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Ambulance disagreement settled for now with OK of $2.8M budget

Jul 28, 2013 - By Eric Blom, Staff Writer

After delays amid sometimes heated discussion for several weeks, Fremont County Commissioners have approved a $2.8 million budget for the Fremont County Ambulance Department.

The plan includes increasing revenues but still runs a $600,000 deficit, cutting into the agency's cash reserves.

Anticipating $2.5 million in revenues and $1.6 million in reserves at the beginning of fiscal year 2014, emergency medical service expects to end the year with $972,000 in cash.

At that rate, the agency will run out of money in about two and a half years.

Former director Lauri Wempen first proposed a $4.1 million ambulance budget in May but pared it down to $3.3 million in June. The previous year's budget totaled $2.1 million.

More to come

"Additional decisions will have to be made as far as levels of service, staffing levels and revenue enhancements," chairman Doug Thompson said in an interview.

Interim ambulance director Todd Smith said fees for services had been enough to support EMS for more than a decade, but the financial situation had changed despite careful management.

"As a community we need to decide how we're going to fund it, or if we're going to decrease services," Smith said.

The approved budget already expects about $250,000 more in income from raising the rate EMS charges for ambulance services.

Under the new budget approved Tuesday, the base rate for an ambulance response to an emergency situation is $900 -- up from $700 last year -- and the mileage rate EMS charges rose to $20 from $10.40 last year.

Charges for other services increased as well.

Personnel

Part of the larger budget is due to increased personnel costs. The new plan calls for making 26 employees officially full time.

Changing the employees' statuses will not increase their hours, and federal law requires Fremont County to provide them with benefits, Smith said.

He explained those emergency medical technicians have been working full-time hours but were classified as part time.

The federal Affordable Care Act requires the county to offer those employees benefits, Smith said. The county will offer them benefits including single, two-person or family health insurance and a retirement plan due to the changed status.

"(That is) just like any other county employee," he said.

Their status will officially change Nov. 1 making them eligible for benefits Jan. 1.

In past meetings, Commissioners discussed whether the federal law would allow only offering the emergency medical technicians single health insurance and not enrolling them in the county's plan until July 1, 2014. The county board considered those options because they would save money but ultimately decided against them.

The approved budget also allowed for staffing an around-the-clock ambulance crew in Dubois, Smith said. He expects the service to begin Aug. 1 and to cover many of the shifts with volunteers and part-time EMTs.

Riverton and Lander have been the only areas in the county with such service and have had two crews at the ready at all times.

The new budget also includes a new full-time trainer position.

Smith said a teacher was necessary because of the many educational requirements to become an EMT and to stay certified as one.

'Continuing oversight'

Approval for the budget came contingent on quarterly meetings between ambulance administrators the commission, Thompson said. The county board will provide "continuing oversight" to track whether revenues and expenditures play out as the budget anticipates.

If they do not, "We'll have to make some adjustments," Thompson said.

Commissioners and ambulance officials will continue to consider changing the level of care provided, adjusting the number of staff and finding new revenue streams, he said.

Smith said the same issues still have to be resolved, but he praised the commission's work on the EMS budget.

"The commissioners have been very supportive," he said. "Everybody came to the table."

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Fremont County Commission