The issue: The future of EMS services
Our view: A core county responsibility
The recent controversy over the county’s ambulance service seems even more relevant now that it’s put in perspective of the spread of coronavirus.
County government has a responsibility to make sure that emergency management service is provided to the residents of the community. That is true in each of Florida’s 67 counties.
There are different ways to get the job done — but make no mistake — the job must be done.
In Citrus County a nonprofit service run by a board of volunteers has been providing the ambulance service. Nature Coast EMS service has run into financial difficulty in recent years because it gets virtually no financial support from the county. The county pays $246,000 a year in a subsidy, but Nature Coast EMS pays back the sheriff more than that to make use of the 911 emergency call system.
In much smaller counties like Levy to the north, taxpayers pump more than $1 million a year into their ambulance system.
Our nonprofit has run into financial difficulty over the last five years because it’s darn hard to make such a formula work without taxpayer assistance. The service was completely dependent on charges it could put on consumers for responding to emergency calls.
The administrator of the EMS service tried to prop up the non-profit by creating entrepreneurial efforts such as training to other EMS services and repairing out-of-county vehicles. But the effort was not enough. The EMS service is operating with a financial loss.
The longtime director of the EMS was forced out and the nonprofit volunteer board has been given 90 days to return to the county commission with a business plan that works.
There is little doubt that record keeping and collections at the nonprofit needed improvement. Keeping employee morale up was next to impossible with employee pay levels frozen, aging ambulances logging maintenance problems and an inadequate debt collection effort.
Remember, the ambulance service has a responsibility to pick up any patient who is in need of emergency care and get them to a hospital. Poor people get the same level of service as those who can pay and/or have good insurance. EMS services and emergency rooms probably have the most difficult job in collecting payment in the health care industry.
The county needs to be a partner with Nature Coast to find the long-term solutions in Citrus County. County administration was well aware that the nonprofit was in critical financial condition. A lecture about accounts receivables from a commissioner to the non-profit volunteers at a recent board meeting was more political theater than it was an attempt to find solutions.
The county could just end its contract with Nature Coast at the end of the 90 days and find another provider, but that won’t solve the problem.
The final answers to the improved financial position of EMS will include better collections, a much higher taxpayer subsidy and a partnership with county government.
Providing for the public health and welfare is a core responsibility of local government. A strong EMS service should be at the top of the list. We need to work together to find that solution.