer said he has hired a more aggressive collections agency, and he expects the group to generate about $110,000 more in revenue each year.
Zillmer also is investigating ways in which the department could become a private non-profit organization with public oversight. He expects a non-profit status would allow the ambulance service to receive more grants.
In an interview, he said commissioners have not given him direction to convert to non-profit status.
He also wasn't sure that grants could make up the budget shortfall.
The commission holds a public hearing on the budget July 7 and finalize it July 8.
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