Ambulance questions

Jul 6, 2014 Steve Peck, Publisher

Beset with fiscal difficulty, the department

is looking for answers in different places

Hiring a new director for the Fremont County Ambulance Department didn't change an underlying reality facing emergency services. The department can't make ends meet.

Just as former director Laurie Wempen did for several years before she resigned, new chief Joe Zillmer looked at the numbers at budget time and gave the same report to the Fremont County Commission. The fees charged to the public for using the ambulance service don't cover the cost of operating it -- and the margin is wide.

Now Zillmer has raised a new possibility -- privatizing the ambulance service.

Under one scenario, that might mean contracting with a private company or companies to provide the services that the county now provides at taxpayer expense. The private firms, presumably, would submit bids for service to the county and then operate on their own, charging consumers whatever fees are required to operate the service according to the county's wishes and, yes, perhaps make a bit of profit doing it. It happens just this way in plenty of place around the nation.

Zillmer described a third model in greater detail -- a private, non-profit ambulance service. Such a plan would not permit a service provider to make profit from the emergencies of others, but it would take the burden of operations away from the county and shift it to a non-profit model that would have to cover its own expenses within it allotted budget.

Zillmer points out that a non-profit service would stand a good chance of attracting grant funding that neither a county service nor a for-profit company could get. He's seen the format work in other places, and the Fremont County Commissioners are listening to his ideas with great interest.

They really have no choice. One way or another, the ambulance service has to have more money available if it is to continue to operate in the fashion to which our county's citizens are accustomed.

In her last year as director, Laurie Wempen said the department needed essentially twice as much money from the county as it got the year before.

Some of the money problems are of the county's doing, but many of them aren't. Fuel costs for running ambulances are twice what they were 10 years ago. Insurance and liability costs have zoomed. Part of what the ambulance department offers is health care, and all things health care cost more than they used to.

Plus, the county has more people than it used to, meaning there are more demands on the ambulance service to cover more territory and respond to more calls. And the county now uses fewer volunteers on ambulance crews.

Our county commission does not consist of people who like budget increases. That's a reflection of the voters who put them into office, who don't like a lot of government spending, either. But the same mind set also tends to look at government operations as if they were businesses, and a money-losing business is a failure.

Therein lies the quandary. Our ambulance service can't be allowed to fail, even if it isn't a moneymaker. We want the ambulance service to fulfill its purpose. But we don't want to increase its budget radically. And we don't want it to be a drain on the county's finances.

As county officials look for a handhold that isn't slippery, one thing ought to be keep uppermost in everyone's mind: service. The county ambulance department is not a business, and it certainly is not required to run a surplus. Instead, its long-established purpose is to provide comprehensive, quick, expert service to the citizens of our county when they need it.

In the year ahead, before the next budgeting period arrives, it's very likely that push will come to shove. There is a general feeling that the ambulance department can't continue to be operated in this fiscal fashion. As 2014 also is an election year for three of the five county commission seats, ambulance questions are going to be -- and ought to be -- a key component of the campaign.

Now, for the first time, those questions include not just whether the county simply will allocated more money for ambulance service, but whether an entirely different model, largely separate from government operation, is desirable and feasible for our county.

Several solutions have been proposed, and others still may be to come. As we move forward, however, all involved must recognize that a solution is not a solution unless it ensures that citizens of Fremont County will continue to receive first-rate service. There can be no other bottom line.

-- Steven R. Peck

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