BENTONVILLE — The future of rural ambulance service in Benton County hinges on a Feb. 4 vote, but some city and county officials are preparing for the worst-case scenario.

Siloam Springs indicated Wednesday its ambulance service to the unincorporated areas of the county will end Jan. 1, 2015, if the county is unable to provide the subsidy the city said it requires.

Fire Chief Greg Neely released a statement setting out Siloam Springs’ intentions for rural ambulance service.

“Our fire department has historically relied heavily on revenue funding from the City’s sale of water and electric utilities,” Neely said in the statement. “We recently imposed a tiered increased in those utility rates to our citizens that will eventually double their rates over the next several years. We were forced to increase these rates in order to meet all of our city obligations which has included our willingness to respond with City resources into the unincorporated Benton County with Ambulance service. We appreciate the leadership of Judge Clinard and the Quorum Court for their willingness to fund this service at an agreeable rate for 2014 and beyond.”

“While we understand and appreciate the referendum process, the citizens within unincorporated Benton County need to understand that the City of Siloam Springs cannot continue to operate out in the County without the already defined and agreed upon level of funding from the County,” Neely said in the statement.

“Should the election concerning the $85 per household fee fail in February, and barring no further budget augmentation from the County, Siloam Springs would be forced to spend the remainder of 2014 planning its exit strategy which would commence Jan. 1, 2015, and no longer provide EMS to these unincorporated areas.”

Kurt Moore, justice of the peace for District 13, which includes much of the area served by Siloam Springs, said the city’s stance should be taken seriously by voters.

“That pretty much spells it out,” Moore said. “I’m glad they finally made it clear and put it in writing.”

Siloam Springs adopted a similar position in providing ambulance service to Delaware County residents in Oklahoma, Moore said.

“I had no illusions about Siloam Springs,” Moore said. “I know if they don’t get the money they think they need, they’ll cut off service just like they did with Delaware County. I’ve always known they are serious about it. That’s why I worked so hard to get something they would agree to.”

Marshall Watson, the county’s emergency service administrator, said Rogers sent a similar letter earlier this year, indicating that city would also end rural ambulance service if no money is provided by the county.

“I can’t say I’m surprised by that,” Watson said of Siloam Springs declaration. “I think we could see several providers take a similar strategy. It’s refreshing for them to be up front with us and give us their intentions. Rogers did provide us with a letter indicating that without funding they will eventually cut service.”

The Quorum Court in September created an emergency medical services district and set an $85 annual fee on households outside incorporated cities and towns.

Theresa Pockrus, a Fayetteville attorney, helped organize a petition drive calling for a vote on the fee and district.

County officials have agreed to pay the seven municipal fire departments providing rural ambulance service about $942,000 for 2014. The money would make sure the service is available but not pay the cost of patient care.

George Spence, county attorney, told Clinard he believes the county can schedule an election early in 2014 and have the fee placed on the tax statements if the measure is approved.

Justices of the peace removed the ambulance fee from the 2014 budget after learning of the election. The county estimated the $85 fee would generate about $1.2 million, according to Mike Crandall, accounting manager. Crandall said the county originally budgeted $950,000 for 2014 to pay the cities. The justices of the peace reduced that to $236,000, which will pay the cities through March. If the election succeeds in blocking the proposed ambulance service fee, the Quorum Court would need to find another source of money.

Joel Jones, justice of the peace for District 7, proposed amending the 2014 budget, cutting some $795,105 to have money for ambulance service for the full year. That motion was defeated.

The county has worked with the ambulance service providers to find a funding formula for rural ambulance service for the past four years. The cities, citing state law, have asked the county to cover the cost of making the service available.

Watson said the cities all figure their ambulance service costs differently, so there’s no simple formula that covers all the providers. He said there’s also no simple way of calculating the cost of ambulance service to city residents.

“None of these cities has a dedicated revenue stream for EMS,” Watson said. “The closest thing they have to the EMS fee is a voluntary fee that can be paid to the Gravette Fire Department. But none of them have a dedicated funding stream. They are funded strictly through their normal city budgets. It’s really tough to place an exact number on that.”

Rogers has asked the county to provide money to pay six firefighter/EMTs who would man an ambulance at the city’s Station No. 7 on South First Street. That station would be heavily involved in calls for service in the rural areas.

Rogers Fire Chief Tom Jenkins said the city’s residents do bear a cost for ambulance service, in addition to being billed if they use the service. He said taking the operating budget and dividing it by the city’s population shows a per capita cost of about $135 a year. Jenkins said rural residents’ arguments about paying city sales taxes while in Rogers has a simple appeal, but is misleading.

“City residents pay higher property taxes that help fund the police and fire pensions and other costs,” Jenkins said. “While the sales tax is the primary funding mechanism it’s not the only one. As far as the argument about people shopping in Rogers, while you do your shopping in Rogers you’re protected. My parents live in Oklahoma. Just because they come to Rogers to visit and spend money here that doesn’t entitle them to a Rogers ambulance in Tulsa.”

Jenkins said arguments about city residents needing ambulance service while they are outside the city are also missing the essential point of the debate. He said there’s a cost to have an ambulance care for a patient and that cost is charged to city residents as well as non-residents.

For rural ambulance service, he said, there’s an additional cost of making an ambulance and crew available for service. That’s the cost the city is asking the county to bear, Jenkins said.

“We have to pay for the availability of the service,” Jenkins said. “It’s not based on home jurisdiction. It’s not about the person. It’s about the place. For emergency services, everybody gets a bill, whether it’s inside the city or outside. We also have to pay for the medicine, the oxygen, the supplies, the bandages. Those are things we have to recoup from the patients.”