Cities Defend Ambulance Budgets

BENTONVILLE — Siloam Springs and Rogers officials said their reimbursement requests for rural ambulance service are based on their costs and county officials are welcome to look for a better deal.

“We are sufficiently busy inside the city,” said Tom Jenkins, Rogers fire chief. “If we’re going to be asked to provide service outside the city we have to be able to cover our costs. It’s perfectly acceptable for the county to find another provider that’s cheaper if that’s what they want to do. We just need to know if the county wants Rogers to continue that service or not.”

The county has discussed the costs of rural ambulance service over the past several years with Northeast Benton County Fire Department and the seven cities that now provide the service — Bella Vista, Bentonville, Gravette, Pea Ridge, Rogers, Siloam Springs and Springdale. City officials have cited a provision in state law stating they may provide the service under mutually acceptable agreement, but “All direct and indirect costs of extending those services shall be borne entirely by patient user fees or subsidies provided by the patient, municipalities or county to whom those services are rendered. In no event shall the city extending the service beyond its boundaries be required in any manner to subsidize or otherwise extend financial support to render those services.”

David Cameron, Siloam Springs city manager, said the residents of the city are now subsidizing the cost of rural ambulance service and his city’s request of $416,422.82 will end that. Siloam Springs covers the net losses in its Fire Department through the city’s utility enterprise money. In 2012, he said, the department reported a net loss associated with Emergency Medical Services calls of $1,602,465. With calls outside the city accounting for 28 percent of the calls, the net loss associated with calls outside the city was $448,690.

“Our residents are paying $6.34 a month for a service they don’t receive,” Cameron said.

Cameron said Siloam Springs calculated its costs after taking out all capital costs, while noting the city’s four ambulances cost about $200,000 each, and costs not associated with the EMS service.

“These are our audited financials,” Cameron said. “That’s what it costs us to run an ambulance service.”

The city has raised its water and sewer rates, electric rates and other fees and at the same time cutting its budgets including reducing city personnel through attrition, Cameron said. That included the Fire Department where the assistant chief and training officer positions have gone unfilled. Cameron said the county, by way of contrast, has amassed a large budget surplus.

“That’s part of what’s driving this request,” Cameron said. “They’ve got a surplus and we’re raising rates.”

Rogers’ budget request, which has been put at $209,302 for 2014 and increases to $317,125 in 2015, is based on the cost of making the service available, Jenkins said. Rogers went over its emergency services budget when the county first asked for its needs and the numbers haven’t changed, Jenkins said. After their most recent discussion of the ambulance issue, the justices of the peace asked the cities to revisit their requests and justify them.

“Essentially, we tried to get the numbers correct the first time around,” Jenkins said.

Rogers has calculated that to continue to provide ambulance service to the southeastern part of Benton County the Fire Department will need to hire six new firefighters/EMTs and station an additional ambulance at Station No. 7 to respond to those calls, Jenkins said. He said the city went through a similar discussion with Little Flock, which eventually accepted Rogers’ figures on the cost of the service.

Siloam Springs has also gone through similar negotiations, with West Siloam Springs in Oklahoma, Cameron said. Those talks went on until the Siloam Springs Board of Directors adopted a resolution in November 2007 declaring the city’s intent to end service if no agreement by the end of 2008. Cameron said he doesn’t think the talks with the county have reached that point.

“We haven’t crossed that bridge,” Cameron said. “I hope we don’t have to.”

Tom Allen, justice of the peace for District 4, is chairman of the Quorum Court’s Finance Committee. Allen said he plans to propose the committee review requests from each of the cities separately and take action on as many as they can agree on. Allen said he doesn’t think the county is locked into the present system and if the cites can’t reduce their requests he is open to a county ambulance service.

“I have thought about that and I believe it is a possibility,” Allen said. “I think it is more expensive on the front end, but not necessarily more expensive once you get it going.”

Patrick Carr, justice of the peace for District 12 that includes part of Siloam Springs, said he favors working with the cities to continue providing ambulance service. He said the county needs to make some decisions and move on with the choices it makes.

“Are we going to buy the service or not?” Carr said. “If we’re not, are we going to continue to provide the service ourselves? We have a history of providing this service. Let’s decide what we’re going to do. For me, $3 million to start up a county service and then $2 million a year to run it — that’s a lot of money. Where are we going to get that? To me, paying $1 million a year to do the same service it will cost us $2 million to provide is pretty clear.”

Carr said the justices of the peace shouldn’t continue to just talk about the issue.

“We got the study done,” he said. “We got some data. We know this is going to cost us ‘X’ amount. Let’s do it or not do it. Let’s continue forward. Let’s make something happen now.”